Eli5: what is the difference between a generic drug to the original drug, and why do some doctors will swear by the original drug?
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Only real reason is they are being paid off or have their own medical stores right where that 100x priced product is being sold , conflict of interest !
Generic are pretty much same molecule of drug and cheaper well because they didn’t have to spend for RnD and are just copying a tested thing that works , also undercutting . Got multiple Medical Doctors in family who hates the medicine field because of how much it is being misused and people’s health is exploited .
It should noted that pharmaceutical firms often provide lavish “training” programs for physicians who write lots of scrips of their products. These trips can be in exotic locales. Plenty of doctors see this as unethical and don’t do it, but others do.
There are already some great answers to your question. I’d like to add on another potential difference between a generic vs a brand medication. While, as stated previously, the main active ingredient must be the same in both generic and brand forms, the other components may differ. There is a possibility that a patient has an allergy to one of the inactive ingredients in either of the formulations.
Also, some brand pills contain a « delivery system » for an active ingredient. Great examples of this are some ADHD medications such as Concerta. The pill is engineered is such a way that some of the compound is released immediately, and some is released later in the day. This works because a part of the capsule dissolves immediately, while another part of the capsule dissolved slowly. Thus, even if the active ingredient has a rapid action peak and elimination time, because it is released stepwise, one pill can work for a whole day.
Such “release mechanisms” exist for several drugs, and it has been known that at times generics do not replicate these mechanisms well.
Along with what others have said, their packaging processes are different. I recently got generic cold medicine liquid gels from Walgreens and the pill packaging was so coated in glue you couldn’t handle the pills without them getting sticky. I’ll play the extra few dollars to ensure that my medication isn’t covered in adhesive.
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Lots of good posts explaining the difference already but also,
Doctors undergo intense lobbying from pharmaceutical companies from early on in their education. It’s neither good or bad, it just … Is?
Well in any case a lot of information about how pharma brand A drug version is much better is dispensed during those seminars, and so some doctors will prefer to give that version over another one. Are they right or wrong depends but in the majority of common drugs, there is no measurable difference in effectiveness (you can scour pubmed for studies if you want).
In the UK at least, most doctors prescribe by the generic name in the majority of occasions. There are a few exceptions e.g. with epilepsy medications and some long-acting blood pressure meds where each brand is slightly different to each other despite being the same active drug (as explained in other posts).
Some doctors also prescribe by brand name because they are more familiar with it by that name (a little frowned upon), there are no generics available (still patented) or they have become a little too cosy with drug reps…
My endocrinologist prefers brand; he says the consistency pill-to-pill is better. Because these are pretty small amounts that have big effects on metabolism (for my hypothyroidism), he wants that consistency.
As u/EvenSpoonier said, the active ingredients are very small amounts compared to inactive. If there’s poor pill-to-pill consistency of active ingredients, particularly if it’s poor batch-to-batch (one 90-day supply runs high, the next runs low), there could be negative effects. While the effects may not be severe, I’d rather avoid them.
Only once was I told to not get the generic (hydrocodone) and to get the prescribed brand (Vicaden). I was told that the generic was more of a whole body painkiller while the brand name specifically targets areas better, in that case; face, jaw, neck and back. So it’s kinda like generics are a shotgun and brands are a rifle.
Doctors might not get paid to use brand names but they sure go on some nice holidays and retreats
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