The RIP: Brand vs Generic Drugs
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You’ve got a migraine. You go to the pharmacy and, throbbing headache aside, are feeling quite pleased with your choice of Advil or Tylenol. After all, there’s a reason they’re trusted brands and, you expect, you’re getting higher-quality ingredients, product safety and, best of all, a much more efficient cure for just a small premium in price.
This is exactly the thinking that leads most people to overspend on medications by as much as 80%. Brand name drugs cost more simply because the companies that make them spend a ton of money on research, marketing and advertising. Once a drug’s patent expires and is up for grabs by generic drug makers, brand names have little to do but come up with various marketing gimmics: liqui-gels, 8-hour tablets and what have you. The truth: generic drugs are made of exactly the same active ingredients (ibuprofen or acetaminophen) and have to comply with the same safety requirements. And, as we saw with the recent Tylenol recall and the ongoing FDA investigation into alleged deaths and other serious side effects, just because a drug carries a well-known brand doesn’t necessarily mean that it’s perfectly safe.
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leave a commentJust because the active ingredient is the same does not mean that the drug is absorbed and distributed the same way in your body. For a few people on chronic therapy, changing from a branded form to a generic form caused unwanted side effects, and the FDA responded to this by tightening requirements on generics. If you and your physician decide to switch to a generic or your pharmacy switches generic suppliers and you see significant changes, you might want to see if switching back or choosing a different supplier might be better for you.
That did open my eyes.
In my household, we buy generic more often than brand name, so I think this is an awesome post.
Perhaps this applies to over the counter drugs, but the same does not hold true for a lot of prescription drugs.
For example, there is a medication that people who get cornea implants take to help the body not reject it. The name brand works significantly better than the generic. As in, it’s night and day… people who take the generic reject the implant much more often than those who take the name brand.
I wholeheartedly agree with you! Several years ago my pharmacy suddenly replaced a generic of a medication I was taking with a generic from another pharmacuetical company. Within 24 hours, i knew something was wrong – it was as if I had suddenly stopped taking it and it was a prescription med that cannot be stopped suddenly without severe side effects! I had alot of problems convincing my pharmacy that the replacement was not effective and to take the meds back so that I could locate a pharmacy that was still distributing the same form of generic that I had been taking. I had to go to another nearby town before I was able to locate it! So – they can say what they want but a generic is not a generic – is not a generic! Not when it comes to prescription medications!!!
Another potential ripoff is your prescription plan. Compare: 30 tablets of atenolol 25 mg for $30.00 from my prescription plan. 100 tablets of atenolol 25 mg for $6.50 from Costco. Shop around, and save some money!
Two things:
1. ‘identical’ is misspelled.
2. You cannot underestimate the value of packaging and delivery of the medication. In some cases, it is worth a minor cost difference because generic manufacturers skimp in these two areas. This results in the consumer fighting with the packaging to get to the medication, and then upon swallowing, find it stuck to the back of their throat due to a cheaper coating.
And no, I don’t work for a pharma company, but I do practice ethnography across a broad product spectrum to determine product failings and successful product differentiation. As a consumer, I would prefer it if generic drug manufacturers took the issue of packaging and coating more seriously, but they don’t have to: they sell on price.
If generic drug companies would use better quality, more user-friendly packaging I’d never buy a brand name drug, but it is very hit-and-miss.
When talking about packaging, I’m not talking about the outside of the box, but the actual plastic and foil packaging. I find that often the easiest way to open the generic blister packs is by using a pocket knife–something not commonly needed on the brand name packs.
Primary point – generic medications are only required by the FDA to have 70% of the efficacy of the brand name equivalent. So there is a difference. It’s up to you whether or not the potential added efficacy is worth it to you.
Bottom line – generics are similar, not identical. Do your research more thoroughly in the future to avoid blatant inaccuracies.
Wow, These comments are a great example of the BS the pharma companies are trying to peddle. Forget everyone’s opinion and let’s focus on the science and the chemistry. ibuprofen 200mg is the same, no matter what the brand name is. Its not 70% the same, or almost the same, it IS the same.
