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Don’t judge a drug by its label: choosing between brand and generics

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Posted August 28, 2015

Prescription drugs cost a lot of money – most of that is paid by states’ health insurance systems, which are constantly looking for way to trim expenses. One of the ways to do this is to offer generic drugs – off-patent, non-brand alternatives of the original drugs. But is that a wise choice?

Source: fda.gov.

Source: fda.gov.

While most clinical data says yes, most patients and even physicians say no. Why the difference of opinion? A recent “What do people really think of generic medicines?” study says both groups lack simple education to realize that most generics are actually just as effective and safe to use.

“Generic” does not mean “falsified”

One of the main problems, the authors point out, lies within the misunderstood term itself. According to Drugs.com, “generic drug” is “exactly the same as the brand-name drug, but can only be produced after the brand-name drug’s patent has expired”. Generic drugs tend to be a lot cheaper than brand versions, since they do not have to offset the cost of research, competition pressure, patenting and so on.

For example, Ibuprofen was originally marketed as Brufen, but is now known under a variety of names, including Advil, Motrin, Nurofen and others. Yet a different name does not mean the drug is any less effective – generic drugs actually go through the same drug approval process, and are not licensed unless they match the original in dose, strength, the way they work or how they are taken, etc. With a few notable exceptions (e.g. antiepileptic drugs), clinical evidence suggest generics are safe and fine to use.

Yet, patients often take the word “generic” to mean something quite different, such as “counterfeit” – a cheap copy that is unlikely to be effective; or, in the most extreme cases, misread it completely (e.g. as “genetic’), which leads to a lot of confusion both in choosing drugs, and responding in relevant research surveys.

Physicians – just as confused?

Consult your doctor or pharmacist if in doubt? Unfortunately, this rule is not very helpful here either. Research shows that physicians have surprisingly conflicting opinions about generic drugs, which do not reflect the scientific evidence at all. As the researchers suggest, this might be due to confusing editorial articles, which counsel against generic drugs in certain cases (e.g. treating cardiovascular disease), even though the advice is in contradiction with actual clinical facts. Other issues include physicians’ lack of knowledge about drug regulation process, and inability to check out the actual evidence for themselves.

However, what the doctor says often trumps even patients’ own beliefs; that is why it is so important that physicians be correctly informed about the pros and cons generics.

Paradoxically though, pharmacists seem to be a lot more educated on the subject – yet patients usually favor advice of their doctor over that received in the drug store. On the other hand, pharmacists’ recommendation might not necessarily reflect their knowledge, especially if commercial factors are in play.

First impression matters

Moreover, as demonstrated by several studies in the field, patients are more likely to stick with generic drugs if they have had a positive experience in the past. Since generics are usually an economically favorable choice, and have the same level of effectiveness, the only thing that may stand in the way of a “positive experience” is likely to be personal attitudes, rather than anything else. For that reason physicians should invest enough time to explain the availability and equivalence of generic drugs to patients during their very first meeting.

As the authors of the present study suggest, simple “myth-busting education” could clear a lot of the confusion surrounding generic drugs, both for patient and physician groups. This would ensure the consumers feel more confident about cheaper versions of prescription and over-the-counter medications, resulting in large savings for both individual and state budgets.

Approved generic versions of brand drugs can be looked up at the FDA’s Orange Book here.

Written by Eglė Marija Ramanauskaitė

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