Are generic drugs as good as brand-name medicines?

Brand name vs. generic drugs | Biosimilar vs. generic drugs | When to choose generic | When to choose brand

You have a raging headache so you head to the drugstore searching for relief. The choices are overwhelming. Should you opt for an over-the-counter generic ibuprofen, or go with a well-known brand-name version like Advil or Motrin? Should you ask your healthcare provider to prescribe Lipitor, or is atorvastatin just as good? The brand names are backed by big, successful drug makers with well-paid scientists. Their drug products must be superior to generic drugstore brands, right? But the price is giving you pause. Some of the brand names cost nearly twice as much as the generics. Which one should you choose?

According to the U.S. Food and Drug Administration (FDA), generic drugs are “created to be the same as an already marketed brand-name drug in dosage form, safety, strength, route of administration, quality, performance characteristics, and intended use.” Generic drugs contain the same active ingredients as brand-name ones, and thus have the same benefits, risks, and side effects. In 2016, research notes about 90% of prescribed drugs in this country were for generics.

Are generic drugs as good as brand-name medications?

Yes, say experts. In fact, one study looking at over 3,500 people found that those who took generic versions of prescription drugs for chronic conditions like diabetes, high blood pressure, and depression had “comparable clinical outcomes” compared to those who took the brand-name products.

“Cheaper does not mean lower quality,” says Jawad N. Saleh, Pharm.D., a clinical manager of pharmacy services at the Hospital for Special Surgery in New York City. “Generic medications are held to the same high-quality manufacturing standards as brand-name medicines.”

Before they can bring a generic drug to market, the FDA requires drug manufacturers to submit what’s called an abbreviated new drug application (ANDA).  “When a new brand-name drug is developed, its developer must prove to the FDA that it’s safe and effective,” explains Brittany Riley, Pharm.D., a clinical associate professor at Marshall University School of Pharmacy in Huntington, West Virginia. “That approval process is abbreviated for generic drugs, because the generic drug company just has to ensure the drug has the same active ingredient, strength, dosage form, and route of administration. In other words, it has to show it is bioequivalent to the brand-name drug. Generic manufacturing plants must pass the same quality standards as the brand-name manufacturing plants.” 

What’s the difference between brand-name and generic drugs?

Basically, there are three: price, inactive ingredients, and appearance.

Price

According to the FDA, generic medicines can cost up to 85% less than their brand-name equivalents. The lower price tag is due to the fact that generic manufacturers don’t need to perform all the costly clinical trials showing safety and efficacy that brand-name manufacturers need to supply before they can obtain FDA approval. What’s more, manufacturers of generic drugs typically don’t pay big bucks for branding and advertising of the product.

Brand-name drugs are under patent for about 20 years. After that time, manufacturers lose their exclusivity to it.  At that point, multiple companies can bring a generic drug to market, thus creating more price competition.

Some popular generic drugs and their brand-name equivalents are:

Compare prices of popular brand-name vs. generic drugs
Brand name	Generic name	Price
Ambien	zolpidem	Compare prices
Ativan	lorazepam	Compare prices
Flonase	fluticasone	Compare prices
Glucophage	metformin	Compare prices
Prilosec	omeprazole	Compare prices
Proventil	albuterol	Compare prices
Wellbutrin	bupropion	Compare prices
Xanax	alprazolam	Compare prices

Inactive ingredients

Inactive ingredients are the dyes, preservatives, and fillers manufacturers use in their drugs. They don’t have any therapeutic value. Meaning, they don’t affect how well the drug treats the medical condition you’re taking it for. And, they can vary between generic and brand drugs. 

Appearance

Thanks to trademark laws and branding concerns, generics have to look different than their brand-name counterparts. They might be a different color or have a different flavoring. But these differences won’t impact the drug’s overall effectiveness. 

What is the difference between biosimilar and generic drugs?

To understand what a biosimilar drug is, you first have to understand what a biologic drug is. Biologics are drugs produced by or that contain living organisms (think proteins, cells, DNA, or blood components). Vaccines and some hormonal therapies are examples of biologic drugs. 

Unlike generic drugs, which must have the same active ingredients as the brand-name ones, biosimilar drugs are what the FDA calls “highly similar” to an already-approved FDA biologic drug (called a reference product). But they may have minor differences. In other words, unlike generics, they are not identical to the drug they are modeled after. For example, Cyltezo (adalimumab-adbm) was approved by the FDA as a biosimilar of Humira (adalimumab) to treat rheumatoid arthritis.

“A biosimilar must behave in a way that is not meaningfully different from the brand-name drug,” explains Dr. Riley. “But due to the way biologic drugs are produced [from living organisms], it would be difficult to create true [chemically identical] generics to them. Therefore, the FDA created the biosimilar pathway, which helps to decrease cost associated with the biologic agents, which are typically very expensive medications.” They are similar to generics, in that they are typically less expensive than their biologic counterparts.

Why should you choose generic drugs?

Whether you choose a generic or brand-name drug will likely come down to price, health insurance coverage, and personal or prescriber preference.

Price

As noted above, generic drugs can be wildly less expensive than their brand-name equivalents. For example, brand name Ambien can cost over $600 for a monthly supply, while the generic zolpidem can cost as little as $60 for the same amount. With SingleCare, you can get an even lower cost around $30!

Insurance coverage

Because generic drugs are cheaper, insurance plans are more apt to cover them. This means that your copay will be more affordable if your healthcare provider prescribes a generic drug instead of the brand name. In one recent study, researchers compared Medicare Part D coverage of more than 1,300 generic and brand drugs and found that 84% of the plans only covered for the generic drugs while 0.9% only covered for the brand-name ones (15% covered both). If cost is an issue, don’t hesitate to ask your healthcare provider if a generic alternative is available.

Personal/prescriber preference

State laws may vary, but if you prefer to save money, have your prescriber indicate “substitution permissible” on the prescription or write the prescription with the generic name. If there is a generic available, the pharmacist will fill your prescription with the generic. You can always ask the pharmacist before your prescription is filled, if you have questions on pricing and availability of generic alternatives.

When a generic may not be a good idea

Most of the time, brand-name drugs and their generic alternatives are interchangable. There are a few isolated cases where making the switch can impact your health. One example, says Dr. Saleh, is seizure medication. Changing from a brand-name antiseizure medication to a generic one may result in a loss of seizure control. Generic drugs for certain eye conditions may not produce the same result in patients. 

But, in general, switching to a generic makes sense when there’s one available and you’re comfortable making the swap. Talk to your healthcare provider about what’s the right choice for you. If it’s a choice between not taking the medication because of cost, and a generic, the generic is the obvious right choice.

“Since generics are the bioequivalent to brand-name medications, switching to a generic whenever available can be a good tactic to reduce costs to a patient, pharmacy, or institution,” says Dr. Saleh.

For even greater savings, search singlecare.com to see how much you can save on the generic version of your medication.