Please, do some research before you start spreading misleading information. By law, generics have to have the same active ingredients as brand name. And gosh, in some cases, people may have an allergic reaction to the filler in the brand OR the generic. Just because its brand name does not make it better. period.
Wait what? Where did you find this morsel of information?
Hi Ken,
That is just not true, they are required to be between 80 and 125% as effective as the original. Here is a source for that:
http://www.fda.gov/Drugs/DevelopmentApprovalProcess/ucm079068.htm
Please do your research more thoroughly in the future to avoid blatant inaccuracies.
Cheers.
you are completely wrong!
Generics and Brands must be equivalent regarding strength, potency, purity and safety.
Where did the 70% figure come from?
Brand drugs do work better, but not for the obvious reasons. There were experiments performed where the same drug (painkiller) was given to multiple people, and the ones who paid more for it got a better result than the ones who paid less for it.
Yes, it is just “in our head”, but it can have very real results.
That says nothing about brand name drugs. That just says people are crazy (gotta love ‘em) and are willing to pay extra money to maintain the status quo. If they just thought about how each one, regardless of emotions or money, is exactly the same then they would be golden.
This article seems to disagree with a few commenters. It states that the FDA requires generics to be “pharmaceutically equivalent and bioequivalent to the innovator product”. It goes on to explain that “pharmaceutically equivalent” means using identical active ingredients. As long as the brand name doesn’t hold a patent, the generic equivalent should be considered 100% identical.
http://www.medscape.com/viewarticle/421495_3
I buy both genera and branded OTC and prescription drugs. However, I AM VERY supportive of branded prescription drugs. Generic manufacturers are out there violating patent rights of drug manufacturers. If branded drug companies like Pfizer, Merck, Astra Zeneca, Sanofi Aventis, Abbott Labs, Glaxo Smith Kline, etc. can’t make money on the drugs they’ve invested money into, we won’t have continued innovation to continue to develop new drugs. Generic manufacturers don’t develop cures to diseases, they just copy drugs and sell them cheaper because they don’t have invest in the research or market them. I don’t know about you, but I sure would like to see a cure for cancer, diabetes, multiple sclerosis, etc… And it’s going to come from the big drug companies, not the generic manufacturers!
That sounds all well and fine, but in many cases the drug companies are not in the business of curing diseases, they’re in the business of TREATING them. And at a price at that.
And I’m not arguing that generic pharmaceuticals are identical to brand name drugs, but I personally think that the current system that we have for patents regarding these medications is pretty upside down. You’ve got companies that are sitting on patents for drugs that could save millions of lives simply because they either can’t make a profit from a generic form of it, or they feel that it will cut into their profits.
Take Merck & Co. for example. They refused to allow a generic form of an AIDS drug called efavirenz to be made unless they were given $1.10/pill (apart from the 65 cents/pill that Thailand pays for the same drug). So the President of Brazil opted to go ahead and make arrangements to make a generic form of the pill anyhow. Thus breaking the patent law and likely saving many lives as the Brazilian government is willing to give the drug to AIDS patients at no cost to them.
See the article on MSNBC here: http://www.msnbc.msn.com/id/18490388/
O_O
Seriously? You’d prefer that pharmas (already raking in record profits year after year selling boner pills) are allowed to have patents in perpetuity? You think that creating a drug based on an expired patent is “violating patent rights”?
Oh, DO go on.
I agree with you that it is sort of unfortunate for the drug’s inventors to have patents the lengths they are. They spend all the time searching for the right chemical, only to patent it, spend 8 years testing for its safety, leaving them only 2 years to make up the profit to pay back the cost of the research behind it.
That being said, most pharmaceutical companies are in search of treatments, not cures. Finding a cure to a high-profile disease, and all the fame and world happiness sounds great, but a treatment for diabetes or arthritis that people will become dependent on for the rest of their lives ensures them a lot more money.
