Friday, April 13, 2007

Why Do We Hesitate To Use Generic Drugs?

Despite being much cheaper than brand name drugs, why do we hesitate to use generics? Here are some of the reasons that I heard-

Concern about quality. There is a concern that generic medicines are not of same quality as brand names. Not many people know that generic medicines need to be approved by FDA just like brand name drugs. Read FDA’s statement on generics.

Visibility factor. Let us say there are five products belonging to a class of drugs. Four of them are generic. Only the company marketing the brand name is likely to be in a position to spend money on direct-to-consumer marketing. This can be in the form of TV and magazine advertisements or articles published in the print media and internet. This leads to better visibility. People tend to trust a name that they have heard of more than the one they have never heard of.

Anything less expensive must be lower quality. Human nature: in the absence of knowledge of a product, we tend to use price as an indicator of quality. We tend to think that more expensive must be better. We apply this principle to medicines too.

Just because research showed product A from a group to have beneficial effects does not mean product B, C and D from the same group will have the same effects. Let us say a research study shows that cholesterol-lowering medicine Zocor can dissolve blockages in the heart arteries. Zocor belongs to a group of medicines called statins. Can we safely presume that this is a class effect, and other statins like Lovastatin, Pravastatin will also do the same job? Moreover, nobody is likely to spend dollars on research involving a generic medicine because margin of profit on generics is low. How do you deal with this issue?
- You should compare the price of generic with that of brand name. If the difference is enormous, it may make case for cheaper generic.
- Unless one product from a group has been found to be inferior to another from the same group in a head-to-head comparison, there is no justifiable reason to pay many times over for a brand name.
- In order to find research on a generic drug, look for the research done on this product before it became generic. For example, Zocor is the trade name for the cholesterol lowering medicine Simvastain. You are unlikely to find research on Simvastatin after it turned generic. But you will find plenty of research done during the time it was exclusively marketed under the brand name Zocor.

Some products are generic and less expensive and some are brand name and more expensive. Does this not mean that generics are of inferior quality? When a company develops a new drug, it gets it patented. The patent protection gives the company exclusive right to produce that drug for several years. Once that patent expires, many different companies get to manufacture that drug. That is when drug is said to have gone generic. The cheaper price of generic drug is due to competition and not due to lower quality of the product.

How can you tell that effect from a generic is not just a placebo effect? In other words, how can we be sure, for example, that a generic aspirin pill contains aspirin and not some sugar powder? Before they are allowed to produce generics, the manufacturers have to meet standards set by FDA. As for placebo effect, some studies suggest that up to 30% of effects of all drugs could be due to placebo effect.

Where can we find cheap generic drugs? Unless you shop around, you can end up paying as much for a generic drug as for a brand name. Walmart and Target have programs where they sell a month’s worth of many generics for $4. You do not need proof of insurance for that. Make these pharmacies your first stop. If the drug you are looking for is not included in their $4 program, make sure to look at other pharmacies for best price.
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