OK. At least some people realized that Obamacare is real. It has not been repealed. It has not been adjudicated as illegal by the Supreme Court. Which means a lot of you are going to have to change another mistaken impression. Generic drugs a priori are not inferior to brand name drugs.
(I need to provide the following background. I have been the primary driving force behind a brand-name manufacturer AND a generic drug supplier, in the past. BOTH had the same basic rules of quality assurance and control. I have also been a vital consultant to both sorts of suppliers over the years.)
Oh, sure, there have been problems with some generic drug manufacturers. But, there have been recalls and problems with brand name drugs, just about as frequently. The biggest recalls of the past decade include Pfizer (2), Sandoz, Novartis (2), Johnson & Johnson (3), Merck, Sanofi Pasteur, Medimmune, Able Labs, Bausch & Lomb, Bayer Labs, Wyeth (now part of Pfizer), Prestige, and Blacksmith. Notice that there are only 3 generic firms on that list.
And, there still are problems with a lot of “overseas” vendors- but that is another issue. (I hate to be an American-first poster, but I would personally avoid all generic drugs vendors from developing countries. Consider the generic version of Wellbutrin that cost Ranbaxy $ 500 million in fines– and left many a depressed patient just that way. I don’t think that will stop unless and until the FDA is properly funded- they lack the means to adequately examine the operations of these overseas facilities.)
Since 1984, when generic drugs were given a push by Congress (the Hatch-Waxman Act), copycat drugs may be sold as long as they are identical to the brand-name versions. And, they are. Last year, some 84% of all prescriptions were filled by generics. And, unless the physician specifies otherwise, a generic MUST be substituted for a brand name, if one exists.
Why? Because generics are cheaper. Much cheaper. And, that saves you and/or your health care insurer money. No, I am not talking about the push that many a brand name drug has made to render their drugs over-the-counter, which means the insurance company saves and you pay more. (Consider this- Claritin used to cost my family $ 10 for a month [with the insurance company picking up the rest of the tab); now it costs my children an average of $ 20 a month. And, it’s not a deductible expense, either. [Only prescription medicine and eyeglasses are deductible, when you itemize on Schedule A.])
But, just because physicians know that generic drugs were a better value and most (90+) consider them offering equivalent side effects (Drs. William Shrank, Emily Cox, Michael Fischer, Jyotsna Mehta and Niteesh Choudhry, Brigham & Women’s Hospital, MA) does not mean that information conveys to the general public. Only 38% of American citizens consider generic drugs first ,when they are purchasing prescribed medicines.
Mdmes. Keri Sewell, Susan Andreae, Elizabeth Luke, and Dr. Monika M. Safford revealed that many rural poor (often African American) were against generic medicine. And, stopped taking their brand name medicines that were too costly, leaving their health at risk. Those surveyed were positive that generics lacked the quality of the brand name drugs. But, there was another subtext, one that sounds remarkable like the mis-statements many make about Obamacare. The respondents were sure they had to “settle” for lesser drugs or were serving as guinea pigs, since they were poor and Black.
Given that, it may be less surprising that those with higher-level education or higher income levels are more prone to accept generics as the smart financial choice. Because they understand the dynamics.
What dynamics you ask? As I stated above, generic drugs are subject to the same rules and regulations as brand name drugs; they must be equivalent. That’s not the same thing when one considers generic foods or other “stuff” sold in the supermarket. (But, I did share with you some ways to find which “generic” items are actually the brand name versions, with a different cover, in another blog post.)
Consider this fact- over the past decade, our health care expenditures have been lessened by $ 1 trillion due to generic drugs, or about $ 200 billion just in 2012. (Yes, the substitution is increasing, partly due to the patent expiration of many a brand name drug.)
WOW Roy, those are impressive numbers! I’ve never turned my nose up at generics, given the real savings. And if they are good quality, that’s good for all of us.
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Glad you haven’t, Amy! It certainly helps to keep your costs down. And, mine- since we all pay higher rates when folks keep electing to charge more to the insurance company.
I didn’t know we had a choice. Is the choice for generic the doctor’s choice or the pharmacy’s choice?
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The physician is NOT supposed to mark your scrip “brand name only”, unless he/she has a bona fide reason to do so. (There are some examples- why Crestor and Lipitor have some very different and specific effects.) Without that marking, the pharmacist is to use the lowest cost drug to meet the needs prescribed by the doctor.
I agree totally from my experience and my husband’s, except for one drug. I have hypothyroidism, and was originally prescribed the generic levothyroxine. It didn’t work very well. A number of people recommended I try the brand name. I did and it worked much better. I’ve read a lot of similar observations about this one drug. But Synthroid is getting more and more expensive. I am wondering if I should try levothyroxine again, and I wonder why so many people, including me, seem to have better experiences with the brand name of this particular drug.
Ms. A:
That is absolutely correct. There are some “inert” ingredients that are less than inert – and vital for the action, as you described.
I always advocate generic- with exceptions. Those exceptions prove the rule!
I defer to my doctor on generic decisions. My understanding is in some cases, they are not equivalents (in particular where it relates to dosage consistency due to quality control issues). Fortunately, I’m not on many meds (one, in fact, due to a disorder diagnosed when I was 12). It’s sad to see what an initial seemingly smart concept has become with the advent of HMOs and the associated loss of consumer connection with costs.
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No, No, Nanette. (I just had to say that!). Seriously, it’s not a quality control issue- it’s an adjuvant or additional component a drug has that is considered by the manufacturer as an inert component (but it’s not- it has some critical function).
But, as I listed for Julia, there are some drugs that are best used brand name, but most are perfectly fine as generic. And, again, certain foreign manufacturers (some have just been banned for sale in the US) should always be avoided.