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The FDA requires brand-name and generic levothyroxine to have similar bioavailability, but some clinicians continue to prescribe the more expensive brand-name version. In this retrospective cohort study exploring bioequivalence, researchers used a national pharmaceutical database to identify adults with newly filled prescriptions for levothyroxine and baseline thyrotropin levels of 4.5 to 19.9 mIU/L. Two groups of patients taking generic or brand-name forms (4570 patients total) were propensity matched for several clinical and demographic variables. Patients were assessed at 3 months for thyrotropin levels that were normal or markedly abnormal (defined as <0.1 or >10 mIU/L).
Most patients (almost 86%) took ≤50 µg daily of either form of levo…