Generic And Brand Name Drugs: Understanding The Basics

Generic and Brand Name Drugs:Understanding the BasicsWe’ve been there. We can help.

Joe has just been diagnosed with bipolar disorder. After talking to his doctor, he decidesto see a therapist and go on medication. Joe’sdoctor gives him two weeks’ worth of samples fora brand name drug called SteadyMood and askshim to come back to see him in two weeks. Whenhe returns, Joe’s feeling a little better and agreesto keep taking SteadyMood for another month.When he gets to the pharmacy, Joe learns that his insurance plan’s co-payfor a month’s supply of SteadyMood is 40. This seems a little expensive to him,so he asks the pharmacist about it. His pharmacist tells him that he’s fortunateto have insurance coverage; without it, the brand name would cost 100. Joeasks if there’s another drug he could take that costs less. The pharmacist tellshim that his medication comes in a generic form. His insurance co-paywould be 10 for a month’s supply of the generic, but his doctor would haveto approve it.The pharmacist calls Joe’s doctor and gets approval to fill his prescription withthe generic. The next morning, Joe opens the bottle and sees 30 round, whitepills. He’s confused and believes there must be some kind of mistake since theSteadyMood samples his doctor gave him were pink ovals. Joe calls his pharmacist who tells him that the round, white pills are the generic form forSteadyMood and they should work just fine.After taking the generic for a month, Joe’s feeling much better. He returns tothe drugstore with another prescription from his doctor, and this time, itallows for generic substitution. Joe fills his prescription and leaves. The nextmorning, he opens the bottle to find a completely different-looking medicine—now, the pills are yellow and square. Joe’s frustrated and even moreconfused. Is this a different drug altogether? Is it another type of generic drug?Should he simply stay with the brand name version that his doctor originallygave him? Many of us have found ourselves in situations like Joe’s and canunderstand his frustration.2

Making Smart Choices about MedicationsMany prescription medicines are available to treat depression and bipolardisorder. The pharmacist might ask ifyou want your prescription filled withthe brand name medicine or the genericmedicine. Each option has pros andcons to consider. This brochure willgive you the information you need tohelp you decide what’s right for you inyour treatment and recovery plan. You’lllearn that the decision to choose abrand name or a generic is one thatinvolves you and your health care team.“The decision to choose a brand name or a genericis one that involves you and your health care team.”What are brand name and generic drugs?A brandnamedrug is amedicinethat’s discovered,developedand marketed by a pharmaceutical company. Oncea new drug is discovered, the companyfiles for a patent to protect against othercompanies making copies and selling thedrug. At this point the drug has twonames: a generic name that’s the drug’scommon scientific name and a brandname to make it stand out in the marketplace. This is true of prescription drugs aswell as over-the-counter drugs. An example is the pain reliever Tylenol . The brandname is Tylenol and the generic nameis acetaminophen.Generic drugs have the same activeingredients as brand name drugs alreadyapproved by the Food and DrugAdministration (FDA). Generics onlybecome available after the patent expireson a brand name drug. Patent periodsmay last up to 20 years on some drugs.The same company that makes thebrand name drug may alsoproduce the genericversion. Or, a differentcompany mightproduce it.3

What’s the difference between brand nameand generic drugs?It’s important to remember that there arebrand name and generic versions of medicines not only for mood disorders but forother conditions as well—high bloodpressure, diabetes, etc. Today, about 50percent of all prescriptions are filled withgeneric drugs. The FDA has establishedstandards for generic drugs that mightseem complicated but are really quitesimple.The SimilaritiesThe DifferencesAccording to the FDA, to substitute ageneric for a brand name drug: It must contain the same activeingredients (the chemical substancethat makes the drug work).Here’s how generics and brand namedrugs differ: They look different. (Federal lawrequires this.)– They could have different sizes,shapes, colors or markings.– They have different names. It must have the same dosage strength(the amount of active ingredients, forexample 20 mg or 40 mg). It must be the same dosage form (thatis, it needs to be available in the sameform as the original—for example, asa liquid, pill, etc.). It must have the same route of administration (the way the medication isintroduced into the body). It must deliver similar amounts ofthe drug to the bloodstream (thatis, it needs to deliver a comparableamount of the drug into the bloodstream within a similar time periodas the brand name drug). They might have different inactiveingredients.– Drugs are made up of both activeand inactive ingredients. Some people may be sensitive to inactive ingredients. For example, some peoplehave reactions to certain dyes used insome drugs. The generic costs less than the brandname drug.– The cash price and insurance co-payis usually lower. Generics can costbetween 20 and 80 percent less, butkeep in mind that cost is only onefactor when considering the rightmedication for your condition. Generics vary by manufacturer, whichmeans you could receive different versions based on where you purchaseyour medications and what type ofgeneric they dispense.– Different pharmacies carry differentgenerics.– Even the same pharmacy may changegeneric suppliers.4

