I’m grateful for generics and use them whenever I can. But I agree with MaddyStrut that pharmacists and drug companies need to be very, very careful about claims that drugs are “exactly the same” when they are not. Any differences should be noted.
“The only difference is the coating.” is a lot different from “Slightly different formulation with slightly different side effects.”
Generic. Always generic. Always pisses me off to see Bayer, for example (the wonderful folks who trademarked Heroin) asking five times the price for aspirin. And having worked in a pharmacy, never understood people actually demanding to pay more for the same drug (and yes I take note of Maddysrut and Zoe, but I’d say usually it’s the same. )
Generics are fine with me. My insurance will only pay for generics; if there’s a brand name out there without a generic equivalent, chances are it’s on their “Does Not Cover” list. That’s where it gets sticky.
I have an older coworker who’s on a good-sized lst of meds for different ailments. Our insurance doesn’t cover most of them because of the “no generic equivalent”. So he’s forced to pay through the nose…sometimes he ends up spending most of his paycheck on 'em.
He can’t go on Part D because he’s a FT employee.
The same thing happened to my mom when they switched her meds around a couple of years ago. Until Part D came around she was paying roughly $600/month for meds. Now it’s between $100-200/month. She’d probably be paying half of that if any of her meds were generic. The cynic in me thinks, Of course they’re NOT going to make generics for stuff like Aricept and Namenda and Lipitor and all the other drugs seniors need to slow down or manage whatever it is they have!
could go on but choosing not to
I have no problem with generics, but it does bother me when there are peer reviewed studies showing that the brand name drug is actually more effective t han its generic counterparts (for whatever reason), and the insurnace still will only cover the generic version.
FWIW, I refer to Imuran, which my doc has told me is more effective in brand name form for my condition than its generic counterpart azathioprine.
My health insurance REALLY used to stick it to me, making brnad name copays 40 bucks (and I take a lot of drugs with no generic counterpart yet), and if you requested a brand name when a generic was available, it would be 40 bucks plus the difference between the cost of hte 2 drugs.
I tend to buy generic for almost everything. Drugs included.
I’ll take what ever is cheaper. In almost all cases that is generic.
I forgot to mention my favorite part. Because I can’t try the brand name drug without paying through the nose for it, I instead am going to need to start IV infusions, for the cost of a regular doctor’s visit. These IV infusions, I’ve been told, cost in the neighborhood of 20K per year. I’ll probably eventually need them anyhow, but don’t you think it would have been worth trying the brand name drug for just a little while in order to save costs?
For prescription drugs, I’ll use generic unless there’s something annoying about doing so. There are only two prescription drugs that I need, and it’s a split decision.
I take Neurotin over generic gabapentin. I used generic for a while, then got a refill that gave me a bad taste in my mouth. I went back to Neurontin, and the taste went away. I went back to generic, and it came back. So now I pay the extra $35 for Neurontin even though I don’t want to.
I use generic carteolol over Ocupress. There’s no difference that I’m aware of.
For non-prescription drugs, I almost always go with the store brand, while my wife generally buys name brand.
[QUOTE=crazyjoe]
I forgot to mention my favorite part. Because I can’t try the brand name drug without paying through the nose for it, I instead am going to need to start IV infusions, for the cost of a regular doctor’s visit. These IV infusions, I’ve been told, cost in the neighborhood of 20K per year. I’ll probably eventually need them anyhow, but don’t you think it would have been worth trying the brand name drug for just a little while in order to save costs?
[/QUOTE]
Absolutely. Most health plans have what’s called a P&T (Pharmacy and Therapeutics) committee to make these decisions staffed by local drs and pharmacists. We get requests like this all the time and our on-staff pharmacist and medical director review them. I then send their decisions to the prescribing dr and pt. 98% of the time I completely agree with their decisions - they are just common sense.
Has your dr asked your health plan for a tier exception, or an appeal? As long as your prescription insurance and your medical insurance are paid for by the same entity you or your dr should be able to help your plan to save some $.
