Generic medicines can cost a fraction of the price of brand-name versions. For most medicines, they work in the same way, but there are a few situations where staying on one version matters.
Imagine collecting your usual blood pressure tablets and finding a different box, a different colour and a name you do not recognise. You worry the pharmacy has made a mistake, or that the cheaper version will not work as well.
What a generic medicine is
When a new medicine is developed, the company usually holds a patent for a number of years. During that time, only it can sell the medicine, under a brand name. When the patent expires, other manufacturers can make the same medicine. These are called generic medicines.,A generic contains the same active ingredient, at the same strength, in the same form (tablet, capsule or liquid) as the original. It is usually named after the active ingredient, such as atorvastatin rather than a brand name.
How regulators check generics
Before a generic is approved, regulators such as the UK Medicines and Healthcare products Regulatory Agency, the European Medicines Agency and the US Food and Drug Administration require evidence that it is “bioequivalent” to the original. This means it releases the active ingredient into the bloodstream at a similar rate and amount.,Generic manufacturers must also meet the same quality and manufacturing standards as brand-name companies.
Why generics are cheaper
Generic manufacturers do not have to repeat the expensive clinical trials needed to develop a new medicine, and competition between manufacturers drives prices down. Generic medicines save health systems huge amounts of money, which can be used for other treatments.
What can be different
- Colour, shape and size of the tablet
- Packaging and the name on the box
- Inactive ingredients (fillers, dyes and coatings), which rarely matter but can if you have an allergy or intolerance, such as to lactose or certain dyes
- Some people notice small differences in how a tablet feels or tastes
When staying on one version matters
For most medicines, switching between brands or generics makes no difference. But for a small number of medicines where small changes in blood levels can matter, healthcare providers often recommend staying on the same manufacturer’s product. Examples include some anti-epileptic medicines, lithium, ciclosporin and tacrolimus, and some modified-release products.,Levothyroxine and some other medicines may also need checking if you feel different after a switch. If you take one of these, ask your pharmacist to supply the same product each time and tell your healthcare provider if a switch happens.
Avoiding confusion
- Know the active ingredient name of each of your medicines, not just the brand
- Check the name on the box against your prescription
- Ask your pharmacist if a tablet looks different
- Never take two medicines with the same active ingredient by mistake, such as two boxes with different names
- Keep an up-to-date medicines list
Biosimilars
For biological medicines, such as some treatments for arthritis, diabetes and cancer, the equivalent of a generic is called a biosimilar. Biological medicines are made from living cells, so biosimilars are very similar rather than identical, but they are tested to show no meaningful difference in safety or effectiveness.
Generics around the world
In many low- and middle-income countries, affordable generics are essential for access to treatment for conditions such as HIV, tuberculosis and malaria. However, substandard and falsified medicines are a serious problem in some markets. Buy medicines from licensed pharmacies, check packaging for signs of tampering, and report any medicine that looks unusual or does not seem to work as expected.
Frequently asked questions
Are generics as safe as brands?
Yes. They must meet the same safety, quality and effectiveness standards.
Can I ask for the brand?
In some health systems you can pay for a brand if you prefer, but for most medicines there is no clinical benefit.
Why does my medicine look different each month?
Pharmacies may receive stock from different generic manufacturers. The active ingredient is the same.
But I feel different since switching
Tell your pharmacist and healthcare provider. For most medicines it is unlikely to be the generic, but for some it may matter, and they can arrange a consistent supply.
Your next step: Write down the active ingredient names of all your medicines and keep the list in your phone or wallet.
Related: How to take levothyroxine
Sources: UK Medicines and Healthcare products Regulatory Agency, European Medicines Agency, US Food and Drug Administration, World Health Organization.
Leave a Reply