Generic and Brand Name Drugs: Understanding the Basics

Making Smart Choices about MedicationsMany prescription medicines are availableto treat depression and bipolardisorder. The pharmacist might ask ifyou want your prescription filled withthe brand name medicine or the genericmedicine. Each option has pros andcons to con sider. This brochure willgive you the information you need tohelp you decide what’s right for you inyour treatment and recovery plan. You’lllearn that the decision to choose abrand name or a generic is one thatinvolves you and your health care team.“The decision to choose a brand name or a genericis one that involves you and your health care team.”What are brand name and generic drugs?A brandnamedrug is amedicinethat’s discovered,developedand marketedby a pharmaceutical company. Oncea new drug is discovered, the companyfiles for a patent to protect against othercompanies making copies and selling thedrug. At this point the drug has twonames: a generic name that’s the drug’scommon scientific name and a brandname to make it stand out in the marketplace.This is true of prescription drugs aswell as over-the-counter drugs. An exampleis the pain reliever Tylenol ® . The brandname is Tylenol ® and the generic nameis acetaminophen.Generic drugs have the same activeingredients as brand name drugs alreadyapproved by the Food and DrugAdministration (FDA). Generics onlybecome available after the patent expireson a brand name drug. Patent periodsmay last up to 20 years on some drugs.The same company that makes thebrand name drug may alsoproduce the genericversion. Or, a differentcompany mightproduce it.3

What’s the difference between brand nameand generic drugs?It’s important to remember that there arebrand name and generic versions of medicinesnot only for mood disorders but forother conditions as well—high bloodpressure, diabetes, etc. Today, about 50percent of all prescriptions are filled withgeneric drugs. The FDA has establishedstandards for generic drugs that mightseem complicated but are really quitesimple.The SimilaritiesAccording to the FDA, to substitute ageneric for a brand name drug:■ It must contain the same activeingredients (the chemical substancethat makes the drug work).■ It must have the same dosage strength(the amount of active ingredients, forexample 20 mg or 40 mg).■ It must be the same dosage form (thatis, it needs to be available in the sameform as the original—for example, asa liquid, pill, etc.).■ It must have the same route of admin -istration (the way the medication isintroduced into the body).■ It must deliver similar amounts ofthe drug to the bloodstream (thatis, it needs to deliver a comparableamount of the drug into the bloodstreamwithin a similar time periodas the brand name drug).The DifferencesHere’s how generics and brand namedrugs differ:■ They look different. (Federal lawrequires this.)– They could have different sizes,shapes, colors or markings.– They have different names.■ They might have different inactiveingredients.– Drugs are made up of both activeand inactive ingredients. Some peoplemay be sensitive to inactive ingredients.For example, some peoplehave reactions to certain dyes used insome drugs.■ The generic costs less than the brandname drug.– The cash price and insurance co-payis usually lower. Generics can costbetween 20 and 80 percent less, butkeep in mind that cost is only onefactor when considering the rightmedication for your condition.■ Generics vary by manufacturer, whichmeans you could receive different versionsbased on where you purchaseyour medications and what type ofgeneric they dispense.– Different pharmacies carry differentgenerics.– Even the same pharmacy may changegeneric suppliers.4

Insurance PlansFor most consumers, their insurance plan determineswhat they pay for medication. Both private and governmentinsurance companies promote using genericdrugs when possible. They might even require substitutinga generic for a brand name drug. As in Joe’s story, the co-pay for the genericmight be $10. But the co-pay for the same dosage and amount of the brand namemight be $40. Some insurance plans might require you to pay the entire cost ofthe brand name drug if you don’t accept the available generic.Why do brand name drugs cost more than generics?It takes several years, costly scientificdevelopment and many clinical studiesto get a drug approved. Manufacturersof new brand name drugs (also called“pioneer drugs”) usually take on theresearch and development costs for newmedications. These research and developmentcosts, along with marketing costs,account for most of the higher prices wepay for most brand name drugs.In contrast, generic drugs have lessresearch and development costs since theoriginal manufacturer has already donemany studies to make sure the drug issafe. These savings are passed on to theconsumer.However, while the brand name form isstill protected by its patent, no genericscan be produced. And, if a brand namedrug has only just recently lost its patent,there may only be one generic form available.Usually, when there’s only onegeneric option available, it will be moreexpensive.5

