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Living Well

Save by Switching to Generic Rx

Last updated: Oct 15, 2019

Are you skeptical about generic drugs, worrying that a less expensive generic equivalent couldn’t possibly match up to the name-brand drug?

Summit Medical Group’s Laura Balsamini, PharmD, BCPS, would like to set your mind at ease—and help you save a bundle.

The average cost of a generic drug is 80 to 85 percent less than its brand-name counterpart, and 8 out of 10 prescriptions filled in the United States are now for generic drugs, explains Balsamini, SMG’s vice president of pharmacy services. Acceptance of generic medicines is growing, but Balsamini thinks even more people could benefit.



Strict Standards Followed

“Generics are scrutinized. The Food and Drug Administration evaluates and takes a scientific look at the brand medications and the generics, and patients can know that a generic drug wouldn’t be approved if it didn’t meet the strict standards the brand-name has met,” Balsamini explains.

These are some of the key steps before a generic drug can be sold:

The FDA ensures the safety of the raw ingredients for both generic and brand-name drugs and when ingredients are identified to have impurities, the FDA will recall these agents from the market.

The FDA reviews the active ingredients, strength, purity, and dosage form—if the brand-name drug is a capsule—for instance, the generic must also be in capsule form—and it must be used to treat the same condition as the brand-name medicine.

The manufacturer must prove the generic will perform in the same way and is as safe and effective as the brand-name drug. A “bioequivalency” test is required. In this test, a person is given the generic drug, then is given a blood test to be sure the same concentration of medicine is in the bloodstream as was the case for the name-brand drug

Fewer Reasons to Skip Medicines

Because of their lower cost, Balsamini sees generics as improving “medication adherence.” A common medical adherence issue occurs when a cash-strapped patient stretches out an expensive daily medication by taking it only every other day. Not surprisingly, these attempts at cost-saving have an impact on patients’ health outcomes.

“Physicians are becoming more supportive of generics because they’ve seen the benefits,” Balsamini notes. She suggests people discuss generic medicines with their physicians as well as their pharmacists. The doctor might not realize how expensive a certain drug is, or realize that a generic option recently became available. “Talking to the doctor also provides patients with peace of mind to know that, you know what? I can try this and it is safe.”

Balsamini also hopes the savings on generics will limit the temptation to buy prescription drugs online or from pharmacies outside the United States. “You just don’t know what you’re getting. You don’t know if what’s on the label is in the pill,” she says.

Why Generics Are Cheaper

Not everything about generic drugs is identical, of course. Brand-name drugs are more expensive because the drugmaker has done the research and development, then clinical trials to ensure safety and effectiveness, and finally advertising and marketing to tell the world about the new drug. All those costs are the reason drugmakers are allowed to have a patent on their drugs for 20 years—from the point of discovery—to recoup their expenses.

Generic drug manufacturers are not required to repeat clinical trials done for brand-name drugs, and they are allowed to have different inactive ingredients—such as dyes—than the name-brand drugs. Because of this variation, some people may encounter side effects or allergy-related problems.

Rather than give up on the generic drug, Balsamini suggests working with your pharmacist to try a different generic manufacturer. “Nine out of 10 times, the patient does well” with the alternative, she says. Still, if you have problems after trying a few alternatives, Balsamini suggest returning to the brand-name drug.

Exceptions to the Rule

While generic medicines are the best bet in most situations, there are a few exceptions. Certain drugs have a narrow range between being safe and effective and being harmful, requiring close monitoring.

There is one widely used medication that falls into this category. If a person has been managed long term on the brand-name blood thinner Coumadin, for example, it would usually be best to stick with the brand-name rather than switch to the generic warfarin.

Balsamini notes that if a patient has already been using the generic for this drug and is doing fine, there is no need to change. “It’s preferable for people to stay on what they’ve started on,” she says.

In most cases, though, the generics will be fine. “I, myself, had my parents take generics. They were very happy to save a lot of money out of pocket,” says Balsamini. “I wouldn’t preach what I don’t practice.”

Find Out More
Check out Laura Balsamini’s podcast,
Generic vs. Brand-Name Medications: Is There a Difference?” 
and her Mythbusting video,
Are Generic Medications as Effective as Brand Medications"