I buy both generic and branded OTC and prescription drugs. However, I AM VERY supportive of branded prescription drugs. Generic manufacturers are out there violating patent rights of drug manufacturers. If branded drug companies like Pfizer, Merck, Astra Zeneca, Sanofi Aventis, Abbott Labs, Glaxo Smith Kline, etc. can’t make money on the drugs they’ve invested money into, we won’t have continued innovation to continue to develop new drugs. Generic manufacturers don’t develop cures to diseases, they just copy drugs and sell them cheaper because they don’t have invest in the research or market them. I don’t know about you, but I sure would like to see a cure for cancer, diabetes, multiple sclerosis, etc… And it’s going to come from the big drug companies, not the generic manufacturers!
What possible reason would ANY company, generic or not, have to suddenly STOP profiting on American Idiocy?
Seriously. Say Tylenol is a $200 million dollar income stream, yearly. Are you going to go ahead and say to your board of directors, and SHAREHOLDERS, that you have decided that it will be much better if you just stop pushing that silly stuff so hard, and start focusing on some other newer untested unknown drug for whatever purpose?
You’d be out of a job so fast, not even your new drug could cure your headache.
Big Pharma has a wonderful little game going already. Think they’re going to stop anytime soon? I personally see NO END (until the government finally says they have to knock it off) to those lovely commercials, telling me about a pill that will let me play on the beach with my dog (and has ten seconds of incredibly dense talking about all the other stuff that might happen to me, tacked on at the end).
Named brands work better because of the powerful Placebo effect.
Where did the 70% figure come from Ken M? Do you have a source for that?
The FDA’s website says it will only approve “identical” products[1]. Here’s a summary of the three most pertinent Q&As from the site:
Q: Are generic drugs as safe as brand-name drugs?
A: Yes…
Q: Are generic drugs as strong as brand-name drugs?
A: Yes…
Q: Do generic drugs take longer to work in the body?
A: No…
Remember, don’t believe any Internet comment that doesn’t have a source!
[1] http://www.fda.gov/drugs/emergencypreparedness/bioterrorismanddrugpreparedness/ucm134451.htm
Great graph!; and I need to show this to my wife.
BTW, both ingredient and milligram are misspelled.
98% of the time there is no difference between brand and generic. The active ingredients are the same drug, and people who want “brand” because they feel it will be better don’t have a clue. Many times the same drug company will make both brand and generic drugs, at the same plant, using the same ingredients, and the same processes and people will still complain the generic doesn’t work as well. (placebo effect in reverse?) Just ask the pharmacy to see the generic for protonix. (generic is pantoprazole) Pantoprazole actually has “PROTONIX” written on it.
The difference in many drugs lies in the excipients. The stuff that holds the pill together. Most of the time its corn starch or something similar.
The pharmacist also recognizes the very few cases where brand vs. generics aren’t comparable. The number one drug that you do NOT want switched is any thyroid medication. You can still use the generic, but whatever drug you start on, then you continue on that. Start on brand, stay on brand. Start on generic, stay on generic.
Protonix is a special case. In 2008, the brand manufacturer introduced a generic version as a legal and business strategy after a generic manufacturer introduced a generic version while challenging the patent awarded to the brand manufacturer. The protonix patent was set to expired in 2010.
The brand manufacturer sued the generic manufacturer for patent infringement and US tribunals sustained their case.
http://www.fda.gov/Drugs/EmergencyPreparedness/BioterrorismandDrugPreparedness/ucm134444.htm
Drugs must be the the same strength and dosage form and same active ingredient. Generics have to prove there is the same bioavailability as brand. In other words, if you take 20 mg of brand name drug x, you might only absorb 50% in the blood stream. Depending on kinetics (drug distribution, metabolism etc) there might be 2mg in the blood stream that can be used by your body. If you take a generic drug, there has to be tests to show that if you take 20 mg of generic drug x, then 2mg will be in the blood stream after having the same kinetics. Ken M, can you show me a reputable source for your (70%)? I’m not saying I don’t believe you, or your wrong. On the contrary, I like to learn and gather as much information as possible, so if you can send me the source, that would be appreciated.
