Some People Think Generics Are Somehow Inferior
There are people out there who really think the name-brand slapped on conveys some kind of magical properties to medicine not covered in the active ingredient list, as Janet's sad story of how she got humiliated by her boss shows:
Janet writes:
My boss gave me a list of a few things to pick up for him at CVS last week. Advil liquid gels were on the list. I bought him the CVS brand of liquid gels with the same milligrams of ibuprofen in them. When I returned he flipped out on me saying that they are not the same and these won't work as well. He told me to keep my penny pinching to my own purchases. Then a few days later he brought it up in front of a few other co-workers. They all agreed with him.The CVS brand costs half of what Advil costs for the same thing, while I thought I was doing him a favor, I was setting myself up for laughter, apparently. This made me think, how many other people out there believe this? Over-the-counter medications give you a list and amount of ingredients right on the back, if everything is exactly the same, why spend twice as much?
It makes me feel like I must be taking crazy pills.
Don't feel too bad, Janet, some of those co-workers may have just been nodding their head because they want to keep their job. At least now you know in your office who can't think for themselves (your boss + those people).
(Photo: yoshiffles)
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I would've told him that he's wrong and explained why he's wrong.
The real difference is that Wal-mart, Rite-Aid and Walgreen's don't send reps to doctor's offices and buy everybody lunch or give away useless pens and crap (like a plush stuffed stomach and esophagus my ex-wife got once). Now, correct me if I'm wrong, but when it comes to life-saving or life-sustaining meds, the exact proper doses are critical and consistancy cannot be achieved with discounted price meds (or did I just buy into the commercialism).
Janet should have grown a set and told her boss the generic has the same active ingredients the first time he criticized her.
@esp13: ... and someone please direct me to a good report that I can use to back up the Name-brands-are-not-better-than-generic stand.
I worked in a plant that made over-the-counter (OTC) generics. It was gross. Products that molded. Beetle eggs in product that would hatch while out on the market. Had a clean FDA inspection. Still in business. Gross.
As for generic versions of prescription drugs, there is a range for Active Pharmaceutical Ingredient (the true medicine in a drug) that is acceptible. For the sake of argument, we'll say 5-10%. Your generic may come in at 5-6% and your brand will more than likely be 9-10%. While this may not be the case in all drugs, it is something to be aware of. Also, brands and generics may have completely different "fillers" or the non-active ingredients. Just my 2 cents.
Um yeah... sometimes generic ISN'T the same. Why don't you look up how many applications there were last year for companies wanting to make generic prescription meds in places like India and China? It's a fairly well-known fact that the medication I take - synthetic thyroid hormone - is not as likely to be as accurate or work as well in generic form.
@esp13: Umm, hunh? Are we talking about OTC cold medicine or prescription meds? Cause they both have generics but in different ways.
You don't see Rite-Aid generic Flonase (fluticasone) but there *is* a generic equivalent that works just as well. Generic prescription meds depend on the patents expiring before they can be sold.
I have found some generic brands do not work as well as others. Its not just the amount of the active ingredient but the quality. I buy generic when possible but some just don't work as well and I end up taking more than with another generic or even a name brand.
in my own anecdotal evidence, Advil is better for curing pain than a generic. It could be the placebo effect, or it could be that Advil's pills are better engineered.
I have come to the conclusion that most of the population is either on meds, or off their meds.
@esp13: Umm...
We're discussing over the counter medication. In which case, can you not simply read the label? If it has the same active ingredients, in the same quantities... What exactly makes those which cost twice as much better?
@esp13: You just bought into the cmomercialism. Manufacturers of generic medicines are still required to demonstrate that their products are chemically identical to the name-brand medicine. Any difference in effectiveness is due solely to the placebo effect.
And what percentage of generic drugs are from China?
Or the chemical precursors of the drugs?
Have you forgotten the heparin scandal of not so long ago?
I know that a huge amount of no brand OTC drugs & vitamins are from the Poisoned Republic of China!
I used to agree with this post, then I had a generic that gave me a bad reaction.
Yes, the active ingredients are supposed to be the same: the inactive ingredients don't have to be. The inactive ingredients can give you a bad reaction.
I'm not saying that all generics are bad, but there needs to be some clarity on the part of both the FDA and insurance companies that a change in the inactive ingredients of a drug CAN affect a certain amount of people.
I feel bad for Janet ... I'm also a generic user, and have experience being with a friend, trying to help her gather OTC drugs for her upcoming (at the time) childbirth, getting the generic and being told she only wants the namebrand because that's what her doctor told her to get and she's not taking any chances. It's the exact same drug, held to the exact same FDA standard ... the generics just haven't had to pay for the R&D and advertising. And most generics are manufactured by competing brand-name companies.
There's a basic courtesy thing here for me, in that if he specified a brand name then it's polite to assume he wanted that specific brand. His dollar, his brand.
For me I find I sometimes prefer a name brand simply because they offer a version that I find easier to get down my very gaggy throat. And I like my Advil coated tabs... /shrug.
