Are Brand Name Drugs Better Than Generic?

The decision to go brand name over generic when choosing prescription drugs is usually far from scientific.  In fact, it tends to boil down to the simple question:  “Eighty dollars or ten?”

Because while the subject matter is entirely scientific, we’ve been conditioned to believe that the difference is so minimal that the price supersedes potential risk.  Our doctors support the trade-off and from what we can tell, there’s no difference!  So when the question over $80 or $10 arises, we chose $10.  We are happy about our savings and leave Walgreens with a smile..  an hour later, however, we’re left wondering if we made the right choice…

The debate over whether brand name drugs are better than generic is one that is frequently discussed among healthcare professionals, and the conclusion seems to be… sometimes?   Which leaves us with an alternative question, “When is sometimes?”  In what situation does an extra $70 bucks spare us another trip to the hospital?

In order to come up with the answer, I researched the debate online everywhere from NYT, “Not All The Drugs Are The Same,” to Crazymeds.com, “Brand Name versus Generic Medications,” and what I found was fairly consistent – the question of whether brand name drugs are superior was dependent on the problem, patient and situation.

For example, in multiple studies around the treatment for epilepsy, neurologists found that patients who switched from a brand-name product to a generic one had more seizures or higher hospitalization rates.

The New York Times quotes Kimford Meador, a professor of neurology at Emory University:

“For many drugs, generics are just fine.  But when you’re taking a seizure medication, the therapeutic window is narrow.  If the absorption of the drug is slightly different between brand and generic or between generics, then the patient could have a seizure, and that seizure could lead to serious injury or perhaps even death.”

You heard her – death – an important “sometimes” to distinuish, I’d say.  On the other hand, some specialists feel differently.  According to Medical author, Melissa Stoppler, M.D, there is no cause for concern:

“…There’s no truth in the myths that generic drugs are manufactured in poorer-quality facilities or are inferior in quality to brand-name drugs. The FDA applies the same standards for all drug manufacturing facilities, and many companies manufacture both brand-name and generic drugs. In fact, the FDA estimates that 50% of generic drug production is by brand-name companies.”

So what can we conclude in this debate between brand name vs. generic?  Small problems caused by differences between brand name drugs and their generic counterparts are not common, but exist. “Problems caused by switching from brand medications to generic drugs or one generic drug to another generic drug comprise, at the very most, 1-2% of the adverse reactions / negative experiences / “side effects…” Crazymeds.com concludes.  So if you’re not concerned, go generic.  If you are, research the particular drug to ease your worries.  At the end of the day,  few things in medicine are black and white.  The point is, the decision to go brand name or generic isn’t just a matter of $80 or $10.  Do you agree?

8 thoughts on “Are Brand Name Drugs Better Than Generic?

  1. J-kai Hsu says:

    I view generic drugs similarly to the generic food brands counterpart. I use to work at Safeway Corporate and worked on negotiating deals with vendors to make the Safeway brand equivalent for different types of products.

    For example Go2Cola was made by Coca-cola in 2006-2007. The difference in price point was $1 for a liter of Go2Cola vs $3 for a liter of Coke. Coca-cola claimed they will use the same ingredients for the Safeway generics brand as their Coke brand. In theory, the taste between Go2Cola and Coke would be the same. But in reality, the taste of Go2Cola pails in comparison to the Coke brand…why? because the devil’s in the details. It turns out that Coca-cola uses a slightly different formula (but still uses the same ingredients) to manufacture the generic brands. That difference is what causes the taste to be night and day.

    What does formula really mean? I’m no PhD scientist, but what I’ve researched is that formula is how something is put together. If the same methods of making generic foods is applied to making generic drugs, than I will always go for the real deal. What’s difference between $80 and $10. Your $80 is actually being well spent, as suppose to throwing away 10 bucks.

    • Kelsey says:

      The difference is the FDA ensures that there is no difference in safety or efficacy btwn generics and brand name drugs. The FDA doesn’t make sure that Go2Cola and Coke taste the same.

  2. Lindsay says:

    That’s a great way of thinking about it J-kai, and thanks for sharing! Just curious, what’s the biggest difference you’ve paid for a brand name over a generic? Also, have you ever noticed a difference between the two first-hand, in terms of side-effects and overall effectiveness?

