Generic versus brand-name drugs

Originally Published: December 5, 2003 - Last Updated / Reviewed On: March 6, 2014
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Dear Alice,

I've been using name brand birth control pills for eight years and now my insurance company will only cover generic birth control pills. Do you know anything about the pros and cons of using generic pills as opposed to name brand pills? Are they as effective?

Thanks,
Confused

Dear Confused,

A brand-name drug and its generic counterpart are chemically the same. They may have different branding names, colors, and shapes, but they are required by U.S. law to be the same drug.

After a pharmaceutical company develops a drug, that drug is granted a 20-year patent, which means that no other company can make it for the entire duration of the patent. After those twenty years are up, however, other companies are free to copy the drug and create generic versions. Generic drugs are regulated by the FDA and are required to meet the same guidelines as their brand-name counterparts. Furthermore, generics must be the same in several respects: the active ingredients (those ingredients that are responsible for the drug's effects), the dosage amount, and the way in which it is taken. This is called bioequivalency, which means that the same amount of active ingredient(s) is/are delivered to the body by the generic medication as by the brand-name drug. The FDA requires that the generic medicine have a comparable bioavailability to that of the brand-name drug.

Bioavailability is the amount of time the drug takes to be absorbed into the body under identical circumstances; manufacturers of generic drugs must show that the bioavailability of their product does not differ by any statistically significant amount (often considered 20 percent from the mean absorption) from that of the brand-name product. Generics have the same amount of active ingredient; the amount of time it takes for your body to absorb it may be slightly different, but not by enough to change the effectiveness of the drug.

The differences between a brand-name drug and its generic counterpart (for all drugs, not just birth control pills) are in the coloring, shape, and name, which are protected for the original company even beyond the twenty years of the original patent. There may be some differences among the inactive ingredients (i.e. the 'vehicle' for the drug) from one brand to another, but those do not have any effect on the desired benefits of the medication. However, if a person has a negative reaction to a drug (brand name or generic), it may be worth talking with a health care provider and investigating a possible intolerance or allergy to one of the inactive ingredients, in addition to other possibilities. 

In terms of effectiveness, there are no cons to taking a generic version of a brand-name drug: they are both the same chemically, and both are produced under the same guidelines and regulated in the same way by the FDA. There is one major benefit for you and your insurance company: generics cost less than those that carry the brand name. Brand-name drugs cost more and are protected under a twenty-year patent so that the company that originally developed them can recover those development costs. The U.S. government has determined that twenty years is enough time for the recovery of those costs and that after this period, there is no reason for the patient to be paying this extra cost.

The only catch is that the specific drug you are on may not yet have a generic version. Talk with your health care provider about your options. There may be a generic form of the birth control pill you are currently taking, or you and your provider might consider switching to a different pill with a generic version on the market in order to use your insurance's prescription coverage. You also can review your options with your insurance company. Check your insurance card for their customer service phone number and/or web site to get more information on what your options with your plan might be.

Alice