Insurance PlansFor most consumers, their insurance plan determineswhat they pay for medication. Both private and government insurance companies promote using genericdrugs when possible. They might even require substituting a generic for a brand name drug. As in Joe’s story, the co-pay for the genericmight be 10. But the co-pay for the same dosage and amount of the brand namemight be 40. Some insurance plans might require you to pay the entire cost ofthe brand name drug if you don’t accept the available generic.Why do brand name drugs cost more than generics?It takes several years, costly scientificdevelopment and many clinical studiesto get a drug approved. Manufacturersof new brand name drugs (also called“pioneer drugs”) usually take on theresearch and development costs for newmedications. These research and development costs, along with marketing costs,account for most of the higher prices wepay for most brand name drugs.In contrast, generic drugs have lessresearch and development costs since theoriginal manufacturer has already donemany studies to make sure the drug issafe. These savings are passed on to theconsumer.However, while the brand name form isstill protected by its patent, no genericscan be produced. And, if a brand namedrug has only just recently lost its patent,there may only be one generic form available. Usually, when there’s only onegeneric option available, it will be moreexpensive.5

Since a drug’s generic and brand name versionslook different, how can I be sure I’m getting the rightmedication at the pharmacy?Be sure to check your medication labelsand confirm the name and dose of yourprescriptions. Generic forms of a brandname drug should all have the samename, no matter what company producedit. If your original prescription was writtenfor the brand name, and the doctorallowed generic substitution, the bottlelabel should indicate this. Never assumethat the drug is identical if it looks different. Your pharmacist can verify this foryou, and your doctor can also confirm thiswhen you bring your medication bottle toyour appointment. If you have a genericprescription, to reduce confusion, askyour pharmacist to refill your generic prescription with the same drug, from thesame manufacturer, each time.Why doesn’t my doctor automatically prescribegeneric drugs?Not all medications havea generic form available.Some doctors might notbe aware of recentlyapproved generics.Doctors also differ intheir beliefs towards, andexperiences with, different medications. Our medical histories,insurance and personal preferences mayalso influence our doctor’s decision. It’simportant that we consult our doctorsbefore deciding if ageneric is right for us.If you’re interested intrying a generic drug,first find out if it’s available. Ask your doctor.Also, your pharmacistwill have a list of generic drugs and canusually tell you how much they will coston your insurance plan.What if I have a preference?If you and your physician determine thateither a generic or brand name drug isbest for you, make sure your pharmacistknows. If your doctor writes your prescription specifically for the generic, that’swhat the pharmacist will give you. Asnoted earlier, there might be several6different generic drug manufacturers.If you require the brand name drug,ask your doctor to indicate that on yourprescription. Different states have different laws and regulations on genericsubstitutions.

Making an informed choiceIs the brandname medicineor the genericversion the bestoption? Theanswer is that itdepends. Thereare several different things thatyou and your doctor can consider: How difficult it is to control yourmedical condition How sensitive you are to changesin medication treatment How difficult it is to pay for yourprescriptions, including whetheryour insurance covers prescriptionsDrug FormulariesEach insurance plan has a formulary, a list of drugs that it approves and prefersfor certain medical conditions. (Public insurances, like Medicaid and MedicarePart D, also have formularies.) A formulary lists which drugs the plan covers andat what level they’re covered. Ideally, insurance companies base this list on thebest medical information available at the time. They negotiate the prices of drugson their formularies with drug manufacturers. And this often means dollar savingsfor the consumer.When you enroll in an insurance plan, you should receive its formulary. A bookletand/or a website usually containthis information. If you’re considering changing insurance plans, compare the cost of your medicationson the formularies.It’s important that we consult our doctors beforedeciding if a generic is right for us.7

Prescription Checklist for Informed ConsumersUse the checklist below for either option to help you get the most out of your decision.If you and your doctor wantthe brand name drug:If you and your doctor wantthe generic drug: Have your doctor indicate on the prescription that it is for the brand namedrug only. Know the drug’s brand name as wellas its generic name. Tell the pharmacist you want thebrand name version if your prescription doesn’t specify which. Know how to identify the genericfrom the label on your medicinebottle. Check to make sure the medicine youget is the brand name drug. To help cover the cost:Ask your doctor for samples of anynew drugs that you are trying.Ask your doctor about any couponsor voucher programs.See if you qualify for financialassistance by checking outprograms like these:Know what the generic looks like(color, size, shape, markings), especially if it looks different than it did themonth before or if you use a daily orweekly pillbox. Check with your pharmacist to be surethat you’re getting the right drug. Tell your doctor about any differencesyou might experience taking thegeneric.Partnership for PrescriptionAssistance (PPA)(888) 477-2669www.pparx.comTogether Rx Access(800) 444-4106www.togetherrxaccess.com8