Generic Prescriptions- Worth the Price Break?

Many patients understandably prefer generic medications because of cost. Most physicians are very in tune with this, and will give you their honest opinion about which drugs seem to have clinically equal generics. In my personal clinical experience, I would broadly say that most generics are perfectly fine, but I see I higher rate of patient satisfaction with name brand products in hormones (primarily birth control and thyroid), certain migraine medications, and a few specific antidepressants. That being said, it is VERY patient specific- the only way to know if you tolerate a generic better or worse than a name brand is to try it. For example, while probably 95% of my patients who take sleep aids are happy with the generic, there is a subset that find a dramatic difference between that and name brand, from deriving a morning "hangover" with the generic to simply a decreased effectiveness.

The FDA requires that generic prescriptions have the same intended use, dosing, delivery system, and safety as the original drug. The active ingredients are the same, but there can be different byproducts in the generic which may cause a reaction.

Why do doctors ever write brand names on a prescription if they want you to have the generic? The answer is simpler than you might think- brand names are usually shorter. In fairness, doctors also have their "favorite" drugs, and we think of them often with their trade name. In the old days of drug company-sponsored elaborate trips and gifts, I'm sure physician "favorites" were indeed swayed by the pharmaceutical companies, but I can attest that the vast majority of doctors that I know and work with have "favorites" based on what WORKS for patients- combining effectiveness, side effects (good and bad), ease of dosing (the fewer doses per day or even week, the better), delivery system (shot vs. pill vs. patch or cream), and yes, COST.

BOTTOM LINE: Don't hesitate to ask your doctor what she thinks about the generic alternatives to your prescription medications, and together you will figure out which name brand medications are important for your health.