It isn’t always (or even usually, IME) true that the generics are made “by the same company on the same machines as the brand names”. There are entire companies out there that do nothing BUT make generic versions of pharmaceuticals - Apotex, Sandoz (although they are a sub-set of Novartis), and Pharmascience are three that come to mind (mainly because I’ve recently applied to work at all of them!)
It is, however, true that they exact same manufacturing, analytical testing and clinical requirements are enforced for the manufacturing of these generic drugs. These facilities must meet the same standards as the brand name companies in the eyes of the FDA, HPFBI (Canada) and/or European/Asian authorities depending on their intended markets. For known, off-patent drugs (which really is what generics are), there are established rules on exactly how the drug product is to be made and tested (USP, EP, JP), what does and does not constitute a “pass”, and any deviation from these methods is a serious problem.
In fact, because generic manufacturers do not have the power of the brand name company behind them when it comes to quality control and good media coverage, they tend to be even more careful about making sure that absolutely everything is correct and within all the known rules, regulations and guidelines. I used to work for a contract manufacturer, which made both generics and brandnames on behalf of other companies, and trust me, they went above and beyond when it came to auditing their own work and ensuring compliance.
I take the generics when I can. The only exception is because I once took a different brand name of ibuprofen, and had a reaction to one of the excipients, but I never had any problems with Advil or Motrin. So to be safe, I stick to Advil or Motrin, but I’m willing to take generics for pretty much anything else.
Slightly off-topic, the lack of quality control and FDA regulation are the reasons why I don’t trust herbal remedies and such.
[QUOTE=SusanStoHelit]
Absolutely. Most health plans have what’s called a P&T (Pharmacy and Therapeutics) committee to make these decisions staffed by local drs and pharmacists. We get requests like this all the time and our on-staff pharmacist and medical director review them. I then send their decisions to the prescribing dr and pt. 98% of the time I completely agree with their decisions - they are just common sense.
Has your dr asked your health plan for a tier exception, or an appeal? As long as your prescription insurance and your medical insurance are paid for by the same entity you or your dr should be able to help your plan to save some $.
[/QUOTE]
To be honest, that decision was made back when I was covered by a different company. I’ve changed jobs a couple times in the past few months (well, started out as a contractor and converted to regular employee, but my insurance has switched twice), so I haven’t pursued it terribly vigilantly. And the decision for the infusions has already been made and scheduled, so I have no real desire to try the brand name drug just to see if it will postpone this necessity.
But if I do, I’ll be sure to give a shout out to you to see if you can help me navigate this mess some.
Joe, who used to work in Healthcare IT before deciding it wasn’t an evil enough industry and switching to banking IT. 
Found a cite (PDF Warning!)
From BlueCross/BlueShield of Tennessee:
that means that drugs now cost more than inpatient hospital care, which is nuts because the cost of hospital stays was the driving force behind the formation of medical insurance in the first place.
I think my medications at home are generics, but I couldn’t swear to it. I just don’t pay much attention to whether they are or aren’t.
[QUOTE=Anne Neville]
I think my medications at home are generics, but I couldn’t swear to it. I just don’t pay much attention to whether they are or aren’t.
[/QUOTE]
So here’s another question for everyone: Do you all know what a formulary is and why health plans use them?
I’ve talked to many people (mostly Medicaid patients) who are in their 40s or 50s and have never heard of a formulary.
I thought that they were relatively common tools, and that anyone who has had any contact with the health insurance industry in the past 20 years would know what they are. Apparently I’m wrong.
Although to be fair, we are directed by the state to assume that each Medicaid patient has no more than a 6th-grade education. We also can’t use hyphenated words or write paragraphs that span pages.
[QUOTE=SusanStoHelit]
So here’s another question for everyone: Do you all know what a formulary is and why health plans use them?
I’ve talked to many people (mostly Medicaid patients) who are in their 40s or 50s and have never heard of a formulary.
I thought that they were relatively common tools, and that anyone who has had any contact with the health insurance industry in the past 20 years would know what they are. Apparently I’m wrong.
Although to be fair, we are directed by the state to assume that each Medicaid patient has no more than a 6th-grade education. We also can’t use hyphenated words or write paragraphs that span pages.
