Generic and Biosimilar Prescribing in Children and Adolescents: Technical Report

Guidance from the American Academy of Pediatrics on generic drugs was last published in 1987. The regulatory process for development of a new generic product in place of the reference brand-name drug requires extensive Food Drug and Administration (FDA) standards for similarity to expect the same safety and effectiveness profiles. Since the last guidance, the growth in biologic agents and the development of biosimilars as alternatives to the originator have become more common across the United States. As with generics, FDA requires extensive evidence of biosimilar agents as compared to the originator drug. Generic drugs are identical to the brand name drug and must meet the regulatory standard of bioequivalence whereas biosimilars are "highly similar" but may differ clinically inactive components and even molecular structure, as long as these differences are not "clinically meaningful." Confidence in the development and approval of generic and biosimilar medications should guide providers toward generic and biosimilar substitution. This technical report summarizes domestic and global regulations, development of generic and biosimilar drugs, and the literature review of a variety of generic products and biosimilars.