Whether you're shopping for blue jeans or CD players, chances are you'll end up buying a known brand. As consumers, we tend to trust the familiar names. But when it comes to medications, brand names aren't necessarily the best choice. Hundreds of medications now have generic alternatives, drugs that contain the same active ingredients -- often at a fraction of the cost.

An example: The antidepressant Prozac is now also available under the name fluoxetine (the active ingredient in Prozac). Prozac costs up to $151.80 a month for a dose of 20 mg a day. Compare that to fluoxetine which costs as little as $15 a month for the same dose, and saves the consumer more than $1,641 a year.

While cheap, off-label blue jeans tend to fall apart easily, generic drugs are required by law to meet the same standards as their brand-name counterparts. They must have the same strength, purity, and stability. Most importantly, they must be "bioequivalent," meaning the generic drug's rate of absorption into the blood must be within 20 percent of that for the brand-name drug. The producer also has to meet certain manufacturing standards. If the drug is too weak or too strong, too fast or too slow, it shouldn't make it to the drug store.

Despite these safeguards, doctors sometimes prefer to prescribe brand-name drugs, especially if the exact dosage is critical. Certain drugs -- including the blood thinner warfarin (brand name Coumadin), and the anti-seizure drug carbamazepine (brand names Epitol and Tegretol) -- require people to maintain a constant and precise level of medication in the blood over long periods of time. Doctors may be hesitant to replace these drugs with generics for fear of upsetting a delicate balance. If they do, they generally monitor the patient to make sure the drug is working correctly. If the exact dosage isn't critical, however, it's fine to routinely substitute a generic. (Check with your doctor if you have questions about a particular drug.)

In many cases, generics aren't an option because drug companies still have exclusive rights to the active ingredients. Whenever a company develops a new drug, it obtains a patent to protect the invention. No generic version can be marketed until that patent expires.

If your doctor prescribes a brand-name drug, ask if there's a generic alternative. If your medicine isn't available in generic form, there may be a similar one that is, or a cheaper version in your health plan's formulary (preferred drug list) that works the same way. If your doctor doesn't want to make the switch for medical reasons, make sure that the "no substitutions" box on your prescription is checked and the pharmacist fills the prescription exactly as written.

-- Chris Woolston, M.S., is a health and medical writer with a master's degree in biology. He is a contributing editor at Consumer Health Interactive, and was the staff writer at Hippocrates, a magazine for physicians. His reporting on occupational health earned him an award from the Northern California Society of Professional Journalists.

References

First published July 8, 2003
Last updated April 8, 2008
Copyright © 2003 Consumer Health Interactive

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