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Generic vs Brand Name: What's Good For One May Not Be Good For Another

Updated on November 22, 2014
Carol Reed profile image

Carol graduated from Indian Hills C.C. with an AAS in H.I.T and an AA in Arts & Science. A Social Media Booster for Wine Diamonds Film.

Generic vs. Brand Name Drugs

I prefer generic over brand name drugs because of the low cost and mostly the same results. However, I must also say there are times when generics just don’t work well for me and others. I believe this depends on the individual's genetics. After speaking with others and my endocrinologist, many factors come into play.

Levothyroxin vs. Synthroid

Thyroid Replacement The name brand is on the left & the generic is on the right.
Thyroid Replacement The name brand is on the left & the generic is on the right. | Source

Patient's Point of View

1. Premarin: I myself, get a better result with this name brand. This has been proven to be true for at least 19 years of my personal experiences after trying other supplementary medications in hopes to save money. I have had to go back to Premarin.

2. Levothyroxin vs. Synthroid: I have a couple of family members that have found their levels fluctuate when using levothyroxin. This medication is used to replace a deficiency in the thyroid hormone. A person's thyroid gland controls the metabolism. Just recently, after speaking with another family member, I discovered that this sibling also has to take Synthroid, due fluctuating levels on the generic medication.



Thyroid Replacement Choice of Treatment

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Endocrinologist Confirms

My specialist explained to me that in this case, just because the levothyroxine has the same
ingredient and the same dose, doesn’t mean that the generic drug will have the exact dose each and every time. This depends on the manufacturer.

For example, if the levothyroxin is slightly off from a dose of 0.075 mg this is acceptable by the FDA table as 75mcg (0.075 mg). So depending on which manufacturer a patient receives their medication from, one month it could be a true 75 mcg and the following month could be higher or lower.

When a patient has their blood work done, their results might be found to be normal. However, the months before, because of manufacturing variability their dosing is often variable enough to produce symptoms such as mood changes, fatigue and other symptoms of insufficiency. This may not have the same outcome with every patient. These are approved as legal substitutions for the brand name drug, Synthroid. and as so often happens insurance companies refuse to cover the cost of superior brand name drugs.

Comparison Making a Drug Like Making a Cake

A friend once said, that after he was having problems with the generic drug to treat his thyroid issues, his specialist explained to him that making a drug is like making a cake. The manufacturer may have all the same ingredients, same amounts and mixes them in the same order but there's no guarantee that another manufacturer with the drug will take those exact same steps.”

It's why cakes taste different depending on who's making it and why the same generic drug may be different from month to month.

My Personal Experience with a Pharmacist's Point of View

After standing in a long pharmacy line in a big city away from my home state, I arrived
back at the place I had taken up residency for a few days. I reached into my bag to discover my label on my medication bottle said, levothyroxin. Disappointed in myself for not noticing this before I left the counter; I called the pharmacy and spoke with the woman that filled my prescription.

She said something like, “Ma’am, these have the same ingredients, they are the same dose and we show that your doctor will approve you for generic.”

I said, “The whole reason for my office visit with this doctor was discussing the generic that I have been already taking and how my family has told me I was showing some of the same signs as they were when they were taking levothyroxin.”

“Well then, why doesn’t your doctor just up your dose?”

“Maybe, because the higher dose would be too strong," I responded. "I'm not a doctor how would I know? My doctor explained to me what can happen with this particular generic drug.”

Her tone became more aggravated, “It’s the same ingredient and same strength.”

At this time I’m thinking, she may know her drugs but she’s not my doctor, “Why would he give me samples of Synthroid if he was going to fill-out a prescription for levothyroxin?”

She softened her tone but still sounded as though I offended her, “Ok, since your whole visit was about changing your prescription, bring the medication back in and I’ll exchange it.”

I said, "Thank you." I hung up the phone and rushed back to the pharmacy before they closed. I was thankful for her breaking the rules because as far as I know, this seldom happens.

Not All Drugs Have A Generic Choice

When Nuvigil releases the generic version in 2016, I plan to give it try because this drug costs $556.50 for a 30 day supply without discounts.
When Nuvigil releases the generic version in 2016, I plan to give it try because this drug costs $556.50 for a 30 day supply without discounts. | Source

My View

No one knows a person better than themselves. The insurance companies are not doctors, pharmaceutical companies are not physicians, politicians aren't physicians. If by chance anyone working those positions also carry a physician's license, what qualifies them to make health decisions toward patients they haven't seen face to face or without knowing their past history? Even nurses playing an important role by listening to patients and being their advocate aren't doctors. Insurance companies, pharmaceutical companies, politicians, physicians, and nurses all have something in common. They have the ability to listen to all the people fighting these health issues, they can be patient advocates working together with the doctors and their patients. Please keep in mind, what works for one may not work for another.

