An ex-girlfriend of mine insisted that I only buy name-brand over-the-counter drugs. She would get upset at me if I bought the cheaper one, implying that I didn’t care enough to spend the money on her.

Generic brand medicines are often significantly cheaper than their name-brand equivalent. So why doesn’t everyone just use the generic version? Is it really worth paying the premium for the name-brand drug, or can you get by with the generic one?

Why are generics cheaper?

Drugs get brought to market under a strict FDA process in which the drug eventually gets tested on real patients. The drug company will charge a high price for the new medicine to cover their research and testing expenses (and to make a nice profit!). When their patent runs out, that’s when other pharmaceutical companies jump in to capitalize on the drug with lower prices.

“Official” teaching

Though I went to medical school, the merits of generic versus name-brand medicines is not taught. The official stance is that they are equivalent; the FDA requires that the active ingredients are the same. Therefore, in theory, there should be no differences.

Reality

The reality is that there are differences. There are differences in the manufacturing process as well as differences in non-active ingredients. Because of this, I suspect there might be differences in the actual bio-availability of the active ingredient. The FDA does not go through the strict clinical trials for generic drugs. They only require that the active ingredients are equivalent.

In the news

Who knows how these non-active ingredients or the manufacturing process may affect the actual effectiveness of the active ingredient. There have been several cases described in which patients insisted that the generic medicines were inferior to the name-brand version.

Personal thoughts

Bottom line, I’m not sure whether it makes a difference. In part, it depends on what kind of medicine it is. Pain medications (tylenol, aspirin, narcotics, etc) and antibiotics I suspect would be perfectly fine if you bought generic. For other medicines, such as thyroid medicines, any psychiatric medicines (medications for which bio-availability might be an issue) I might be a little more cautious.

Recommendation

I suspect that for most cases, the generic drug will work just as well as the name-brand version. I recommend trying out the generic version and then waiting to see if you or your doctor notice a difference. I doubt that any harm would come to you this way. And you may end up saving a huge amount of money in the long run.

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