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P hysicians sometimes turn a skeptical eye toward generic versions of brand name productsand with good reasonHistoricallynot every generic medication in ophthalmology has performed as well as its branded counterpartFor exampleprednisolone wasn’t as effective at controlling inflammation as branded Pred ForteAllerganIrvineCalifand diclofenacwhich is the generic version of Voltarenhad instances of corneal melts in patientsleading to withdrawal from the marketsaid LJay KatzM.DWills Eye InstitutePhiladelphiaSo naturally when branded XalatanPfizerNew Yorkwhich reduces elevated intraocular pressure in patients with open-angle glaucoma or ocular hypertensionwent to generic latanoprost in Marchdoctors had questionsGenerics can often work wellbut sometimes there’s a question of efficacy and tolerabilitysaid DrKatzThe brand name and generic products are not identicalOne is called Xalatan and the other is called latanoprostsaid Nathan RadcliffeM.Dassistant professor of ophthalmologyWeill Cornell Medical CollegeNew YorkThe bottle is going to look different so to your patientsthere’s a differenceand there may be confusionLatanoprost doesn’t have the same pricewhich is a differenceDifferent bottle designs can be problematic for some peopleespecially glaucoma patients who tend to be older and may struggle with drop delivery due to arthritistremorsand other mobility issuesDoesthe bottledeliver the drug the same wayasked DrKatzDoes too much come out or does too little come outIs it easy for someone who’s 90 years old to get the drop outRegulations don’t govern drop administrationbottle designor rigidity of the bottlehe saidso in reality there can be noticeable differences between the generic and branded designIn terms of the specific formulationthoughboth must include the same active ingredients in the same concentrationas well as the same preservativesAccording to spokesmen for the FDAthere is no qualitative or quantitative difference between the two versionsSince the product is a solution and has the same active and inactive ingredientsthere viagra generico contrareembolso, viagra generico contrareembolso, viagra generico contrareembolso, viagra generico contrareembolso, viagra generico contrareembolso, viagra generico contrareembolso. would be no difference in performancesaid Lisa KubaskaL.C.D.RU.SPublic Health ServiceFDAWe assure that a generic version of any product works the same in the bodyDrRadcliffe would prefer to see data from human trials that supports the safety and efficacy of generic ophthalmic medicationsManufacturers are not required to release the concentrations of the inactive ingredients of branded medicationshe saidGenerics are typically created using reverse engineering practiceshe saidSince you’re not recreating it from the identical recipe and manufacturing processthere may be some small differencesA number of different companies produce generic latanoprost including ApotexWestonFlaBauschLombRochesterN.YFalcon Pharmaceuticalsaffiliate of AlconFort WorthTexasGreenstonePeapackN.Jand MylanCanonsburgPaThe problem for patients and physicians is neither know which company’s version of the product will end up in patientseyesit may change month to month by the filling pharmacyWe don’t have any control over thatsaid DrKatzPatients may do fine or there may be an issue with tolerabilityThere may be side effects they didn’t have beforePerhaps there’s a chance it might not be as effectiveThe only way to know is to try itAt least one major positive difference between the two drugs is costGenerally speakingthe generic is much cheaper than the brandedalthough exact price varies widely depending on location and insurance planThe cheapest I’ve heard was around15 a bottle totally out of pocketsaid DrKatzThat’s with no copayIf you’re considering switching a patient to latanoprostit’s important to have a direct conversation with him or her about what you know and what you don’t know about the drugNot every patient will want the generic versionSome may be totally opposed and insist on the brandedWe don’t want to make assumptions regarding how much savings a patient will be gettingand we don’t want to assume that savings is something the patient is determined to pursuesaid DrRadcliffeWe’ve got to talk to the patientsRight nowif a physician writes Xalatana lot of people come back with the generic formulation anywaysaid DrKatzMany patients are willing to do thatbut some people prefer not to use genericsIf it turns out that a patient isn’t happy with the generic version for whatever reasonit’s probably best to switch him to a competitor in-brandIf the patient does switch medicationsit’s a good idea to follow him a little more closely to make sure his pressure levels are controlledIf you’re switching the patient to a genericyou’ve got to think twice before you sayI’ll see you in 6 monthssaid DrRadcliffeI believe the generic versions are safeI believe there may be small differences we will learn about over the next few yearsThese differences could also be between genericsIf they should all be lumped together under one headline remains to be seenAre they all the exact same thingI don’t think we know thatsaid DrKatzThey’ve been out such a short period of time that we can’t tell yetWe’re waiting to see some papers come out that are an independent analysis of the composition of each of the bottlesassuring us they are all pretty much the same

Reactivation of Herpes Simplex keratitis has been reported during treatment with XALATANXALATAN should be used with caution in patients with a history of herpetic keratitisXALATAN should be avoided in cases of active herpes simplex keratitis because inflammation may be exacerbated.

