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Generic Drugs vs. Brand Name Drugs

Posted Aug 1st, 2008 by Patient Assistance Team
There used to be a common question: are generic drugs as good as brand name drugs? Now it’s reasonable to ask if brand name drugs are as good as generics. Probably predictably, the answer is “maybe” or “yes to both”, or just about any answer that isn’t a clear cut answer, because it depends on your problem.

Generally, you’re better off with generic drugs. Basically, generic drugs are drugs that have been around for a while, that have been used for years, so that there are no surprises. Computer experts sometime say never to buy a program with a version that ends in zero. That means that no matter how extensive the testing of version 1.0, or 3.0, or any other .0 has been, there are bound to be bugs. The world is filled with surprises, so why take chances? By the time a drug has become a generic, which means that it has gone off patent, it has been around long enough to be understood.

Years ago, there were really differences between generic drugs and brand name drugs, because even though they might have the same active chemicals, the manufacturing processes might be different. This meant that two tablets might contain the same 100 milligrams of active drug, but they could put different amounts of the drug into your bloodstream. There were lots of examples, some of drugs that didn’t work, because they didn’t release as much of the drug as the original product, and other cases when the generic product released too much, and people got overdoses.

That no longer applies. Science has caught up. Before the United States Food & Drug Administration, or the similar regulatory agencies in other countries, approve a generic drug, the manufacturers have to demonstrate that it produces the same blood levels of active drug as the original product. Then, the generic drug has to be made the same way, every time they make a batch. There may be differences in the way the generic and the original drug are formulated – and these may be important for people with allergies – but when it comes to how effective the two drugs are, they’ll be equal.

Often, a brand name drug will be a slight modification of an older drug, and be represented as a new, improved model. Often, the new version is really better, but not always. Sometimes it’s about the same, and on rare occasions it has some problems that weren’t predicted.

But, there are times when only the latest drugs will do. The first, most obvious case is for conditions where there are no effective older treatments. The second case is when the condition being treated is a moving target, where resistance patterns change over time. Cancers are one example, and infections are another. Cancers usually develop resistance to drug therapy, so that a drug that worked as initial treatment may not be as effective, or sometimes may not be effective at all, in a relapse.

The same thing is true of antibiotics. It helps to think of bacterial resistance in terms of Darwinian models. It’s not a true model, but it’s an easy one. If you have an infection, there are millions of bacteria, and some of the individual bacteria will be more susceptible to penicillin than others. Give a dose of penicillin, and it will wipe out all the sensitive bacteria – but it means that the only bacteria left are going to be resistant to penicillin. Do this a few times, and sooner or later, with natural selection, you have bacteria that can eat penicillin for lunch.

Sometimes that means antibiotics shouldn’t be used at all – because use of antibiotics when they aren’t needed is a waste of money, and just helps encourage development of resistance – but it also means that there are times when the newest antibiotics are going to be the most effective. Yes, they’ll be single-source drugs, patented, at the highest price, but they’ll often also be the ones most likely to be effective against the newest strains of bacteria.

This rule doesn’t always apply, particularly if you live near a hospital and your physician is on the staff there. Hospitals have microbiology departments, and they regularly publish reports on the infections they’re seeing, both those that have developed within the hospital, and those from the community. That can be important information when it comes to picking an antibiotic – but it isn’t always available. In that case, there will be times when the newest drug is really worth the money.

So, there are times when brand name drugs actually have an advantage, but the rest of the time, it’s probably wisest to start with something old and reliable. There’s less chance of getting any surprises, either from side effects, or the price.