Since a drug’s generic and brand name versionslook different, how can I be sure I’m getting the rightmedication at the pharmacy?Be sure to check your medication labelsand confirm the name and dose of yourprescriptions. Generic forms of a brandname drug should all have the samename, no matter what company producedit. If your original prescription was writtenfor the brand name, and the doctorallowed generic substitution, the bottlelabel should indicate this. Never assumethat the drug is identical if it looks different.Your pharmacist can verify this foryou, and your doctor can also confirm thiswhen you bring your medication bottle toyour appointment. If you have a genericprescription, to reduce confusion, askyour pharmacist to refill your generic prescriptionwith the same drug, from thesame manufacturer, each time.Why doesn’t my doctor automatically prescribegeneric drugs?Not all medications havea generic form available.Some doctors might notbe aware of recentlyapproved generics.Doctors also differ intheir beliefs towards, andexperiences with, differentmedications. Our medical histories,insurance and personal preferences mayalso influence our doctor’s decision. It’simportant that we consult our doctorsbefore deciding if ageneric is right for us.If you’re interested intrying a generic drug,first find out if it’s available.Ask your doctor.Also, your pharmacistwill have a list of generic drugs and canusually tell you how much they will coston your insurance plan.What if I have a preference?If you and your physician determine thateither a generic or brand name drug isbest for you, make sure your pharmacistknows. If your doctor writes your prescriptionspecifically for the generic, that’swhat the pharmacist will give you. Asnoted earlier, there might be severaldifferent generic drug manufacturers.If you require the brand name drug,ask your doctor to indicate that on yourprescription. Different states have differentlaws and regulations on genericsubstitutions.6

Making an informed choiceIs the brandname medicineor the genericversion the bestoption? Theanswer is that itdepends. Thereare several differentthings thatyou and your doctor can consider:■ How difficult it is to control yourmedical condition■ How sensitive you are to changesin medication treatment■ How difficult it is to pay for yourprescriptions, including whetheryour insurance covers prescriptionsDrug FormulariesEach insurance plan has a formulary, a list of drugs that it approves and prefersfor certain medical conditions. (Public insurances, like Medicaid and MedicarePart D, also have formularies.) A formulary lists which drugs the plan covers andat what level they’re covered. Ideally, insurance companies base this list on thebest medical information available at the time. They negotiate the prices of drugson their formularies with drug manufacturers. And this often means dollar savingsfor the consumer.When you enroll in an insurance plan, you should receive its formu lary. A book letand/or a website usually containthis information. If you’re consideringchanging insurance plans, comparethe cost of your medicationson the formularies.It’s important that we consult our doctors beforedeciding if a generic is right for us.7

Prescription Checklist for Informed ConsumersUse the checklist below for either option to help you get the most out of your decision.If you and your doctor wantthe brand name drug:■ Have your doctor indicate on the prescriptionthat it is for the brand namedrug only.■ Tell the pharmacist you want thebrand name version if your prescriptiondoesn’t specify which.■ Check to make sure the medicine youget is the brand name drug.■ To help cover the cost:Ask your doctor for samples of anynew drugs that you are trying.Ask your doctor about any couponsor voucher programs.See if you qualify for financialassistance by checking outprograms like these:If you and your doctor wantthe generic drug:■ Know the drug’s brand name as wellas its generic name.■ Know how to identify the genericfrom the label on your medicinebottle.■ Know what the generic looks like(color, size, shape, markings), especiallyif it looks different than it did themonth before or if you use a daily orweekly pillbox.■ Check with your pharmacist to be surethat you’re getting the right drug.■ Tell your doctor about any differencesyou might experience taking thegeneric.Partnership for PrescriptionAssistance (PPA)(888) 477-2669www.pparx.comTogether Rx Access(800) 444-4106www.togetherrxaccess.com8

