Generic Drugs vs. Name-Brand Prescription Drugs

When I switched endocrinologists, my new doctor wasn’t happy to see I was taking the generic version of Synthroid, called levothyroxine, to treat my Hashimoto’s thyroiditis autoimmune disease. We discussed how my previous endocrinologist didn’t seem to mind, as he’d checked off the “allow generic substitution” on the prescription, which allowed my pharmacy to fill it with the generic version to begin with.

New doctor said there’s not always a consistent dosage in the pill because the Rx can be filled with generics from different manufacturers — and particularly now, I need my dosing to be precise. I wound up switching back to the name brand, Synthroid, and I believe I feel the difference. I feel that it’s treating my condition better. Of course, instead of paying $10 for a 30-day supply of the generic version, levothyroxine, I now pay $25.69 for that same 30-day supply, but it’s the original, Synthroid — it would normally be $30 with my health insurance’s co-pay for brand-name prescriptions, but since it costs less than that, I’m charged the lower price.

The FDA claims the active ingredients in generic drugs have to be the same. But there are other ingredients such as fillers that can cause the body to absorb the medicine differently than if it were the brand-name drug. I don’t find this to be true of every generic — I still use generic versions of Tylenol, Motrin, DayQuil, antibiotic first-aid cream and the like — but I feel the difference with the Synthroid. I’ve also used generic versions of birth control and antibiotics with no problems.

Differences Between Generic & Brand-Name Prescription Drugs

1. The names. Brand-name drugs have, well, branded names — names that are heavily featured in marketing materials and advertisements. They’re on notepads, pens, clipboards and stethoscope covers used by doctors and nurses. Free samples are given to doctors’ offices in the hopes that they’ll be more apt to prescribe the drug to patients if they can give them a “starter” pack.

2. There can be some variation in the absorption rate. The active ingredient has to be the same, but the amount of time it takes for the drug to be absorbed in the body can differ by up to 20 percent. But that’s not supposed to affect how the drug works on patients.

Pros & Cons of Generic Drugs

PRO – Generics are cheaper — sometimes, a LOT cheaper. That’s much easier on the wallet, especially if you’re on a long-term drug, like I am. I’ll be taking some dosage of Synthroid — whether name-brand or generic — for the rest of my life.

PRO — Generics are regulated by the Food & Drug Administration. Which means, theoretically, you should always have the same amount of active ingredient in your pills.

CON — A lot of doctors don’t trust generic formulations, even though they’re suposed to be regulated. My doctor offers a prime example of this mistrust.

CON — While the FDA says the absorption rate of the active ingredient in a generic prescription drug has to be within 20 percent of that in the brand-name drug, the FDA doesn’t follow up to enforce that rule. That’s not very reassuring!

There is always going to be a lot of back-and-forth about whether generic prescription drugs can 100-percent be confidently used to replace brand-name prescription drugs, so it’s best to ask your doctor about which is preferable in your specific situation.

10 comments to Generic Drugs vs. Name-Brand Prescription Drugs

  • Ammy

    Generics are as same as brand, they are having same active ingredient and only the inactive ingredient differs.

    So for me taking generics or brand is same since the effectiveness of the generic medication is going to be same as that of brand.

    I get generics at low cost from InternationalDrugMart

  • darlene

    i thought i was having a problem with generic seraquel. it’s been several months now. in the beginning i thought it was me, but i keep having the feeling that the dose in each pill is not consistant. after reading this article, i’m inclined to believe my suspicions are correct. i have to take more than i am prescribed and it takes longer for me to fall asleep, even up to several hours. i dont think my insurance will pay for name brands if a generic is available.

  • lunettes

    Nicole, I also take brand-name Synthroid. I’ve found the best price is usually at Costco or Sam’s. All my female family members are Synthroid brand loyalists, ha.

    Thankfully I have an HSA which makes the price a little less painful (I miss copays that were $10/30 day supply.)

    • Nicole

      @Lunettes: Thanks for the suggestion. I don’t have a Costco or Sam’s membership, so it probably wouldn’t be worth it for me to pay the fee. Perhaps in the future!

  • I am always wary of generic names, unless it’s for aspirin or allergy pills.

    They’re 50% the cost, and work just as well, but for something specialized like what you’re mentioning, I would probably go with the brand name to be on the safe side.

  • I use generic meds unless the name brand’s cheaper with a coupon. My birth control is name brand simply since there is no off-brand Ortho Evra ring yet or I’d gladly save some of the $300 I’m shelling out a year!

  • I didn’t know that generic drugs were different in composition. I had always assumed they were made by the same company, just for a lot cheaper under a no-name brand. That’s sort of discouraging. I wonder how generic aspirin and motrin rank in terms of dosage and absorption? I normally purchase these types of meds in generic form.

  • Very interesting that you say that. While I haven’t taken Synthroid, I too have heard the same argument about it actually being a bit different from the generic and I believe it. It actually played out in terms of the market share of the brand. Typically, in pharma markets, the brand name share plummets immediately after a low cost generic comes to market. In Synthroid’s case, it’s share dropped, but at a much slower rate than other drugs with generic incursion.

    • Nicole

      @Squirrelers: Interesting tidbit about the share drop. Good PR blitz or factual basis? That’s what drives me nuts — we’ll never know.

  • Red

    Mr. Red refuses to buy generic OTC meds, even if the ingredients are exactly the same. Like you, I’ve used generic birth control for quite a while and haven’t noticed a difference beyond the price. $9 per month instead of the regular $50 that the name brand costs!