METHODSThis multicenterrandomizedinvestigator-maskedparallel-group study allocated 266 patients with OH or POAG in a 1:1 ratio to latanoprost or Xalatan administered once daily for 6 weeksThe primary endpoint was the mean change in 8:00 AM IOP of the study eye from baseline to week 6Secondary endpoints included mean change in 8:00 AM IOP from baseline to week 2and in 12:00 noon and 4:00 PM IOP from baseline to week 2 and week 6The safety and tolerability of both drugs were also assessed.

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Aims & Objectives

To support an intelligent debate on Scotland's constitutional future by providing timely evidence and rigorous analysis of the issues in the debate on Scottish Independence.

To turn Scotland from an economy which relies on an ever-dwindling supply of resources to a sustainable economy which relies on resources which will still be available for future generations .

To tackle social exclusion and the uneven distribution of wealth, so that the wealth which the Scottish economy produces benefits the poor as well as the rich.

To offer policies analysis on how Scotland can make its economy more competitive .
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Dr. Azeem Ibrahim
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Born in Glasgow, Dr Ibrahim was named one of the Top Global Thinkers of 2009 by the LSDP European Social Think Tank and a Young Global Leader by the World Economic Forum.

With a PhD from the University of Cambridge, Dr Ibrahim is highly in demand for his expertise in the area of geopolitical strategy. He has advised many world leaders in recent years and served as an International Security Fellow at Kennedy School of Government at Harvard, a World Fellow at Yale and an Adjunct Research Professor at the Strategic Studies Institute, US Army War College.

Dr Ibrahim also founded over half a dozen award-winning companies in three continents, including his most recent venture, Ibrahim Associates - a non-profit global strategic consultancy firm. His many years of experience as an economic expert led him to consider the situation of his own home country. He knew that innovative policy solutions were required if Scotland was to remain globally competitive, and he responded to this need by setting up The Scotland Institute.
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With a first class degree in Economics and masters in International Politics and Research Methods, Nicholas Mitchell has been working as a political researcher ever since university. While originally based in Munich, he investigated the role this Bavarian city played in the birth of National Socialism and published a guidebook to the Dachau Memorial Site. He is now highly in demand as an independent researcher, with clients in both the US and UK.
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After 8 years in the Civil Service, Corrine returned to full-time education and graduated with a first class LLB honours along with two awards from the University. She subsequently undertook her Legal Practice Diploma in Aberdeen and is currently completing a PhD in Marine Renewables, Policy and Legislation.

Corrine was also awarded a scholarship and worked/studied at Oregon State University in the United States for 3 months where she facilitated contacts for the Oregon State University representatives who were travelling to Orkney to meet with European Marine Energy Centre with the purpose of gaining information to assist in setting up a marine testing bay in Oregon. Ultimately this resulted in talks between two Universities in holding joint Masters Programmes.

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Shazia was a Business Manager for Scotlandís only full time Asian Radio station, Awaz FM where she also presented the extremely popular show 'Drive Time' for over 6 years.
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Jonathan has studied at the universities of St Andrews, Edinburgh and the Institut Catholique de Paris. Legally trained, he has gained experience working in alternative dispute resolution and mediation, as well as NGOs focussed on development and human rights.

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Martyn Tulloch

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Dr Cripps (Cambridge) is a senior strategy consultant with over 20 years experience in policy research, academia and think tank consultancy. As a former practicing architect and now urban regeneration consultant, he specialises in the interface between spatial, visual, social and economic issues. The focus is also on the methods for a multi-cultural approach to urban regeneration in the UK. Making working links with academies and practitioners in other global regions is a key part of this. Christopher has worked with governments, local authorities and academia having undertaking hundreds of assignments in Masterplanning, research, policy and regeneration.
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After studying under the tutelage of noted Scottish historian Professor Niall Ferguson, Ben graduated from Jesus College, Oxford with a degree in Modern History. Following this he went on to study Acting at the Central School of Speech and Drama and, since graduating for a second time, Ben has worked as an actor and stand-up comedian. He has performed for the likes of the West Yorkshire Playhouse, Gideon Reeling and Visa, as well as at comedy clubs and festivals all over the country, including Bestival, Komedia and - Britain's best - The Stand in Edinburgh and Glasgow. In addition to his performing, Ben has worked as a private tutor in English, History and Politics and a fundraiser for a variety of major charities. He currently has a Radio 4 version of his debut Edinburgh Festival show in development.
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