Interview with a Family Doctor

I had discussion with a family physician that went something like this:

He said “levothyroxine is one of the generic drugs that the FDA has approved to be within a 20% variance (10% on each side) of the dose printed on the label of the bottle. This means some months a person could be at the low end, at a high end or bounce between the levels. Over all, depending on the persons sensitivity, it may not be noticeable, but often it allows symptoms of too little or too much thyroid hormone to be noticeable. With the brand name, Synthroid, you know the level is the exact level written on the bottle.”

I said, “My endocrinologist that I had to see in North Carolina was explaining to me about the 20% range. He’s among at least three endocrinologists in Virginia and at least one in Iowa treating their patients with the brand name, Synthroid because they had a hard time controlling their patient's thyroid symptoms with the generic drug.”

He responded, “This is a mood-affecting drug. Some drugs are fine as generic because some disorders don't matter if a patient's level is within a 20% range. However, diseases like hypothyroidism, seizures or heart arrhythmias, we want to be sure they are on the exact dose. Allowing a 20% variance in drug levels can lead to serious and life threatening side effects. Being low or high by 20% over a period of six months could cause a person to have a seizure or someone suffering with heart arrhythmia could die. Unfortunately, doctors no longer have control. They can appeal to insurance companies to get them to pay for the medications but often fail.”

"That has happened to me," I said. " I once had a doctor appeal to my insurance company explaining why I required Nuvigil. The insurance company turned him down. I personally had to write my insurance company and told them they would be responsible to take care of my family if I died because I couldn't have this drug. Reluctantly, they approved this drug but unfortunately due to a job change and health insurance change, I'm back to square one again.

“You can help others by educating them like you are doing here. You can tell them they have a right to appeal to their insurance companies who are trying to substitute a less expensive and less effective medication. If more people did this, insurance companies might begin to remember who the actual customer is and who's helping keep them in business," he said.

A Few Generic & Brand Name Medications

Brand Name
Generic Drugs
Diagnosis
Synthroid
Levothyroxin
Hypothyroidism
Premarin
None but there are different kinds of estrogen replacements.
Menopose
Nuvigil
None but insurance companies will try to force patients to try other medications first.
Narcolepsy
When dealing with diagnosis's or diseases that are life threatening or mood controlling, if generic works that's great but when they don't, the patients life if worth the brand name without paying outrages prices.

Denial

I have recently discovered that sometimes when a person is denied a prescription this may not be because the patient is ineligible. This could mean that a provider’s number failed to be reported or for a simple reason as to not enough documentation supporting the reason for why the particular medication was denied. Therefore if you are denied, I say to you, call your insurance company and ask why? What can it hurt, besides being on hold for a few hours or maybe even half of the day? I have been asked over and over if this was due to the “Obama Care” and I can honestly say, no. These problems existed before our president was voted in office the first time.

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    • Carol Reed profile image
      Author

      Carol Clarke Reed 2 years ago from Remote

      Thank you, brakel2, for sharing your story.

      I know I can’t be the only patient that feels like a ‘go between’ or feels like they are doing other peoples jobs. I ended up getting a week of the generic to get me by, figuring this has to be better than nothing. In the meantime I had to call my specialist and ask him to send a statement of why I need the name brand vs the generic to my local provider.

      The following isn't including what I had to go through a week before this: I had to call my new insurance to find out why my pharmacy said I was denied a name brand prescription that I still had one refill remaining.

      The insurance company explained that it was because the provider number was missing and supposedly this was faxed back to the provider.

      I called my provider’s nurse, she said they haven’t received anything, yet.

      I called my insurance company back and inform them that my provider never received a fax from them. The insurance company told me to have the provider contact the “Pharmacy Help Desk” and ask them why my provider hasn't received the fax. Eager to stay one step ahead of this game, I asked, “What if they don’t know what a ‘Pharmacy Help Desk’ is?” The woman on the other end of the phone said, “Have them call me and I will transfer them but they should know.”

      Simple right?