[/QUOTE]
Yes, I do. And that’s not just because I sell health insurance, I knew what it was before that. 
To answer the OP, I take generics whenever possible. Partially because it saves me money and partially to do my part in reducing overall heathcare costs.
I’ll take generic drugs, if available, for everything except my birth control pills. When I took generic BCP, I had a devil of a time with breakthrough bleeding and weird (too long or too short) periods. My doctor told me that the proportions of active ingredients in generic drugs aren’t measured as precisely as they are in brand-name drugs, and that the variance was what was wrecking havoc on my cycle. She put me back on brand-name pills and everything went back to normal.
[QUOTE=Smeghead]
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.
[/QUOTE]
I’m the exact same way. I’ll take ibuprofen for aches and pains, but if I have a headache, I must have Excedrin. I’m actually kind of frightened by the amount of Excedrin I take…which is why I’m going back to the doctor in October. 
[QUOTE=SusanStoHelit]
So here’s another question for everyone: Do you all know what a formulary is and why health plans use them?
[/QUOTE]
I know what they are- they’re lists of medications that are covered under your health plan. I got a copy of the formulary from my insurance when I wanted to switch birth control pills.
But if everything seems to be working, I just don’t pay much attention to my meds, except to make sure I take the right amounts every day. Whether they’re generics or not just doesn’t enter into thinking about my medications on a day to day basis. (There’s also the fact that I take them in the morning, when I’m on autopilot and not thinking much at all). I have Kaiser health insurance, so I go to their pharmacy, and I always go to the same one because it is within walking distance of home, so the issue of going to different pharmacies doesn’t come up.
[QUOTE=mnemosyne]
It isn’t always (or even usually, IME) true that the generics are made “by the same company on the same machines as the brand names”. There are entire companies out there that do nothing BUT make generic versions of pharmaceuticals - Apotex, Sandoz (although they are a sub-set of Novartis), and Pharmascience are three that come to mind (mainly because I’ve recently applied to work at all of them!)
It is, however, true that they exact same manufacturing, analytical testing and clinical requirements are enforced for the manufacturing of these generic drugs. These facilities must meet the same standards as the brand name companies in the eyes of the FDA, HPFBI (Canada) and/or European/Asian authorities depending on their intended markets. For known, off-patent drugs (which really is what generics are), there are established rules on exactly how the drug product is to be made and tested (USP, EP, JP), what does and does not constitute a “pass”, and any deviation from these methods is a serious problem.
In fact, because generic manufacturers do not have the power of the brand name company behind them when it comes to quality control and good media coverage, they tend to be even more careful about making sure that absolutely everything is correct and within all the known rules, regulations and guidelines. I used to work for a contract manufacturer, which made both generics and brandnames on behalf of other companies, and trust me, they went above and beyond when it came to auditing their own work and ensuring compliance.
[/QUOTE]
Yup. I used to work for a company that manufactured only generic prescription drugs–Purepac in Elizabeth, NJ. I had access to and involvement with all parts of the operation, and I have full confidence in the quality and effectiveness of the generics.
Mnemosyne makes a good point about how the generic manufacturers can’t rely on the power of the brand name. Another factor that promotes quality is that there is only one company making a particular on-patent drug, so the pharmacies are forced to deal with that company. But there are any number of companies that can produce a generic, so if there is a problem with one, the pharmacy can easily switch.*
*Getting all the approvals needed to produce the generic drug is an incredibly complex and time-consuming process, so it’s not like a generic drug company can just start pumping out the paroxetine. But with a popular drug like paroxetine (Paxil), you can bet that many of the generic companies got approved ASAP so they could get a slice of that profitable pie.
[QUOTE=SusanStoHelit]
However, the people that demand Nexium over Prilosec just because it’s “the new purple pill” just make me go 
[/QUOTE]
Can you tell me what the difference is here?
I will use the generic in every case. I have only once had a different reaction to a med that was generic. When I moved from Canada to the US, I was on birth control pills. My doctor prescribed the US generic of this exact pill, and it completely killed my libido. Zero, none, bye-bye.