What’s the difference between brand and generic? Really?

source: fda.gov

As a practicing pharmacist, I get this question a lot. And here’s the honest truth; it depends. But before we go into that, you first have to understand what a brand medication is. I can already hear you saying to yourself, “Well, that’s the original and everything else is a copy.” Well, yes that’s true, but that’s not the full picture.

Here’s really how it works.

From the moment a pharmaceutical company finds a potential chemical that they think may have success as a drug, they will patent it. The patent protects them for 20 years, and within that time frame, the pharmaceutical companies must conduct all research and development on that chemical to provide to the FDA for approval, as well as figure out logistics and marketing data. Realistically, by the time the drug is actually FDA approved to be sold, the life on the patent is down to only about 7-10 years. That’s the first time the company can actually start making money off the drug.

Once the patent runs out, other companies can legally create the same drug, which is called a generic. There are actually two different kinds of generics, branded, and unbranded. For now, let’s focus on the generic class as a whole. So what’s a generic drug? How is it different from the brand?  A generic is chemically identical to the brand, meaning the active ingredient has to be the same as the brand. What can be different however, are the rest of the components, ie. the fillers.

Does that mean that all generics are as good as the brand? Not necessarily. While the vast majority of generics are just as good as the brand, there are exceptions to the rule. People with very sensitive digestions, or drugs with a very narrow therapeutic index (NTI) should stay with brand medications. There are also studies that have shown certain medications like Synthroid, have a difference in absorption between brand and generic. For those people that have been on brand, they should stay on brand. Or if they are thinking of making a switch to generic, they should start with a trial of generic for a month first.

I’m not advocating that patients only stay with brand. Generics offer for many a cheaper alternative to getting a more effective therapy to treat their conditions. Newer medicines are created to be more effective than older medicines or designed to have less side effects. Once these newer therapies go generic, it creates an opportunity for patients to transition to a possibly more effective medication for little to no additional cost.

To wrap up, I am not advocating sticking with brands when generics are available. I believe both brands, as well as generics, have their place in treatments for patients. It’s up to each patient and the healthcare team they work with to find the right therapy for them. At the end of the day, no amount of data is going to be able to tell you how one medicine or another is going to work better for you. It’s up to you to find that out yourself. That is why medicine is a practice, not an art. Each individual is unique, and must be treated on an individual basis.

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What’s the difference between brand and generic? Really?

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