Hierarchy of Technoscience Estimation: the Case of Drug Equivalence Dispute

Abstract

Semantic framework of the discussion about the equivalence and interchangeability of the original drugs and generics is considered in the article. Generics are identical to the original drugs in terms of chemical structure, nevertheless some patients and doctors consider that generics are less effective and have more severe side effects than original drugs. These discussions are considered as an example of a public deliberation concerning the achievements of technoscience. The conflicting parties determined the identity either from the chemical structure of the drug (according to D. Chalmers - secondary intensional) or from the phenomenal characteristics of the situation of its application (primary intensional). In this regard, the method of resolving the conflict is the alignment of the hierarchy of methods for determining equivalence in biomedicine. The methodology of evidence-based medicine already has such a hierarchy, which makes it possible to determine the validity of outcomes of clinical trial. According to this hierarchy, the phenomenal characteristics of the outcome of treatment (quality and life expectancy of patients) are more important than instrumentally established indicators. Thus, new clinical data on the efficacy and safety of a generic should give the opportunity to cancel the recognition of drug equivalence. More generally, this means that technoscience achievement which directly affects a person can only be assessed by him/her. The recognition of such priority is the basis of the ‘division of linguistic labor' during public deliberation concerning the achievements of technoscience.