How do I find out more?Navigating the world of prescription drugs doesn’t have to be confusing. Thebest source of information about brand name and generic drugs is open discussionwith your doctor and pharmacist. Individuals vary in their medical history,response to treatment and preferences. Only you and your doctor can determinethe medication that best fits into your treatment and recovery plan. And gettingto know your pharmacist can reduce frustration and increase your understandingabout your care.If you wish to learn more, you can find additional information on several websitessuch as the following:www.DBSAlliance.org/RxAssistA list of drug assistance programs, provided by the Depression and BipolarSupport Alliancewww.nimh.nih.gov/publicat/medicate.cfm#ptdep15A list of psychiatric medications by brand name, provided by the NationalInstitute of Mental Healthwww.nimh.nih.gov/publicat/medicate.cfm#ptdep14A list of psychiatric medications by generic name, provided by the NationalInstitute of Mental Healthwww.fda.gov/cder/ogdconsumerinfo/generics/q&a.htmFAQs on generic and brand name drugs, provided by the FDA’s Center for DrugEvaluation and Researchwww.nlm.nih/gov/medlineplus/druginformation.htmlConsumer-friendly medication information provided by the U.S. National Libraryof Medicine and the National Institutes of Healthwww.nimh.nih.gov/publicat/medicate.cfmThe National Institute of MentalHealth’s medication resource9

My Health InformationYou can use this form to record helpful information about your doctors, medicinesand insurance program.My family doctorNAMEPHONE NUMBERCITY STATE ZIPMy therapistNAMEPHONE NUMBERCITY STATE ZIPMy psychiatristNAMEPHONE NUMBERCITY STATE ZIPMy pharmacist/pharmacyNAMEPHONE NUMBERCITY STATE ZIPMy insurance informationCOMPANY/PROGRAM NAMEPHONE NUMBERMY ID AND POLICY NUMBERMy daily medications, vitamins, supplementsNAME DOSAGE NAME DOSAGENAME DOSAGE NAME DOSAGENotes10

Please help us continue our education efforts.We hope you found the information in this brochure useful. To help us continueour education efforts, please fill in and mail or fax the donation form below, call(800) 826-3632 or visit www.DBSAlliance.org for details.Yes, I want to make a difference. Enclosed is my gift of:■ $100 ■ $50 ■ $20 ■ Other $NAMEADDRESSCITY STATE COUNTRY ZIPDAYTIME PHONE■ Check (payable to DBSA)E-MAIL■ Money order (payable to DBSA)■ VISA ■ MasterCard ■ Discover ■ AmExACCOUNT NUMBEREXPIRATION DATESIGNATURE (REQUIRED)■ I wish my gift to remain anonymous.■ Please send medonation envelopes to share.■ Please send me information on including DBSA in my will.■ I have enclosed my company’s matching gift form.If you would like to make your gift a Memorial or Honorary Tribute, please complete the following:■ In memory of/in honor of (circle one)■ Please notify the following recipient of my gift:PRINT NAMERECIPIENT’S NAMEADDRESSCITY STATE COUNTRY ZIPPlease send this form with payment to: DBSA, 730 N. Franklin Street, Suite 501, Chicago, IL60610-7224 USA Questions? Call (800) 826-3632 or (312) 642-0049.Fax credit card payments (VISA, MasterCard, Discover or AmEx) to (312) 642-7243.Make secure online donations at www.DBSAlliance.org.DBSA is a not-for-profit 501(c)(3) Illinois corporation. All donations are tax deductible based on federaland state IRS regulations. Consult your tax advisor for details. All information is held in strict confidenceand will never be shared with other organizations. Thank you for your gift!11

We’ve been there. We can help.The Depression and Bipolar Support Alliance (DBSA) is the leading patient-directednational organization focusing on the most prevalent mental illnesses. The organization fostersan environment of understanding about the impact and management of these life-threateningillnesses by providing up-to-date, scientifically-based tools and information written in languagethe general public can understand. DBSA supports research to promote more timely diagnosis,develop more effective and tolerable treatments and discover a cure. The organization works toensure that people living with mood disorders are treated equitably.Assisted by a Scientific Advisory Board comprising the leading researchers and clinicians in thefield of mood disorders, DBSA has more than 1,000 peer-run support groups across the country.Nearly five million people request and receive information and assistance each year. DBSA's missionis to improve the lives of people living with mood disorders.Depression and Bipolar Support Alliance730 N. Franklin St., Ste. 501Chicago, Illinois 60610-7224 USAPhone: (800) 826-3632 or (312) 642-0049Fax: (312) 642-7243Website: www.DBSAlliance.orgVisit our updated, interactive website for important information, breaking news, chapterconnections, advocacy help and much more.DBSA does not endorse or recommend the use of any specific treatment, medication orresource mentioned in this brochure. For advice about specific treatments or medications,individuals should consult their physicians and/or mental health professionals. This brochureis not intended to take the place of a visit to a qualified health care provider.©2007 Depression and Bipolar Support Alliance 4/08Models used for illustrative purposes only