Brand Name vs. Generic



The cost of prescription medication in the United States is an issue that has been debated for many years, incorporating a triangle of viewpoints --pharmaceutical manufacturers, insurance companies and patients. Government, as a regulatory agent, is also involved.


Drugmakers invest billions of dollars and many years of effort into developing new medications and bringing them to market. This alone, they contend, justifies the sometimes astronomical costs to purchase cutting-edge medications. Patents are granted by the federal government for a limited time period, preventing other companies from imitating a medication at lower cost until, presumably, the company has had ample opportunity to recoup its investment.

Once the patent has expired and the federal Food and Drug Administration has certified the safety of a generic drug, pharmacists are generally free to make the switch. Pharmaceutical companies don't appreciate the competition; generics are often sold at substantially lower prices.

Insurance companies hold the other whip, working to keep their own costs down by forcing subscribers to accept generic versions when available and reducing reimbursements or refusing coverage for some drugs altogether.

Both insurance and pharmaceutical companies claim to be looking out for the consumer; the more important consideration often appears to be their own bottom lines.

Pharmacists are usually authorized to automatically substitute generics for brand-name drugs -- unless specifically instructed not to do so. Major drugmakers are fighting back by lobbying state legislatures to make it more difficult to make substitutions, seeking to require direct communication between doctor and pharmacist before making each switch. Maryland's General Assembly considered two such bills during the 2008 legislative session and will likely see similar proposals in 2009.

While doctors may have legitimate reasons to prefer a brand-name drug, they also have the option to make that specification on a prescription. There is no need for a phone call to a busy doctor every time a prescription is filled.

This lobbying is an attempt to protect pharmaceutical profits by making it more difficult to purchase generic drugs. Since many insurance plans will not pay for a brand-name drug once the generic is available, this could end up costing patients a lot more --or forcing them to forego a medication altogether.

What good is a cutting-edge, lifesaving medication to patients who cannot afford to purchase it?