One time my sister was over and she had a headache and wanted some Tylenol so I got her a bottle of acetamenophen. At the time my significant other worked as an engineer at the company that makes all the name-brand equivalents, so we got all this stuff free.
My sister shook out about six and when I sort of looked at her funny she said, "Well it's generic so you have to take twice as much." And she was serious. I am not making this up.
My educated, very intelligent sibling truly believed this. We still bring it up and laugh (at her) about it, it was so silly.
Medication - especially prescription medication - is not like breakfast cereal. Equal ingredient quantities does not make for an equal product. Some generic medications are manufactured in dubious conditions, with inferior quality ingredients. Maybe when it comes to ibuprofen and certain pain-killers, there might not be as big of a deal. But let's please be careful before we imply that all generic medications are equal to their brand-name counterparts.
Additionally, it doesn't all come down to ingredients. Some brand-name medicines work better because they have a better release system. Not all Gel coating is the same. Now I'm not saying it's a huge deal or anything, but there IS a difference.
Also, I don't want to be a jerk - but if the OP's boss had written down "Advil Liquid Gels" on the shopping list, I would have bought exactly that. I try to be frugal myself, but I'm not going to assume that everybody else is okay with certain brand-name substitutions, especially if I'm paying with their money.
Still, it's a jerk move for the boss to keep bringing it up in conversation. It's certainly not something worth "flipping out" about.
@funkadelica: If you're talking about Synthroid, you've bought into Abbott Labs marketing. Abbott's predecessor, Knoll, commissioned a study examining the bioequivalence of Synthroid, Levoxyl, and two generic preparations. All were found to be bioequivalent and "interchangeable in the majority of patients receiving thyroxine replacement therapy". Knoll attempted to have the study suppressed, and it wound up in litigation and ultimately published in JAMA. Knoll also settled a suit filed by nearly every Attorney General due to Knoll's false claims that Synthroid was superior to other thyroid-replacement medications.
The active ingredient is supposed to be the same, and if the FDA is doing its job (question right there) there should be no difference between brand name and generic. However, the delivery system (the inactive ingredients) do not have to be the same and they affect how and how quickly or slowly the active ingredient gets into the bloodstream. For stuff like aspirin, it probably doesn't matter but for heart medications, etc., I'll probably stick with the name brand. FWIW, I used to represent a pharmaceutical company who manufactured both name label drugs and generics (different plants) and this was their take on the matter.
@BodeMiller: Oh yeah, that's might funny when she overdoes on something. I'm not ridiculing you, I'm ridiculing the attitude that OTC is so safe that doubling the dose is still OK>
Not all the generic drugs are the same with brand names. Although the active ingredient might be the same, sometimes it is the inactive ingredient that makes the differences perhaps.
I've done some research on BC pills and there are a lot of people complaining about the tri-sprintec which is generic brand as opposed to the Ortho Tri-Cyclen which many people recommended due to it's lighter side effects.
Other than if a pill has particularly high-tech and patented time-release coatings, the kind you'll only really find on drugs that need them for safety reasons, the generics will do just as well. Most drugs taken chronically reach a steady-state in your blood anyway so it doesn't matter.
And for stuff like ibuprofen there's about a 99.999% chance that there's no difference. I rather suspect a lot of posters here work for non-generic drug companies judging by the total BS being posted.
Most pills use the same bindings and fillers anyway. A lot of the time if you think a generic isn't working as well, trying another brand of generic should fix the problem because for a lot of drugs it's just that some people are more sensitive to a particular binding. But that has nothing to do with generic vs brand names-doctors often switch patients between similar brand names not because the main ingredients have any real difference but because the fillers are slightly different and some people just have better results on one over the other.
If it really floats your boat to waste your money then go ahead, but I still recall (in a public health course no less) some brainwashed girl started SCREAMING at me when I pointed out that Nexium was just an isomer of Prilosec (and arguably actually less effective per mg). For some bizarre reason she felt the need to insist that it was a totally different drug. They must have done a heck of a marketing job because I've seen nurses actually ask if their insurance plan covered Nexium over Prilosec, even though anybody who's read the studies would know that Prilosec was equally or more effective in the majority of studies even though they used twice the dose of Nexium. The only reason it was even approved was because Nexium squeaked a win in two studies (again with twice the dose...because magically the "correct" dose of Nexium was twice as high).
There's plenty more hilarious drug studies for FDA approved drugs out there too, since drug companies basically throw the spaghetti at the wall with their usage applications and hope they get an approval with correlations that may or may not be real or even have anything to do with the supposed function of the drug. Like the anti-depressants that barely beat placebo, but get approved. Completely ignoring the fact that the likely reason that it beat the placebo was that it makes people drowsy so depressed people got more sleep and felt marginally better than placebo-something that could have been achieved with $2 generic benadryl.
Seriously, ask anybody with actual pharmacology training (and not a drug company employee) and I guarantee you that they themselves use generics, prescribe generics, and support the use of generics. This doesn't mean that if a patient has a terrible reaction to the fillers in one pill over the other that a doctor wouldn't switch them, but you're just as likely to react to the brand name and feel better on a generic.
