By Scott Scanlon
Daily, often more than once, pharmacist Brent Lange will ring up a big bill for a prescription drug at the Mosher Health Center on Main Street and the customer will ask, “When is this going generic?”
By the end of next year, the question will become more rare.
Three dozen brand name drugs – including Cymbalta, Nasonex and Celebrex – will face challenges in the marketplace this year and next from prescription kin that will drive down the price for most Americans. Patents are set to expire on the drugs, which allows generic drug makers who didn’t have to pay for research, development and advertising to use the same formulas to make less expensive copies.
“Patients should welcome the release of generics into the market as far as cost savings,” Lange says, “and they really shouldn’t worry because the generics are very closely scrutinized by the Food and Drug Administration to make sure that the quality is there. The FDA won’t allow a generic drug onto the market that doesn’t have the same number of milligrams and the same type of quality assurances that a brand name drug has.”
The savings can be significant, says Mona Chitre, vice president of pharmacy management for Univera Healthcare.
On average, every traditional brand name drug – not the specialty drugs – costs $150 to $250 for a month’s supply, she says. “Once a generic enters the market and we have a number of generics, on average, the cost is $20 a month.”
Still, switching from a brand name to a generic is a change, and that can be uncomfortable. Here are some ways Chitre and Lange say can help the medicine go down more easily.
1. Relax and be open
“There is definitely a mindset patients have that the generic is not as good as the brand name,” Lange says, “but they are carefully studied by the FDA. There is a lot of research on the generics to make sure that the quality is there.
“A good part of our job is helping dispel fears about generic drugs,” says Lange, who is 50. “We tell patients if the brand name wasn’t causing any problems, chances are that none of the side effects are going to happen with the generic. I basically tell them that I take mostly generics if I have to take a medication. Usually, if they hear the pharmacist say that, that kind of allays their fears about the generic.”
Generally, when people come back for their first refill on a generic prescription, they’re sold on the idea, Lange says. “They’re just happy to get the generic, with the cost savings. They realize at that point that most of their fears were for nothing.”
The difference in price comes from competition in the market, but will impact patients in different ways.
Those without insurance will see the greatest savings, and those who switch from brand name drugs to generics and have a prescription drug insurance benefit will often pay a lower co-pay.
But those who insist on staying with the brand name may end up paying more. That’s because insurers often will move a brand name with a cheaper generic alternative to the top tier of their co-payment schedule and put the generic on the lowest tier. Often, the third, or highest, tier has a co-pay of $45 or $50, Lange says, where the first tier is only $5 or $10.
3. Take stock
Generic pills will look different than their
brand name counterparts. “Patients should always talk to their pharmacist to make sure what they’re getting and what the pills look like,” Chitre says.
In the first few days and weeks of making the switch, patients also should pay closer attention to the way their prescription works, she says. The potential side effects should be the same, so this is a time to refamiliarize yourself with them. It’s a good time to check drug interactions, too.
If patients have chronic conditions, they likely will need lab tests within two weeks to two months to help assure generics are working properly and not causing any detrimental effect. “Most doctors, when they switch a patient from brand to generic will set up a lab appointment for the patient and they’re very good at monitoring it,” Lange says.
Doctors also may encourage patients to consider a “therapeutic equivalent” of a brand name drug if an exact generic is unavailable. Those drugs generally are designed to perform the same function, like lowering cholesterol, for instance.
4. Beware the Web
As is the case with many things health-wise, the online world can become a confusing frontier for those looking to learn more about prescription drugs. “You type in one topic and you get all sorts of websites with every point of view …,” Lange says. “There’s really no consistency on the Internet and there’s no really good single source on generics.”
Your doctor and pharmacist are your best sources of information. “Anybody can take pills from a bottle and put them into another bottle and slap a label on it,” Lange says. “The professional aspect of our job is counseling patients, making sure there’s no drug interactions and basically making sure someone feels comfortable about the medications they’re put on and any changes in the medications.”
5. Be patient
It’s easy to get sticker shock with the cost of brand name drugs, and Lange often hears patients ask when their high-priced brand name prescription drug will be replaced with a far less expensive generic. Health care professionals can only give ballpark estimates about such changes because drug companies often go to court to extend their patents for as long as possible.
In the end, however, competition wins, Chitre and Lange say, costs come way down and so do some of your co-pays.