The choice between a brand name and a generic is often not ours to make. It usually depends on our specific benefits package. I don’t think I’ve ever used a brand-name, and have never had any problems with generics. Whenever I go to pick up a prescription, the pharmacist looks up my insurance and then just gives me a generic.
In March, I wrote how WellPoint, one of the largest managed-care firms in the U.S., which includes Anthem Blue Cross of California, no longer covers the brand-name Lipitor. Their goal is to encourage members to use lower priced alternatives. But the news made me wonder if treatment with generic drugs is really just as good.
What I’ve found out is that the Food and Drug Administration (FDA) approves a generic substitute if it has proven to be “identical, or bioequivalent, to a brand-name drug in dosage form, safety, strength, route of administration, quality, performance characteristics, and intended use.” The FDA then provides a coding system, called the Orange Book, to help practitioners identify a generic’s therapeutic equivalence, based on data supplied by the generic product’s manufacturers.
I also found a recent survey conducted by Medscape Pharmacists asking their readers about their experience with generic drugs. More than 1400 physicians (64% of the sample), nurse practitioners (32%), and physician assistants (4%) completed the survey. Here are some of the findings:
– 55% of respondents agreed that generics are usually just as safe and effective as the corresponding brand name product, compared to 27% that disagreed.
– Respondents cited a litany of specific generic products about which they had concerns. Antiepileptic, antithrombotic, and hormonal agents were mentioned most commonly; selective serotonin reuptake inhibitors and other antidepressants were also frequently singled out.
– 76% of respondents agreed that after all costs are considered, generic drug products probably save money or reduce expenditures when they are used.
– Several prescribers stated that their concerns regarding the safety of generic products were about fillers and other inert ingredients. Many participants were worried about potential allergies, and one allergist reported that it can be very difficult to track down the inactive ingredients in a particular generic drug.
Helping to remove the barrier of affordability is a big achievement for generic drugs. After all, a drug treatment can’t work if you can’t afford to take it. However, as the survey results indicate, it’s more important than ever to take an active role in your healthcare. Consult with your doctor to discuss the specifics of any medication you may be taking. You can also visit the FDA’s extensive library on generics for more information.