98% of the time there is no difference between brand and generic. The active ingredients are the same drug, and people who want “brand” because they feel it will be better don’t have a clue. Many times the same drug company will make both brand and generic drugs, at the same plant, using the same ingredients, and the same processes and people will still complain the generic doesn’t work as well. (placebo effect in reverse?) Just ask the pharmacy to see the generic for protonix. (generic is pantoprazole) Pantoprazole actually has “PROTONIX” written on it.
The difference in many drugs lies in the excipients. The stuff that holds the pill together. Most of the time its corn starch or something similar.
The pharmacist also recognizes the very few cases where brand vs. generics aren’t comparable. The number one drug that you do NOT want switched is any thyroid medication. You can still use the generic, but whatever drug you start on, then you continue on that. Start on brand, stay on brand. Start on generic, stay on generic.
Lets be clear on our facts here:
Ken was almost right, the FDA requires generics to be bioequivalent from 80% to 125% of the brand name. (http://www.fda.gov/Drugs/DevelopmentApprovalProcess/ucm079068.htm)
So this does not mean that the medications need to be the exact same chemical compound.
However, this does not mean that the generic will be less effective. On a study done comparing the absorption rates of generic and brand name medications, there was only a 3.5% difference in absorption. This was equivalent to the absorption difference in different batches of the brand name medication.
http://www.fda.gov/Drugs/ResourcesForYou/Consumers/BuyingUsingMedicineSafely/UnderstandingGenericDrugs/ucm167991.htm
As an experienced Quality Control consultant for both generic and brand pharmaceuticals manufacturers, I have to say that this post is somewhat misleading. First of all, it shows a mass-normalized price comparison of similar ibuprofen based products to support its argument. However, the products compared are not the same because the brand product uses a more convenient delivery method of the active ingredient, the liquid gel. It has been thoroughly demonstrated that the liquid gel will facilitate the ingestion and dissolution of the active ingredient and therefore will reach the patient blood stream faster. This improves the chances that a patient feels relieved faster. The liquid-gel delivery adds value to the ibuprofen therapy for pains.
Sure, the law states that generics need to meet the same quality requirements that brand drugs meet; however, this does not means that they are the same. If you ask me which are better, branded or generic drugs; I’ll reply that there is no generalized answer but that you have to evaluate each product separately. The problem is that the information included in the labeling is not enough to determine so. Please allow me to walk you through the process of launching a new brand and generic drugs to clarify this.
The FDA evaluate drug performance using statistical tools and a pre-determined set of specifications for drug testing. These specification are usually proposed by the pharmaceutical company the submits a drug for the first time to the FDA. The company agrees with the FDA to prepare batches for the clinical trials that are between 80-120 % of the claimed dose. However, the batches manufactured and used for the clinical trials were 98, 102, and 101 % of the claimed dose. During the trials, these batches help a lot of people feel better and the FDA approves its manufacture and use for the proposed condition. The company manufactures many batches of the drug while their technology is patent protected and becomes able to manufacture these batches with a consistent potency between 102-103 % of its label claim. When the patent expires, generic manufacturers seek permission to manufacture this drug. In general, if the generic manufacturer meets the official specification of 80-120 %, it is considered of the same quality in this regard. Do you think that a generic version whose potency ranges between 85-95% of the label claim is the same as the brand version if the latter ranges between 102-103%. But dont get me wrong, the same thing may apply the other way around because you may find manufacturers of brand drugs that have manufacturing issues that the generic manufacturer is not facing. The law require generic drugs to be of equal performance but to fullfil this requirement applicants may compare their generic against the same quality-indicating requirements that the brand product is obligated to meet through quality testing but not to the actual performance trend that the brand product has become able to meet.
But there is another quality aspect that is more interesting and that most people, even within the pharmaceutical industry may not be aware off. Chemicals of the same identity are not necessarily the same. This means that the ibuprofen of manufacturer X may be indeed different from the ibuprofen of manufacturer Y. Have you tried a recipe that requires powdered sugar using granulated sugar instead. Both are sugar, there is no difference in the chemical composition of these two; however their physical properties are different and this difference make powdered sugar ideal for certain purposes. This may be true for certain drug products too and most importantly, its usually not taken into consideration dring quality testing. Why? Because it would be impossible to test every single physicochemical property of each end every drug product.
