Advise Me

Brand-Name Versus Generic Medications: What’s the Difference?

One product many of us really came to miss early on in the global pandemic was our brand-name toilet paper (yes, TP!). We found ourselves scouring store shelves only to find (gasp!) generic, or cheaper knockoffs, of our favorite brands. Thankfully today, things have settled, and many brand-names are fully stocked, but why the harsh criticism of generics?

Things like generic cereal, knock-off purses and other off-brand products are often looked down upon as lesser versions of the real thing. They look the same, but they are a heck of a lot cheaper. And for many, cheaper equates to lower quality.

When it comes to generic medications, which can cost 80% to 85% less, it’s no wonder many of us are a tad bit suspicious. However, unlike your knock-off Prada bag, generic medications aren’t anything to sniff at. And here’s why.

“Generic medications contain the exact same active ingredients as their branded counterpart and are regulated by the Food and Drug Administration (FDA),” said Kelly Erdos, PharmD, a clinical pharmacist with Banner Baywood Medical Center in Mesa, AZ. “The FDA ensures that the strength, dosage form and route of administration (or the way the medication is taken—such as by mouth) is also the same for generics.”

Currently in the U.S., 9 out of 10 medications are filled with a generic. And this increase is a good thing as it helps create competition in the marketplace—meaning more accessibility for people like you and me.

So, the next time your pharmacist asks if you want generic versus a brand-name, think twice before declining. Here are some helpful facts about how generic drugs work.

Generic drugs are as good as brand-name medications

Unlike your generic cereal, generic medications are made to work the same as their brand-name drugs. Often, generic medications are even manufactured at the same facility as their brand-name counterparts.

“In this case, cheaper doesn’t mean lower quality,” Dr. Erdos said. “Generic medications have the same active ingredients and are held to the same high-quality standards as brand-name drugs.”

The FDA tests them to make sure they offer the same benefits as brand-name medications when it comes to quality, effectiveness, how much and how often you take them, strength and how you take them, whether pill, liquid or other means.

Generic drugs are less expensive than their brand-name peers

Did you know that the median cost of a medication that ends up approved by the FDA costs over $1 billion? This cost continues with pharmaceutical companies spending hundreds of millions of dollars on post-approval monitoring and research. Because of these high costs, a company has a 20-year patent on any new medication so there is a period of time where no generic options are available.

After the 20 years are up, it’s fair game for other companies. Generic medications usually cost much less because they don’t have to go through the same expenses in research and clinical trials to prove they are safe and effective. Plus, more competition in the marketplace can help drive down prices.

Generic medications may look different but that’s done on purpose

You may notice if you’ve recently switched from brand-name to generic that the pills look different. There’s a good reason for this. Thanks to trademark laws and branding concerns, generics have to look different than their brand-name counterparts. However, these differences won’t impact the medication’s effectiveness.

Are there times you should take a brand-name versus a generic?

When you take a narrow therapeutic index drug

In most cases, inactive ingredients—things like dyes, fillers and preservatives—are not a major factor that many patients need to be concerned about or consider. However, in situations where a medication has what’s called a narrow therapeutic index, a small difference in an inactive ingredient, it may become an issue. Drugs with a narrow therapeutic index can be difficult to dose because even a very small change can impact if the medication will stay in the desired range.

Blood thinners, like warfarin, and medications used to regulate the thyroid, like levothyroxine, may need to stay consistent,” Dr. Erdos said. “In these cases, patients are often encouraged to stick with the same brand or the same generic to avoid unnecessary changes.”

When you don’t do as well.

Like with any changes to a medication (whether generic or brand-name), it’s important to monitor for side effects and discuss them with your health care provider.

“For example, if you switch from a brand to generic of your blood pressure medication, and your blood pressure is no longer controlled, you want to explore if the change had any impact on that result or if another factor is at play,” Dr. Erdos said. “The same goes from switching from one generic brand to another. If there is a switch and then a patient starts to have problems or side effects that were not previously there, the patient needs to discuss the issue.”

Your local pharmacist can assist you in seeing if the non-active ingredients are different and may be causing the problem. In general, most people do very well with generic medications, and brand-names are not usually necessary.

Remember, the best medication for you is going to be the one you can afford so you can take it regularly.

“You can always try a generic medication first and if it’s not tolerated, the brand-name can then be tried to see if there’s a difference,” Dr. Erdos said. “In many situations, it may be the medication itself that is not a good fit for the patient (brand or generic), so an alternative drug class may be tried.”

Got more questions about the medications you’re taking?

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