I’ve worked in pharmacies in the past and I’m now the analyst for the pharmacy department of a managed care health plan corporation.
One thing I’ve never understood is some people’s aversion to using generic medications. We get hundreds of complaints and appeals to cover Brand name drugs like Ritalin, Prozac, and Oxycontin (although I suspect the latter is because brand-name 'contin has a higher street-value than generic).
When I worked at the pharmacy we had several patients who had tried one generic in their lifetime, had a reaction to it, and thus would never touch another generic again. Now generic drug manufacturers can use different dyes or fillers than the brand, but the active ingredient is exactly the same. **You are not getting an inferior medication. **
One of our plans is a managed Medicaid program, and if there is a generic available then that is all we cover (with exceptions for people with allergies to the specific dyes). The way some people bellyache about this you’d think we’re asking them to drink snake oil and say the lord’s prayer backwards instead of providing them safe, cost-effective drugs for free.
Our commercial plans often cover brand-name drugs but at a significantly higher copay than the generics. And we still have people who choose those.
I’m looking for Dopers perspective on this. Is there anyone who knows why someone who is not allergic to a generic would prefer to use the brand-name?
I know more pharmacology than the average layperson and I understand that generic = name brand prescription drug where it matters.
However, I have caught myself staring at the backs of generic and name brand over the counter medicines trying to figure out if the generic or store brand people were trying to pull something over on me. I had to make a night run to the drug store to get some gas medicine for my newborn recently. The name brand was $18 and the store brand sitting right beside it was $7. The stuff had only one ingredient and I felt guilty even when I brought it home and I was scared my wife would complain about it. She didn’t though. Marketing can be a powerful thing.
It’s the same reason people will buy Nike trainers for $250 instead of the $20 pair from Kmart that are made in the same factory. It’s why they’ll pay extra in Australia to buy a GAP hoodie when we don’t even have any GAP stores around here, rather than just picking up a brandless one from Target.
Brand name recognition. The drug companies have put a lot of money into making sure people know that Prozac™ is the best, most effective and safest mood altering drug on the market. Just because Prezac™ is made in the same factory, on the same machines, using the same active ingredient doesn’t mean a thing to these people. If they haven’t seen ads or celebrities shilling it, they don’t want to know about it.
Personally I’ll take the generics. If it means paying $12 for my antibiotics or whatever vs $22, then I’ll take the generic and save the tenner, thanks.
That’s the other thing. I’m looking for a cite right now, but IIRC drug prices are not only going up, but they are taking up a bigger and bigger slice of the health care premium every year.
Not that this is necessarily a bad thing - in our Medicare part D plan we’re looking into waiving our copays for chronic disease drugs like Lipitor (cholesterol) and Metformin (glucose control). We figure that spending a few extra bucks on drugs now will save us $$$ in medial claims down the road. However, the people that demand Nexium over Prilosec just because it’s “the new purple pill” just make me go
Heh. I’ll admit to my own brand-name prejudice. About a month back I went to buy a pregnancy test and just couldn’t bring myself to buy the Pay-less store brand.
Everything else, it’s generic all the way. It’s suprising how many store brands are packaged at the same plant using exactly the same ingredients as the brand-brands anyway.
An ophthalmologist I work for makes a point of telling patients that he only knows of one ocular medication where the brand name is actually better than the generic; for all the others, they’re the same. (Sorry, I’m blanking on which, but I know it’s one of the prescription drops.) Sure, some people are sensitive to a filler-style ingredient in a generic but I bet others react to one in a name brand, so one reaction is no reason to totally exclude all generics.
Prescription drugs, I’ll go with generic without blinking an eye.
OTC, though, I’m weird. I get a lot of headaches, for which Excedrin is the only useful treatment. Due to the placebo effect, I’m certain, generic versions have never done the trick for me.
My generics save me about $20 each month, for meds I’ll probably use the rest of my life. That’s two ten dollar co-pays for the generics, instead of twenty each for the brand name.
