Generic vs. Brand Name Drugs
Which should you choose?
Leah Braun, a pharmacist with a local large convenience store, glances down at the pile of orange and yellow capsules on her tray, picks up a long, thin spatula, and quickly separates the pills from the pile in groups of five.

Ten,75,20,25...

When she reaches a count of 60, she slides the capsules into one of the small, ever-present plastic orange containers and screws on the top.
"Whoevers buying this is paying $60 too much, says Braun. Then she shrugs. "But people want what they want.”

The drug is a brand name treatment for anxiety. According to Braun, and just about every other pharmacist across the country, paying for a brand name drug, whether prescription or over the counter, is a waste of money when there’s a generic alternative available.

But in consumers' minds the question lingers: Are generic drugs as good as brand names?

When a pharmaceutical company develops a new drug, it gives the drug two names - a generic name and a brand name. The generic name is the name of the chemical compound that makes up the drug, and the brand name is what the company calls the drug when it's sold to the public. The generic name for the oral prescription treatment for impotence, for instance, is sildenifil. lts brand name is Viagra.

Before a company can sell its drug, it must receive approval from the Food and Drug Administration (FDA), the federal agency made of pharmaceutical and medical experts who approve safe and effective drugs for sale. No drug can be sold without this approval.

Once the company receives the go-ahead from the FDA, it applies for a 20-year patent, which gives the company the exclusive, legal right to manufacture and market the drug for the next 20 years. It also means that no other manufacturer can use the drug's brand name. Many drugs have several patents, which prolong the exclusivity period beyond 20 years.

"And companies will go to great lengths to extend those patents," said Craig Clark, R.P.H., a registered pharmacist and director of Pharmacy with Hamilton Medical Center.” "They'll even develop new forms and doses so it can be patented again and again. It all means more money for the manufacturers."

Once a company's patent expires, other companies can manufacture and sell the drug under a different brand name or under its generic name.
When a company applies for generic drug approval, the FDA requires that it provide exhaustive information and meet the same standards as brand name drugs. A generic drug must contain the same active ingredients as the brand name drug (inactive ingredients may vary); be identical in strength, dosage form, and administration route; be bio-equivalent; meet the same batch requirements for identity, strength, purity, and quality; and be manufactured under the same standards of FDA's good manufacturing practice regulations required for brand name drugs.

The FDA studies this information and determines whether the drug is acceptable.

There is a major difference between the review of a brand name drug and a generic one, though: The manufacturer of the generic drug doesn't have to duplicate the original medical studies to prove the drug is safe and effective. Since medical usefulness was already determined, the generic drug requires only equivalence testing. But the FDA also requires that all manufacturing and marketing of the generic drug must be conducted in strict compliance with their guidelines.

Sometimes the generic version of a drug is a different color or shape than its brand name counterpart, but these differences have no effect on the drug's results.

Sometimes your physician will prescribe a specific brand of drug, but other times he or she will either prescribe or agree to substitute a generic drug. If there is an option, your pharmacist will generally offer you the choice of brand name or generic.

Pharmacists recommend generic drugs because they are thoroughly researched and tested to meet the same high standards set by the FDA for brand name drugs. So there's no need to worry about generic drugs' quality or effectiveness.

According to Clark, there is an instance in which a brand name prescription drug may be preferred, though - when the drug has a narrow therapeutic range.

"This means that there's a small range between getting too much of the active ingredients or too little," said Clark. "If you get too much of it there's a chance for toxicity to occur. If you get too little the drug won't be effective. Two examples are Digoxin, which regulates the heart, and Dilantin, which controls seizures. In these cases I would stick to the brand names. Other than these types of situations, generic drugs are generally the way to go."

As with all medications, you should check with your doctor or pharmacist whenever choosing brand name pharmaceutical drugs or alternatives.

Even though they're chemically identical to brand name drugs, generic drugs usually cost much less. One example is the anti-anxiety drug Klonopin and its generic version clonazepam. A typical price for 90 0.5 mg tablets of Klonopin is about $70. With clonazepam, 900.5 mg tablets are about $17.50.

What does this mean for you? If you're on any medication, you'll save money with generic versions now or when they become available. If you're paying for medication directly, you'll see savings immediately. If your insurance covers medication, savings will be passed on to you in the long run.

With brand name drugs, prices are extremely high in the United States. One reason is that there are no price regulations here like there are in Canada and Great Britain.

"One of the problems with our system is insurance," said Clark. "Because of the co-pay arrangement, people pay $10 or $20 for an expensive brand name drug, and there's no incentive for people to demand lower prices.

"The battle used to be that pharmaceutical representatives would come to hospitals and say, 'You have to buy this brand of XYZ drug,' " said Clark. "With generic drugs now available, that's no longer the case. They have to do more marketing to sell their drugs now, and with so many generic drugs available, they don't have the pull that they used to."

And manufacturers will go out of their way to influence the drug choices of pharmacists, physicians and patients. "It's not uncommon for drug reps to take entire physicians' offices to lunches, all expenses paid," said Clark. "And just last week, I saw two different television commercials for pharmaceutical drugs during one break on the evening news. They're everywhere."

One way Hamilton Medical Center lowers prices on drugs is by purchasing them through a large buying group.

"We belong to a group called the Voluntary Hospitals of America (V HA), and we have a pharmacy contract with them," said Clark. "Because it's a large buying group, it allows us to buy generic and certain brand name drugs at discounts." And that means Hamilton patients reap the price benefits.

So in the generic versus brand name debate, can you feel comfortable using generic drugs?
Yes. And unless your doctor specifically tells you to use a brand name, generic drugs are the best option in terms of price and effectiveness.

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