Posted on August 3rd, 2008 by admin

Shopping for generic forms of life’s daily necessities is relatively easy. In many grocery stores you can wheel your cart down the aisle and select from shelves stocked full of tissues, adhesive strips, raisins, and the like, all bearing the unmistakable packaging and labeling of the generic: black and white it’s hard to miss.But the issue of generic drugs is a much more complicated proposition, a much more difficult shopping expedition. Unlike coffee filters, prescription medicines are locked away, out of your sight and reach, and only two people hold the key to that medicine cabinet: your doctor and your pharmacist. But you can help unlock the door by knowing who and what to ask about generics.

First, what it is: a generic drug (the name of which is usually a condensed version of the drug’s original chemical name) is one whose active ingredients duplicate those of the brand-name product. Acetaminophen, for example, is the generic name of a nonprescription painkiller; Tylenol, Anacin 3, and Panadol are the brand names. While a generic does not have to be the same size, shape, or color of the brand name, by law it does have to be bioequivalent, determined by measuring how much of the drug is absorbed into the bloodstream and how quickly absorption takes place. A generic cannot differ from the pioneer drug by more than 20 percent in either the speed or amount of absorption.

Unlike shopping for generic items in the grocery store, however, the issue of generic drugs does not come down to black and white. And the last few years have been especially troublesome for the generic drug industry, which some say is in the middle of a credibility crisis with critics all around. You see, generic drugs usually are sold at substantially lower prices, and therein lies the rub—to the brand-name manufacturers, that is. On the average, generic drugs are 30 percent cheaper than brand-name drugs—even 50 to 70 percent cheaper than the more expensive medicines—because their manufacturers do not go to the expense of advertising them, nor do they sink money into inventing new products. Instead, they copy older, well-known drugs once these drugs’ patents expire.
Of late, many brand-name “bestsellers,” such as Valium, have come off patent and, therefore, are being marketed—and sold less expensively—in generic forms. As a result, the manufacturers of brand-name drugs and even some medical groups have been questioning the safety and effectiveness of lower-priced generic drugs and urging action against their proliferation and use.

In 1989 the American Academy of Family Physicians, having just completed its own two-year study, asked the nation’s sixty thousand family doctors to stop prescribing generic drugs for patients seventy-five years of age and older, older women with multiple diseases who are taking multiple drugs, and anyone with depression, asthma, congestive heart failure or other heart problems, diabetes, or any type of psychosis. The academy’s own study found that some generic drugs have different inactive ingredients than their brand-name counterparts and that these differences can affect how the drugs treat the symptoms.

While critics of generics are hard at work trying to persuade consumers, doctors, and pharmacists that generic drugs don’t do the job as well as the brand-name drugs they replace and claiming that they do not have the same therapeutic effects, the Food and Drug Administration says this is not true. The FDA says a generic can be safely substituted if it is bioequivalent to the brand-name product—that is, has the same active ingredient(s), dosage form, strength, and route of administration, and if the rate and extent of absorption of the drug is no greater or less than 20 percent of the rate and extent of absorption of the original product.

While the behemoths in the drug industry argue that generics are not always safe and effective because the inactive ingredients in some differ from those in brand-name drugs, consumer groups have labeled these tactics a “campaign of fear.” Meanwhile, the few existing clinical studies on generic drugs indicate that generic products are likely to be as beneficial as brand-name ones.

However, even though thousands of generics are available, doctors prescribe generic drugs only 15 percent of the time—in part, according to a survey in the October 1987 New York State Journal of Medicine, because few patients request them. So, if you wish to save money by using generics, you’ll have to make your desires clear to your doctor and your pharmacist. Start by asking your doctor, “Is there a generic drug available for this medication?” If your doctor doesn’t know—and the chances are good she won’t because doctors don’t put a high value on learning the names of generic drugs—make sure she leaves the option open to the pharmacist to substitute a generic if one’s available.

What if the physician insists the brand-name drug is necessary? Take the prescription to your pharmacist, and ask her to call yourdoctor. If the pharmacist doesn’t want to call, find another pharmacy. And if the physician still insists on the brand name, and fails to convince you of the necessity, then consider switching doctors.

Physicians learn most about the medications they prescribe from so-called detail men, the drug manufacturers’ representatives who visit each doctor on a regular basis, telling her what their drugs do and doling out free samples. As for the potential adverse reactions or contraindications relevant to each medication, the average physician gets that information from package inserts that are provided by the manufacturer. While obviously helpful, reading such information on a little sheet of paper, or even from the famed Physicians’ Desk Reference (PDR) (which is merely a reprint of the package insert), is not what one would call a medical school course in the proper use of what is potentially a very powerful drug. The point here is that there may very well be a generic that does the job just as well but has not been hyped to the practitioner like the name brand.

Finally, comparison-shop for lower generic drug prices. If you are like most people, who have three or four pharmacies in their neighborhood, this should not be too difficult to do, but you may want to save your major time and effort for expensive drugs that must be taken regularly for long periods.

Although you generally will pay less for generic drugs than name brands, unfortunately this is not always the rule at every pharmacy. Surveys have found astonishing price-per-pill fluctuations at different pharmacies. Forty-six states require that when a generic is substituted for a prescribed brand-name drug, the wholesale savings must be passed on to the consumer, but only fourteen mandate that the full savings be passed along. So the bargains (or rip-offs) may vary from pharmacy to pharmacy. Shop around.

Tags: cheaper than brand-name drugs, generic drug, Shopping for generic, the issue of generic drugs