@esp13:
Generics are sometimes made in the same factory, on the same line as the name brand drugs. When the patent on a drug expires the company starts to produce the generic as well, the only difference being the packaging.
There are a few drugs where different brands seem to work slightly differently, thyroid replacement hormone (i.e. Synthroid) being one.
Generally speaking however, generics are made to the same standards and work just as well as the branded drugs.
Sorry to say, but your boss was probably right. According to some research last year, the price of a drug, even though it is the SAME EXACT drug changes the effectiveness of the drug. People think that the more expensive drug works better, and so it does. See here:
http://thelastpsychiatrist.com/2008/03/pricing_of_placebo_affects_eff.html
An employee felt bad because she couldn't follow clear instructions, and got reprimanded by her boss? This is a consumer issue how?
Chalk this up as a learning experience, Janet: Bosses have peculiar tastes, likes, dislikes. They may have batshitinsane reasoning, but they are still your boss, and you still have to do what they want. They aren't asking you to do anything illegal. When you aren't sure if buying the generic brand is alright, ask.
When the boss berates you for penny pinching, just tell them it's because they pay you so little so it's hard to break the habit. :)
First off, I can assure you that we corrected her assumption about doubling the dose of generics immediately.
Second, doubling the dose of almost every OTC medication ever developed is not going to overdose a full size, healthy human.
Finally, in my family we tend to cope with life by finding humor in things. Sue me.
@Ninja007: My own anecdotal evidence suggests that differences between Advil and generics are imperceptable. I'm glad you're willing to at least consider the placebo effect.
That being said, assuming you're relatively young and healthy, it's generally okay to just take another pill (within reason) if whatever pain doesn't subside at the usual dose.
(They market prescription ibuprofen up to 1200mg tablets!)
@Ninja007: It is the placebo effect. You believe it will work better because you trust the brand and you spent more money on it than the generic version. And so it does. Funny how that works!
Want to put it to the test? It's very simple. Do a blind test with the name brand and the generic version. Throw in a dummy pill as a control. Try it a few times and see what your results are.
@xthexlanternx: Not at all, Advil is like the one medication I don't buy as a generic, due to the candy factor.
@Greasy Thumb Guzik: Cite? I'm not sure generics are any more likely to be made in China than any other drug, but feel free to prove me wrong.
OK. I have to say that while for the most part yes, generic is just as good as the brand name. That is not the case with Tums. Tums works perfectly fine, but one day I thought "oh, I know I will try the Walmart brand." They had the same exact ingredients so they must work the same right? WRONG! The Walmart brand consistently gave me horrific diheria. Yeah. Horrific.
@porschegal: Oh really? Did you work at a lab that makes pills for the name brands? How are you sure of the Active Pharmaceutical Ingredient (I'll call it API from now on so I sound more official) for the name brands was that high?
I'm not a drug manufacturer, but I play on on the Internet.
@BodeMiller: Overall, I think that individual users may occasionally notice differences between name-brand and generic medications (if you've got GI issues different preps may change how well you absorb stuff, for instance), but the vast majority of the time it makes no difference, which is why you start with the cheapo and move up if it doesn't work. For OTC stuff, I've never heard of anybody running into a difference that isn't down to flavoring preferences or actual allergies. Which doesn't sound like the nature of Janet's boss's objection.
So, Janet, you are not taking crazy pills, generic or otherwise, and your boss has happily decided to spend his money subsidizing brand-name ad campaigns for the same old stuff. You might want to double-check his budget decisions.
@MoreFunThanToast: This is what my doctor said, too. Fillers can be different and often are to avoid Trade Mark litigation. This doesn't mean that the inactive ingredient doesn't have adverse reactions "aside" from the active ingredient. For example, fillers may cause upset stomach in some but not others....
@tekdemon: Ibuprofen is very different in different doses. You could take four 200mg to equal the prescription strength but you'd get a heck of a lot more fillers than just one 800gm tablet from the doctor. The filler can give you a very upset stomach...
@Coelacanth: Yeah, you can take a whole bunch of Ibuprofen. When I had my wisdom teeth taken out, the doctor said I could take up to 8 Ibuprofen pills at once. That's 1600 mg!
Advil does taste good though. It has the same candy coating as M&M's. I buy it if it's not much more expensive.
@BodeMiller: I don't suppose there was any chance she was thinking OTC vs. prescription strength? No? Okay, laugh on, then.
@Ninja007: @Runs With Gophers: Most of the world's population is heavily medicated for something or other.
Wake up. Take pills. Get ready. Go to work. Work. Work. Lunch break. Take pills. Work. Work. Work. Go home. Eat dinner. Take pills. Go to bed. Repeat.
Personally, I stopped taking whatever meds I had been on a long time ago. Music, a good cigar and some scotch is therapy enough for me.
Tell your a-hole boss to do his own shopping.