    • Bujamg says:

      Great post, I just given this onto a friend who was doing a ltitle research on this. And he in fact purchased me dinner because I found it for him .. So let me reword that: Thanks for the treat! But yeah Thanks for spending the time to talk about this, I feel strongly about it and enjoy reading more on this topic. If possible, as you become expertise, would you mind updating your blog with more information? It is extremely helpful for me. Two thumb up for this blog!

  3. Penelope says:

    Another aspect of things is specific generic formulas. For example, many thyroid replacement hormones out there are generic. However, every generic thryoid replacement hormone has a slightly different formula. Within each generic company the hormones are very tightly controlled, but between the different companies there can be difference. What the endocrinologists I know recommend is getting prescriptions that write out specifically what generic you should be on because thyroid hormones do need to be regulated so closely. For example, if you are started out on Levoxyl (one of the generic brands) then that will be the formula your body has been attuned to and you should continue to always take Levoxyl specifically.

    I do wonder if that’s one thing that happened with the epilepsy patients in the study. It would be interesting to see a study that compared people who have always been on the same specific brand of generic and the level of seizure control compared to people who have always been on the name brand version of the same medication. Certainly among people I know there is anecdotal evidence that what brand of generic you’re on can make a big difference for conditions other than hypothyroidism that also require fine-tuned control, but I don’t know enough people with epilepsy to know if it would apply in that particular case. I could see, however, where epilepsy would be a condition where the control would need to be that fine-tuned.

  4. J-kai Hsu says:

    Lindsay, I didn’t realize you had replied, but I’m glad you asked.

    One example of generic vs branded that I’ve used is Nicoderm CQ and the Target generic Nicotine Patch. Yes I was smoker, but thank god for the patch (they really do work). On the packaging of the Target generic it says “Compare to Nicoderm’s CQ.” But what the heck does that really mean?

    1. Is it the same product as Nicoderm CQ without the brand and the heft price point
    2. Does it have the same effect and side effects?

    I was curious and I tried both, and let me tell you…it is NOT Compared to Nicoderm CQ and here is why.

    1. The patch is suppose to stick to your skin. It infuses doses of nicotine into your blood stream to curve your craving to smoke. Nicoderm’s patch will stick to your skin like epoxy and it won’t come off until you intentionally pull it off. The generic however is a different story. It will stick to you for ~4 hours and then it will start falling off. These patches are suppose to last 16-24 hours

    2. Effects. The side effect of Nicoderm is that it will make your skin a little red and itchy. To me, that just tells me the patch is working. It feels good and I get a slight high from it. The generic however does not give me a high and it feels like I’m wearing a sticker. Without the high, it didn’t really stop me from wanting to smoke. It is the high that makes me feel good and it stops me from wanting to smoke. The nicorette gum gives the same high effect, which is why it can be extremely addicting. I chose the patch over the gum, b/c the gum turns your teeth yellow and it can make you face look bloated.

    So at the end, was saving $20 to use a generic brand worth it? NO. It’s just doesn’t have the same effect. It’s all the little things that really REALLY makes the difference. I do believe the generic patch does infuse nicotine in your blood, but how it does is what makes a product great and what makes it crappy.

  5. Robert says:

    We have a balance of name brand and generic medications in our household to help with my wife’s condition, some based on cost and some based on availability of a generic version of the drug or not. Where we’ve had the ability to use a generic over that of the name brad we’ve seen no difference in quality of the treatment against the condition and the cost savings for us is immense.

    Flip side to this is a co-worker has seizures and the generic version doesn’t absorb the same way and is less effective against her condition. Her issue right now is cost of the namebrand being $600 per month out of pocket as her spouse’s insurance won’t cover this. She’s currently working with the insurance company and her physician to come to some sort of arrangement for the medication as she can’t afford that out-of-pocket expense . She’s also seeing what financial programs the pharmaceutical company may have to help alleviate costs to allow her to continue treatment.

    In both cases, we’re not talking a difference of paying $20 or $10. We’re looking at the costs being a savings of hundreds of dollars or more (in our case we’re lucky that the medication is covered under a mailorder provision otherwise we’d be looking at $1200 per month for the medication out of pocket).

  6. Irina I says:

    This is an extremely important discussion and I’m glad you are bringing this up. In my understanding, it all comes down to absorption, like you’ve mentioned in the case of the epileptic drug. I have a doctor who has prescribed specifically a brand name drug (and not generic) for a certain condition, while other drugs he has prescribed can be generic or brand name. So in the case of the first drug, it comes down to absorption.

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