I always ask for a generic equivalent, unfortunatly they are not always available…
I was on cymbalta…not covered by my provider…now I am on Effexora CR…not the same for me…
I also have major pain issues… almost any oxy/hydro codone generic calms it.
The persons I heard complain for the most part were woman that had to use generics on the work insurance, after having better coverage under their husband’s insurance. Their husbands didn’t have the insurance plans any longer that covered everything for almost no copayment. In the past they used their second work insurance to cover the deductables for their husbands policies. They had no concept that medince and doctor visits cost so much, since they paid nothing, for years because of dual policies.
I’m fond of generics. I can’t stand the idea of paying more for exactly the same active ingredient. I do read the back of OTCs though just because I’m from abroad and still haven’t figured out what brand-name is equivalent to what back home. Once I figure out what’s what, I can grab the generic.
My mom takes a number of drugs for her MS symptoms (urinary incontinence drugs, mood stabilizers, anti-fatigue drugs, etc) and for some she swears up and down that the generic versions have NO effect on her. She’s an LPN and has kept her license even though she hasn’t worked in 20+ years, so I never thought to argue. I wonder if her claims are true, or if she is decieving herself. Would there be any factual basis to this?
I guess I always figured she should just do what’s best for her, but I’m curious now whether there’s any truth to it.
Generic, always, whether it’s a prescription or OTC. I’m saving a small fortune on the generics for heartburn and, um, gastro-intestinal distress. Haven’t noticed any difference in effectiveness.
I think some people get confused. Prescription coverage providers add to that sometimes.
I was on Lexapro and received a call from my coverage provider suggesting I swith to Celexa (the copay would be lower). I’d been on Celexa, and it didn’t work as well for me, but the caller insisted they were the same thing. I called my doctor who explained to me that they were not the same thing. However, the caller was quite adamant that they were.
I realize that’s not the same situation as with generics, but if anyone has received similar calls only to find out that the coverage provider didn’t know what they were talking about, I can see how they’d be suspicious of getting anything other than what the doctor actually prescribed.
I have no trouble with generics but I know several people who are concerned about quality control from anything other than the name brand drug. I also hear people assume that because name brand food from the grocery store tastes better than generics, generic drugs must be similarly inferior (though I’m not convinced that generic food always tastes worse either).
I vaguely recall someone telling me once that, though the active ingredients may be the same, sometimes the generics have a poorer quality coating which in some cases can mean that the active ingredient can be released sooner into your system and with some drugs that may cause stomach irritation. True or false?
AFAIK False - IINAPharmacist, but the Pharmacists that I have worked with all insist that there is no difference. The generic manufacturers can use different dyes or fillers or coatings. These aren’t inferior, just different - because if they interfere with the bioavailability of the active ingredient then they won’t be FDA-approved.
We’ve had some patients who are allergic to a generic by one manufacturer and not another.
As for the Celexa/Lexapro difference, it’s pretty much the same thing that happened with Prilosec and Nexium. The company realized that the patent was almost up so they came up with a slightly different formulation to keep the money rolling in. Celexa is a racemic mixture, while Lexapro only contains the left “handed” molecule. The manufacturer’s copy says that luckily for us, the right handed molecule has all the side effects and the left handed molecule has all the good anti-depressant effect. Whatever.
I do believe that there are some people for whom Lexapro works but Celexa doesn’t. That’s no reason for a Dr to push Lexapro on someone who hasn’t tried any other SSRIs. It’s totally appropriate for an insurance company to require step therapy (try OTC or less-expensive drugs first) IMO.
I didn’t mind them suggesting Celexa. Heck, a lower copay is in my best interest. I didn’t like being told it was the same thing. Actually, as mentioned, I’d been on Celexa first. The dosage that worked also made me drowsy. Lexapro didn’t. That’s why I was so confused when they said it was the same thing. I was sure my doctor had said they were different, but I was confused at first thinking maybe my lack of drowsiness was just psychosomatic.
It’s still not a reason to not trust generics. I was just saying that if someone got a call like that, they may not trust anything they don’t hear from their doctor.