In the end, there is no one-size fits all answer to this debate. The patient will have to determine which products fullfil their needs better. Sorry for the long post.
Robert, I think you misunderstood part of the article (or I didn’t understand your argument). In the article, the generic brand’s liquid gel tablet is clearly represented. The brand name drug isn’t any more relieving for being a liquid gel- the generic brand has the same delivery method.
But I thought your powdered sugar/ granulated sugar metaphor was a good example.
wow, reading some of these comments, really?!? really shows that “you can lead horses to water, but many of them are gonna insist the bottled, named-brand stuff is better,” or, i’m not sure that’s the exact saying. but, i think my point is made. it really shows that people are quite the suckers when it comes to effective advertising. this example, liqui-gels, better, faster delivery? what? 5 minutes? do they really have you convinced that the acids in your stomach have trouble melting a caplet, and gelatin coating is soooo much faster? then it enters your blood-stream faster because it’s a liquid? so is the caplet after it melts. if this so true, then why aren’t prescription drugs delivered in this form, i mean branded ones? do you also believe that hospitals give patients only named drugs, they never do if there is an alternative/ generic. people shouldn’t really be proud that the placebo effect works so well on them, that’s not really a sign of intelligence. this reasoning is also why toothbrushes change design every year, they’re not really very different, but you can be charged full price again for a new product, whereas the old design was falling in price. what kind of toothbrush does your dentist give you?
The ignorance and misinformation in this article is both concerning and sickening. What happend to integrity of the media and checking facts? In the U.S., the FDA must approve generic drugs just as innovator drugs must be approved. The FDA requires the bioequivalence of the generic product to be between 80% and 125% of that of the innovator product.
How is that identical??
Also – what generic drug manufacturer ever developed/processed/invested in any form of intellectual molecular structure that has helped prolong the lifespan and living conditions of virtually everyone in the world. If every one bought generics, large pharmaceutical companies would go out of business and no one would further the intelligence or ability to improve health care. How is it that the Beatles are collecting millions of dollars a year still for songs – but companies (once a patent expires) gain no royalties. Maybe if royalties were paid by generic manufacturers our branded drug prices would drop due to longer revenue.
As a nursing student currently taking my pharmacology course, I have just looked at this as part of my course work, and Robert has hit the nail on the head. The generic drugs are similar, and under many circumstances (i.e. ibuprofen, acetaminophen, etc) work just as well as the brand name. The FDA inspects and monitors them just like they do any brand name pharmaceutical, and as a result they are safe to use and have the same effects. However – some (and I emphasize -some-) drugs vary slightly in manufacturing from the brand company to the generic (not through active ingredients, but through the other ingredients and the form of active ingredients in some cases). In these circumstances, it is really important that you know the difference between the generic and the brand, and be careful switching from one to the other. A good idea would be if your doctor prescribes you a medication, ask if there is a generic version, and if the generic version will have the same effects. In addition, if you start a prescription with a brand name drug, and then find a generic version, don’t just switch – check with your doctor first.
Why is there no generic brand name that is recognizable in every day households? We’ve got CVS seals of approval and Walgreens’, but if a company that dedicated itself to selling generic brand were to establish credibility with quality packaging, good pill coating, and a consistent track record public trust would be established.
marketing – placebo – profit. that’s what people are buying.
Yeah for generics, i really hope they find the next cure or miracle drug. Oh wait they don’t do that, that’s why name brand drugs cost so much. It cost billions to discover a drug. And only .1% of compounds tested make it to market.
I love how pharmas are the evil companies…lets just pray the sickness away.
C. A. S. – Check the figure with the price per dose comparison. It compares Advil liquid-gel and gelcaplets versus generic caplets and tablets.
j.f. – Drug delivery is much more complex than a solid drug dissolving in the stomach. Lets assume you are right, it may take just an additional five minutes to dissolve in the stomach but it may take an additional hour to reach the target cell/tissue/organ in order to undergo symptom relief. Manufacturers do not use gel-based or other delivery methods because these are patent protected technologies and have to pay royalties; there is no value added to their business.
