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“НАШЕ ЖИТТЯ”, ЛИСТОПАД 2011 29 THE GENERIC MEDICATION DILEMMA by Ihor Magun, MD, FACP Today, generic medications occupy more medicine cabinets than ever before. Insurance companies prefer them over the so - called name brands. In fact, some require failure on generic medication before cover ing a more costly brand - name alternative. Is this just a cost - saving tactic or are generic medications just as effective and high in quality? For a medication to be labeled “generic,” the active ingredient must be chemically identic al to the brand - name medication in dosage form, strength, and route of administration. There may be, however, up to twenty - five percent variation in bio - equivalence , which gives some leeway to how the generic medication work s as compared with the name bran d. The trademark law in the United States requires generic medications to have a completely different look — hence the presence of different colors, flavors, sizes as well as combinat ions of inactive ingredients. It has been estimated that the cost of bringing to market an innovative product may be as much as $800 million dollars. The patent provides the funds to develop this new drug as well as generates money to offset the cost of other produced medications that are not profitable. In the United State s, drug patents are good for twenty years, but the clock starts ticking even before the clinical trials begin, so the term of an average patent is 7 - 12 years . One reason that the generic manufacturers are able to produce less expensive products is precisel y because they did not spend any money in the development of a new medication. When the patent on a brand - name drug expires, multiple generic medication companies are able to manufacture the product. This leads to competition and drives the cost of the med ication down. So what are some possible downsides to generic medications? The twenty - five percent variation in bio - equivalence mentioned above may make a difference in some patients. Identification of tablets, which can change from prescription to prescrip tion based on different suppliers, can be confusing to elderly patients. They may already be taking several medications and can easily identify them by their characteristic form, when all of a sudden this form changes. Some medications that affect blood le vels, such as blood thinners and thyroid medicine, may necessitate additional blood testing to verify therapeutic levels. Brand - name medications may require less frequent blood testing. What are the benefits of generic medications? The above - mentioned fact s may play no role in the treatment regimen , and the choice of a generic drug might be therefore perfectly appropriate. The price difference may be substantial , and the savings can be tremendous, especially with chronic daily dosing. What is the take - home message? Talk to your physician, who can recommend the best option. Frequently, discount cards are available — if not from your physician, then online or, at times, they may already be in the pharmacy computer system. Some insurance companies cover expensi ve brand - name prescriptions but only a specific product in a specific drug class. Request a booklet or print out a list and bring it to your physician. It will help you get the best medication at the best price. For short - term use, if the brand - name produc t is better, go for it. You deserve to feel better faster, even if it costs a bit more. Shop around by c all ing several p harmacies . You can speak to a pharmacy technician, who will be able to advise you on the cost and other options. I find that prices (outside of insurance restrictions) can vary even in a chain pharmacy within a small geographic area. Finally, take advantage of non - insurance plans that provide medications for about fifteen cents a tablet. It is quite a bargain when you think about the f act that it took so many millions of dollars to produce. Such medication will make you feel better not only physically but also mentally — for getting your money’s worth .
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