Generic heart medications work just as well as their brand-name counterparts, despite negative commentary on the no-name drugs in medical journals and mainstream media, a new analysis says.

The report in today's Journal of the American Medical Association reviewed 47 head-to-head trials between generic and brand-name versions of heart drugs between 1984 and this year. It found equivalent effects among most medicines in nine drug sub-classes: beta-blockers, diuretics, calcium-channel blockers, anti-clotting drugs, statins, ACE inhibitors, alpha-blockers, anti-arrhythmic drugs (for irregular heartbeats) and warfarin. Americans spend more on those drugs on an outpatient basis than on any other prescription medicines, according to the paper.

Generics cost 30 to 80 percent less than brand-name drugs, according to Bloomberg News.

"Generic drugs can be a very useful part of a treatment plan — they reduce cost and improve adherence, but it's a common view that brand-name drugs are superior to generic drugs," says study co-author Aaron Kesselheim, an instructor at Harvard Medical School. "There is no evidence that brand-name drugs are superior."

Kesselheim also reviewed 43 editorials. Twenty-three cast a negative spin on generics, while 12 encouraged their use. Eight didn't say whether generics were interchangeable with brand names.

The disproportionate negativity may stem from anecdotes doctors hear from their patients, ties to drug companies or the sway of advertisements, Kesselheim says. "Doctors could be falling into the same trap patients are and are influenced by the totality of ads for brand-name drugs, whereas generics aren’t advertised at all," he says, "oror the association of 'generic' with something of lower quality."

Ken Johnson, senior VP of the Washington-based trade group Pharmaceutical Research and Manufacturers of America, said in a statement that generics owe a debt to label drugs. "Without today’s innovative brand-name drugs to legally copy, there would be no generic drug industry," he said, insisting that “The contention that brand-name medicines drive up the cost of health care is fatally flawed."

One generic heart drug that never took off, despite a large, federally funded study showing it worked as well as brand names, is the blood-pressure medication chlorthalidone, the New York Times noted Friday in its "Evidence Gap" series. That may have been because doctors were dazzled by new medicines, pharmaceutical company spin against the trial, known as Allstat, or outside experts' criticism of the trial design and its conclusion, according to the Times.

“The pharmaceutical industry ganged up and attacked, discredited the findings,” Curt Furberg, who chaired the study's steering committee, told the Times.

Image by iStockphoto/Onur Döngel