They're chemically identical and nearly always much cheaper
February 2, 2015
Mrs. Thomas took her prescription for her heart medication to the pharmacy to have it filled. “I don’t want one of those generic drugs either,” she stated. “I want the real thing.” So, are brand name drugs really better than generic version?
According to recent information published in Consumer Reports, the answer is an emphatic no. To win approval from the Food and Drug Administration (FDA), the manufacturer of the generic medication must show that the drug has the same active ingredient and that it is identical in strength, dosage form, route of administration and labeling as the brand name drug.
The company must also demonstrate that individuals absorb and excrete the medication at the same rate. Says a pharmaceutical scientist who worked for decades at the FDA, “People may think that brand name products are better because they’re more expensive, but the body doesn’t know whether the drug came from a brand name or a generic company.”
When a medication goes off patient, other pharmaceutical manufacturers are free to create generic versions of that drug. The consumer can save considerable money by switching to the generic form of that drug. But the price of the drug does not go down immediately after the generic is released to the market.
Let’s take a mythical medication, Fat-no-more, used for weight loss, as an example. The brand’s retail price for a month’s worth of Fat-no-more is $220. Then it goes generic. After one year, the generic price is about half: $110. After 2 years on the market, it goes to $48. After 3 years, the price is $12.
Why does it take so long for the price to go down? When a drug is about to go off patent, manufacturers file lawsuits to challenge the patent. The company that wins obtains a 6-month period to sell that generic exclusively. When that period is over, other generic houses can produce that drug, forcing the prices even lower. Today, 8 out of 10 prescriptions filled in the US are for generic drugs, says the FDA. Cost is a big factor because generics can be as much as 85% cheaper than their brand counterparts.
Costs soaring
The cost of generic drugs is soaring, however.
Relatively cheap as they are compared with brand name products, the price gap between brand name drugs and generics is beginning to narrow – and it is not because proprietary drugs are getting cheaper. A 2014 article in the New England Journal of Medicine revealed that certain older drugs, many of which are generic and not protected by patents or market exclusivity, are now also extremely expensive.
Examples:
- Captopril, used for hypertension and heart failure, increased in price by more than 2,800% between November 2012 and November 2013, from 1.4 cents to 39.9 cents per tablet.
- Doxycycline, a broad-spectrum antibiotic that has been in existence since 1967, zoomed in price from 6.3 cents to $3.36 per pill.
- Clomipramine, a long-established antidepressant, has jumped in price from 22 cents to $8.32 per pill.
- Digoxin, used for atrial fibrillation (irregular heartbeat) and heart failure by millions of Americans, saw a price increase of 637% between 2002 and 2013.
- Some generic versions of codeine formulations for migraine, thyroid medicines, as well as the generic steroid prednisolone, have all more than doubled in price since last year, according to industry analyst EvaluatePharma.
Yet, low-cost generics have saved the health care industry $209 billion in 2012, $239 billion in 2013 and almost $1.5 trillion over the past decade, according to the most recent data.
Sadly, prices have spiked for certain medications because of shortages of raw materials, supply disruptions or other factors that have led some manufacturers to stop producing those medications, resulting in a near monopoly. The number of manufacturers of digoxin, for example, has fallen from 8 to 3.
As Aaron Kesselheim, MD, assistant professor of pharmaceutical economics at Harvard Medical School, stated, “Studies show it is not until you have 4 or 5 companies manufacturing the same generic will the prices really drop.” Therefore, ask your doctor to switch your medications to another drug in that class if you are spending more money than you would like.
Mrs. Thomas’ pharmacist explained the generic process to her and she agreed that perhaps the generic form of her pricy heart medication was as good as the “real thing” and she agreed to switch to the generic. She was pleased at the money she saved, as well as the confidence she gained from her pharmacist’s counseling.
