Eli5: what is the difference between a generic drug to the original drug, and why do some doctors will swear by the original drug?
In: 1046
Most medicine doses are actually very tiny. On their own, a single dose of most medicines might look like only a few specks of dust. This creates problems if you actually try to dispense medicine in that format: it becomes too hard for people to measure out the right dose, or tell two different medicines apart. It’s even too small to really swallow effectively.
To get around this problem, medicines are packaged up into larger pills. Each pill has a predetermined amount of the medicine inside it, called the active ingredient. The rest of the pill is made up of inactive ingredients: fillers to make the pill bigger, colors to make it easier to identify, coatings that make it easier to swallow, and so on. None of these inactive ingredients are medicine: only the active ingredient is. But the inactive ingredients help make it possible to take the medicine in a safe, efficient way, and so in that way, they help the medicine do its work.
The active ingredients in generic drugs must be chemically identical to the ones in name-brand drugs. However, other ingredients can be different. Doctors can specify on a prescription that the brand-name version is medically necessary, if, for example, they think the patient might be allergic to some of the inactive ingredients in a generic version of the same medicine.
Difference, generally nothing as far as active ingredients are concerned. Drug patents last about 20 years I believe, which means that after that is when generics can start being made. If generics are available but doctors are still pushing the original it’s more about trusted quality over effectiveness. Even though today a lot of name brand products and generic products come from the same factory there’s still a difference in quality control and sometimes quality if they are from different manufacturers. Doctor’s do push certain drugs of they are paid for it but in this case they may push Excedrin for example because it’s from a trusted brand and it’s been around a while, over say buying Walmarts generic migraine medicine because of its recommended with their name, even if it’s the same ingredients they want to take every precaution in what they recommend.
The main ingredients that you take the drug for will typically be the same, or from the same family.
In some variations, that drug will come combined with a different “mixer” – Think Vodka and Cranberry Juice, vs Vodka and Pineapple Juice.
Some people *may* be allergic or have a reaction to Pineapple juice, or maybe Pineapple juice hasn’t been on the market for as long (so less info about Pineapple Juice).
So Doctors will swear by the original drug because;
a) They KNOW it, and it’s been around forever so they know how it will react
b) they’re cautious of newer Juices
or the cynical view
c) they’re getting paid by big Cranberry.
Bioequivalent drugs (aka generics) go through a rigorous testing to ensure efficacy prior to entering the market.
It depends on what the drug treats, but there are variances allowed for the active ingredients and non-active ingredients may be different than a branded drug.
If a name brand drug works for you and your insurance requires the generic but you experience side effects or the medication doesn’t work the same, you should be able to go back to your Dr. to document the changes you experience with the generic and the Dr. may be able to get your branded drug covered or switched to another named brand drug (usually within the class instead.)
It’s the lack in variance in the branded drug that your Dr. Has come to depend on to treat the disease/ condition.
Say company A invents a new drug. Producing the drug is not costly, and could easily be sold for cheap. However, a lot (as in: really a lot) of money goes into research, and the company obviously wants that money back, so the price won’t reflect the production cost, but also the research money.
Company B just needs to know the formula, produce it, and sell for cheap to still make a profit, as they didn’t have to do the research.
That’s why drugs are patented, to allow the Company A’s to get that money back, before the Company B’s start selling it for cheaper. Those B’s would be generic.
As to why doctors stick to the original ones, I don’t know.
I work in the pharma industry (though i dont have a phd so take this with a grain of salt). One thing I’ll add to the great answers is that there is a big difference between replicating small molecules and large molecules (biologics). For small molecules, it’s very easy to create exact replicas- so most doctors really should be fine with you taking the generic. For biologics, it’s very hard to prove the new “copy” is exactly the same. Therefore, with this added uncertainty, many physicians are more comfortable prescribing the long-studied drug rather than the newer biosimilar product.
I think other posts have described the difference between generic and brand name well, but I can’t see anyone mentioning a decent reason for prescribing brand name drugs, and that’s the placebo effect.
Put simply for some conditions, particularly those self reporting like pain release brand name drugs work better than generic because people think they are better, even if the ingredients are the same.
Just the first couple of links when I googled to check:
[https://academic.oup.com/painmedicine/article/16/10/1967/2460471](https://academic.oup.com/painmedicine/article/16/10/1967/2460471)
[https://www.cbsnews.com/news/brand-name-generic-drugs-placebo-effect/](https://www.cbsnews.com/news/brand-name-generic-drugs-placebo-effect/)
[removed]
This is a very “no public healthcare” problem – in most countries ALL drugs are generic. As in I pick up my prescription every couple of months in the UK and it’s nearly ALWAYS a different brand of exactly the same drug because anyone is allowed to make it.
In America, big drug companies try to make it hard for someone else to make their product so they can justify charging you an arm and a leg for it.
There is **ZERO DIFFERENCE** between the “original” (which is not actually an original in any way) and the generic (non-branded) form. The reason some doctors might try and convince you otherwise is that the big pharmaceutical companies want you to doubt generic medicine because it threatens their profit margins – so they’ll try and influence doctors to discourage the use of generics. Don’t fall for it.
[removed]
Latest Answers