Everyone – I do buy and consume generic drugs but before I do so, I do my due diligence. I check the manufacturer track record, complaints, practices, etc. There are excellent generic manufactures out there.
Due your due diligence and consult your doctor.
For anyone who thinks there’s absolutely no difference in name brand vs. generic, I can tell you from first hand experience there is. I’ve been given a prescription of Ambien (the sleep medication), and have been taking the name brand. When I found out there was a generic, I was ecstatic, as my co-pay would go down by more than half. When I started taking the generic, I didn’t sleep for the majority of the month I was taking it. When I switched back to the name brand, I had absolutely no problems sleeping again.
Also, I was given a prescription for Percocet for migraines. In that case, the generic actually helped me better than name brand.
I have to agree with Philip. It’s always best to check with your doctor, and find out if there’s any difference before making a switch.
I take Atenolol 50 mg as a migraine preventative. There is most definately a difference in different makes of the drug. Some brands work very well and some are absolutely useless. I got one particular brand and I had a headache every day, the next month I had a different brand and only had one or two headaches. A few months later I had the “bad” brand again and had a headache every day.So not only is there a difference between brand and generic, but also between different brands of generic drugs.
For what its worth: 20 some years ago I spoke to a pharmacist at a big hospital, he said brand x has same mg of med per dose but the “white stuff” that is 95% of the pill may not be soluble. Therefore it goes right through you without going into your body. Things may have changed.
It’s a consequence of being over-insured in this country. Insurance is meant to protect against catastrophic loss, not to pay for everyday expenses.
Let’s imagine that auto insurance was the same as health insurance. How often would you shop around for gas or oil changes if your insurer picked up 90% of the cost? No one would, yet this is exactly how we administer health insurance in this country.
The fix is high deductable plans that put some skin in the game for consumers so they can use their thrift to help drive down costs and increase competition.
Just a bit of information here: If a few advil tabs work for you, what you’ve got is most likely a headache – almost certainly not a migraine. If you haven’t got significant migraine symptoms such as nausea, vomiting, phonophobia, photophobia, hot flashes, chills, dizziness, and so on, it’s definitely not a migraine.
Although migraine sufferers differ in their symptoms, it’s safe to say that the majority suffer severe pain that can’t really be safely treated with ibuprofen. In my own case, if I haven’t any triptans or opiates available, I can chase 800 mg of ibuprofen with a shot of whiskey and get partial relief from a migraine. Unfortunately this will damage my stomach lining and intestines! Even without the alcohol chaser, ibuprofen rather commonly causes colitis or ulcers if used for ongoing migraine treatment. It’s just too chemically caustic in the high doses that are required for migraine relief.
Unfortunately, and perhaps because severe headache sufferers often want to have their pains classified as migraines despite the lack of other symptoms, the line has become pretty fuzzy. This confusion has worked to the advantage of drug companies and is reflected in the pricing of over-the-counter “migraine” medicines that contain active ingredients and dosages identical to those in cheaper “headache” remedies. Read the labels.
If you’ve got migraines, don’t take Advil or Motrin or even caffeinated aspirin until you’ve had a good long conversation with at least one doctor, and read up on the subject. You will almost certainly be better served by sumatriptan or oxycontin. If not, what you’ve got probably isn’t a migraine at all.
Generics are NOT identical to the brand name drug. Why do people insist on thinking that they are getting the same quality for less? THe “dirty little secret” is there is a 25% “variance” allowed by the FDA on the manufacture of generic medications. In addition, as someone previously mentioned if your pharmacy changes the manufacturer from month to month, depending on the lowest available price there will definitely be a difference in the quality (leading to less efficacy and an increased likelyhood of side effects).
I never get generics for antibiotic treatment. My father’s cardiologist told him to never get generics for any of his cardiac medications.
The public seems to forget that pharmacys are a retail BUSINESS. They benefit from “pushing” generics..the patient does not necessarily benefit. We all need to take responsiblity to be informed about our healthcare.