Relève étoile Jacques-Genest 
May 2018

Jacinthe Leclerc

Postdoctoral fellow in Surgery
McGill University

Award-winning publication: Impact of the commercialization of three generic angiotensin II receptor blockers on adverse events in Quebec, Canada: a population-based time series analysis

Published in: Circulation: Cardiovascular Quality and Outcomes


Original medications are the first on the market and remain protected by a patent. But once the patent expires, drug stores may make equivalent generic drug substitutions. According to Health Canada, while an original and a generic medication contain the same amount of medicinal ingredients, their respective bioavailability—the total dosage in the blood—can vary by 20%. Few studies have assessed whether the variations lead to health complications in the individuals who switch to a generic drug, especially in connection with cardiac medications. The aim of the project undertaken by Jacinthe Leclerc was to compare the rates of visits to emergency centres and hospitalizations before and after the commercialization of three generic antihypertensives (losartan, valsartan and candesartan). Relying on data provided by the Régie de l'assurance maladie du Québec, the researchers evaluated monthly complication rates in the three-year period in which the generics were initially released and sold. Prior to the availability of generic alternatives, approximately 10% of the population who took original brand antihypertensives visited an emergency room or was hospitalized on a monthly basis. In the month in which the generics were released, the consultation and hospitalization rates immediately increased among the patients who took losartan (by 8%), valsartan (by 11.7%) and candesartan (by 14%) for up to one year following the introduction of the generic drugs. The differences between the medications may explain the rise in complications in the individuals who take generic medications.