      I then called back and relayed the message about the Pharmacy Help Desk to the nurse. The frustration in her voice was clear when she explained that she had no idea what I was talking about. I asked her to call the insurance company and they would transfer her.

      I was already a week without any thyroid medication so my mood was not my normal calmness but we survived.

      Week two, I called my insurance company to find out where I was standing with my medication. She said that they received the form with the provider number but the “Med Watch Form” was missing.

      My mood had been a roller coaster. My punishment for not excepting a month supply of generic when the nurse insisted, I thought. But why should I have to take something that caused me to reach out to a Specialist in the first place?

      I contacted the clinic, left a message for the nurse about the “Med Watch Form”. I received a call back saying the insurance company wants my provider to see me, in order to continue my pre authorization.

      I spoke with a Physician the other day about “Med Watch Form,” he admitted to not knowing about this form. If one Physician doesn't know there has to be others?

      So now I sit at week three, waiting for an appointment a week into the future and wonder how many other people are discouraged at the lengths they have to go to get what they need, not to be confused with what they want, when it comes to their medically necessary medications.

      I have been asked by a few, “Is this because of that ‘Obama Care’?” I can say honestly, “No.” This battle with being the ‘go between’ and the feeling of doing other peoples jobs has gone on longer than President Obama has been in office. If it isn't the ‘go between’ insurance companies and billing offices; it’s the ‘go between’ Pharmacies, insurance companies and Physicians.

      Is our Government to blame? Are the Pharmacies at fault? How about the Insurance Companies? The Physicians / Providers? The Nurses? The Patients? This is a team problem with miscommunication, education and ball dropping.

    • brakel2 profile image

      Audrey Selig 2 years ago from Oklahoma City, Oklahoma

      Hi Carol - I enjoyed reading your hub about prescription drugs. A brand name for a blood pressure medicine is what I take instead of the generic. Concerns about the extended release have concerned me and others. Your article definitely points out the reasons why some physicians will not prescribe the generic drug, even though many that I know swear by generics. Thank you for bringing this to my attention. Sharing. Blessings, Audrey

    • Carol Reed profile image
      Author

      Carol Clarke Reed 3 years ago from Remote

      “One Rotten Egg Ruins it for the Rest of Us.” By unknown

      Thank you for your comments, cecileportilla.

      I agree, the kick-backs have been a problem but have improved over the years due to rules and regulations. This hasn't been the only problem.

      1. Insurance companies push generics

      2. Hospitals that take money away from doctors for using generic drugs.

      3. Drug companies come out with new brand name medications that are high priced, which in turn makes it hard for doctors to prescribe to a patient that may benefit from them. Either the patient can’t afford, the insurance company wants preauthorization or refuses to pay. The drug companies have coupons for the doctors to pass on to their patients. Why don’t they just lower the cost of the medications?

      4. Sometimes even generic drugs end up higher than the brand names which cause the same issues.

      We have corporate insurance companies, corporate hospitals, drug companies, some politicians and yes some doctors that have put money before human life with pressures of wanting to do the right thing. We do have excellent doctors and others in the medical field that put their patients first and get scrutinized making their jobs more difficult and taking away from quality of care.

      We have kick-backs all over our country, not just the health field but also our schools and I feel this draws the greed out. I do see our government trying to make changes by putting life before the dollar amount.

      As I have said before, right is right wrong is wrong. It’s time to put people and their well being first.

    • cecileportilla profile image

      Cecile Portilla 3 years ago from West Orange, New Jersey

      Nice hub Carol Reed! However, there are many people who believe in “brand” name item only, i.e., if I don’t use a brand name item what will my neighbors think?

      These people may feign adverse symptoms to compel their doctors to give them what they want. Some people will go to extremes to get what they think they deserve.

      When the FDA receives complaints from these types of individuals the FDA cannot properly make an evaluation!

      There have been numerous concerns about doctors who get kick backs from pharmaceutical companies for prescribing brand name drugs only!

      http://articles.chicagotribune.com/2012-11-15/news...

      http://www.thehealthyhomeeconomist.com/is-your-doc...

      http://www.naturalnews.com/036510_doctors_bribes_d...

      http://www.newsytype.com/14448-drug-company-paymen...

    • Carol Reed profile image
      Author

      Carol Clarke Reed 3 years ago from Remote

      Thank you Cecileportilla for sharing your Hub, "Debunking the Myth..." because you inspired me to share some true stories about issues on generic and brand name medications.