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    Updated on Jul 17, 2020. Posted on Jul 10, 2020

    This Expert Explained The Real Difference Between Name Brand And Generic Drugs

    Is the off-brand Tylenol really the same?

    Over the years, I've often wondered if the generic versions of medications work just as well as the name brand. Many times, I opt for the generic to save myself a few bucks. However, if my kid is sick, I usually get the name brand because I have this mindset that it'll be more effective, even though the active ingredients are the same. So I go back and forth, not really knowing the difference.

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    Anyway, I decided now is the time to educate myself...and you all.

    ABC

    To find out, I spoke to expert Joshua Brown, PhD. Dr. Brown is a pharmacist and drug safety researcher for the Department of Pharmaceutical Outcomes & Policy at the University of Florida College of Pharmacy and the Center for Drug Evaluation & Safety.

    Photo of spilled pills.
    Oleg Elkov / Getty Images

    First, let's discuss what the generic version of a drug is. "A generic version of a name brand drug is a 'copycat' product that includes the same active ingredient, but might look different in appearance and may contain other ingredients that are different from those in the original," explained Dr. Brown.

    Photo of different shapes of pills.
    Spicytruffel / Getty Images

    "It is similar to when you buy 'off-brand' Oreos or the 'store brand' paper towels. These products are meant to be more affordable, near perfect copies of the name brand. Of course, when it comes to Oreos, there’s no substitute in my view and some growing evidence suggests this may be true for many generic products," he added.

    Generic versions of drugs get put on the market after name brand drugs lose their patents. "Typically, medications get a 20-year patent, which allows pharmaceutical companies to recoup the huge costs of developing new drugs. Once those 20 years are up, other manufacturers can begin to make copies of these drugs."

    Photo of prescription pill bottle.
    Backyardproduction / Getty Images

    "It is important to know that other components of a medication can be patented as well, so a generic manufacturer might be able to use the active ingredient, but still have to find a new way to make the capsule or tablet deliver the medication to the body," said Dr. Brown.

    Dr. Brown also explained that there is something called “authorized generics,” which is when the brand name company will sell their own product as generic or sell the rights to another generic drug company. "These authorized generics are identical to the name brand drug in appearance and contents, but are sold at different prices."

    Photo of generic vs. authorized generic vs. name brand pill.
    Dr. Joshua Brown

    Above are images that compare the appearance of name brand vs. authorized generic vs. regular generic. You can see that the first two are identical, while the other differs in shape, color, and other ingredients.

    So, will every name brand drug eventually have a generic version? The answer is: most times, yes. "I would say that the vast majority of products that lose patent protection eventually get a generic version, but sometimes there are not generics available for some products," he said.

    Photo of person pointing to medication.
    Sarinyapinngam / Getty Images

    According to Dr. Brown, there are a lot of reasons a drug might not have a generic version, but a big one is because there is a tremendous amount of litigation in the generic drug industry. "Companies who own the brand sue for patent infringement to delay generics being approved. There are also instances where brand companies simply pay off generic companies to not make a generic version. Also, as I mentioned before, different parts of a product can be patented, including the active ingredient, the formulation, the chemical synthesis to make the active ingredient, and so on. Furthermore, making a certain drug may just be too complicated and generic companies might not want to take the risk," he added.

    The active ingredient in generics can vary quite a bit and still be approved. "This is called being 'bioequivalent' to the name brand product. The generic product must deliver the active ingredient into the blood system between 80% and 125% of the name brand product. A study by the FDA found that most are within +/- 5%," explained Dr. Brown.

    Photo of pills outside of bottle.
    Yakubovalim / Getty Images

    The other differences between generic and name brand can be what are called "excipients" — or the other ingredients in the pill, capsule, etc. Dr. Brown said that while these ingredients may differ from those found in the name brand, they are not harmful.

    "Generic drugs make up an estimated 90% of all prescriptions dispensed to patients. In clinical training, we are all taught that generics are the same as the name brand. However, as generic drug recalls continue to occur, and after reading the book Bottle of Lies by Katherine Eban, you start to get a picture that it may not be true. That being said, generics are substantially cheaper than name brand products and cost may end up being a deciding factor between taking a drug or not," said Dr. Brown.

    Woman pouring pills into hand.
    Jay Yuno / Getty Images

    When it comes down to deciding between a name brand and a generic drug, Dr. Brown said there are two broad categories of drugs where a name brand drug is the best option: Those with narrow therapeutic indices and/or serious consequences and complex generic product. "Narrow therapeutic indices are drugs that, if you change the dose — even a small amount — it can change the safety or effectiveness profile substantially. While complex generic product is broadly defined by the FDA as drugs that have complex formulations. Because most drugs do not fit into these two categories, they are less of a concern when it comes to choosing between the generic version or name brand."

    Pills formed into a question mark.
    Brizmaker / Getty Images

    Luckily, most drugs are not complex and do not have severe enough side effects where it would greatly benefit you to choose the name brand over the generic one. "Tylenol is an example of a medication that is not complex nor does it have a narrow therapeutic index. Thus, even if the generic is not delivering enough medication or maybe delivers too much on a scale of +/- 10%, it is not going to lead to anything bad for the patient," he explained.

    Person holding pills at the store.
    Tero Vesalainen / Getty Images

    When it comes to birth control — because this is very important(!) — Dr. Brown said it undergoes the same approval standards as other generic drugs. "Oral contraceptives, which are used by 85% or so of American women who use contraceptives, are not what we would consider 'complex drugs,' so they should not be of concern when it comes to deciding between name brand versus generic," he explained.

    Woman reading instructions on birth control pills.
    Prostock-studio / Getty Images

    TL;DR: What should you keep in mind when considering name brand versus generic drugs?

    While generic versions do differ slightly from name brands, most over-the-counter generic drugs will provide about the same efficacy as the name brand. However, a name brand drug might be recommended over a generic version if the drug you need is a complex, prescription medication. Be sure to discuss this with your doctor, pharmacist, and do your research!

    Lastly, if you suspect that you or a loved one may be a victim of a low quality generic, be an advocate and talk to your doctor and pharmacists about switching to another manufacturer or the name brand. "Don’t assume that your side effects are normal, especially when you have not experienced them before when taking the same drug. You can also submit adverse drug reports to the FDA via their MedWatch program and report any possible concerns," said Dr. Brown.

    Pills on blue background.
    Andy / Getty Images

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