Forced to buy generic medication?

MC - was it the lamotrigine by any chance?

Yes.  I forget, are you on the generic version?

Hi MC - I work for insurance company and can tell you that this is very common and it's not always the insurance company making the decision.  If your employer is Self-Insured they can opt to have this pricing structure in place.  We have a specific term for it called MAC Pricing (Maximum Allowable Cost).  The idea is that it does push people towards generics which saves the employer group on their pharmacy costs.  However, I can tell you that I have seen a few people sucessfully appeal for continued coverage of a name brand drug due to proven ineffectiveness or inadequecies associated with the generic formula.  If you experience severe side effects, I would reccomend attempting to appeal for continued coverage of the name brand drug (understanding that it would most likely be at the highest co-payment level).  The outcome depends on review, of course, but I have seen members able to override this pricing when they have severe side-effects or experience ineffectiveness from a generic.

All that being said, generics are usually very well tollerated by most people and often times they find these drugs to be just as effective as their name brand counterparts.  I hope you are one of these people!

ETA - I am in the US and am not aware of how health insurance works outside of my locale.

generic brands are just the same composition as the branded medication.  The branded drug label like the Tylenol brand is just a name now and once their patent expire, its fair games for other drug manufacturers to apply and produce generic brand.  Next time when your at the grocery store, pick up Tylenol and a generic Acetaminophen bottle and compare their composition. Having taken common medicine in college and my BIL's confirmatio whos' a pharmacist always tells me to get generic to avoid the mark up cost.

ETA: i'm sorry meant to say that the ACTIVE composition is the same.

MC -- I was once switched to a generic for a medication I've been taking for a long time. I didn't think anything of it until about a month later, when I started dealing with symptoms and couldn't figure out why. The short version is ... I'm back to the name brand medication, though fortunately mine costs about 1/10 what yours costs.

I checked on-line boards for my condition and it seems like most people that switched to the generics had no problems. Hopefully the same will be true with you. However, I would take note of the manufacturer of your generic medicine each time you get a prescription filled. Although each of the makers should be using the same formulation of active ingredients, they could be using different fillers so I suppose there's a possibility that some combinations will not be as effective for you (just as the generic substitute did not work for me).

Good luck! I hope the less expensive version works out well for you!

Date: 7/9/2009 5:52:32 PM
Author: MC
Yes. I forget, are you on the generic version?

I''ve had both the generic and the Lamictal.

I thought I could tell a difference although my psychiatrist said I was the only one of his patients on it who had mentioned it and as far as he knew there was no difference in effectiveness.

Since I pay £90 a year for ALL my medications (and this year I pay zero as all meds are free for a year after giving birth) I get the name brand rather than the generic. If I had to pay full-price I would probably just stick with the generic.

In the UK doctors will normally prescribe generics if they are available.

Date: 7/9/2009 5:53:24 PM
Author: D&T
generic brands are just the same composition as the branded medication. The branded drug label like the Tylenol brand is just a name now and once their patent expire, its fair games for other drug manufacturers to apply and produce generic brand. Next time when your at the grocery store, pick up Tylenol and a generic Acetaminophen bottle and compare their composition. Having taken common medicine in college and my BIL''s confirmatio whos'' a pharmacist always tells me to get generic to avoid the mark up cost.

ETA: i''m sorry meant to say that the ACTIVE composition is the same.

Yeah, with acetaminophen and basic stuff like that I always buy generic and feel they''re comparable.  The medication I''m on is much more serious than that, which is why I''m concerned.

Date: 7/9/2009 6:03:10 PM
Author: Pandora II

I''ve had both the generic and the Lamictal.

I thought I could tell a difference although my psychiatrist said I was the only one of his patients on it who had mentioned it and as far as he knew there was no difference in effectiveness.

Since I pay £90 a year for ALL my medications (and this year I pay zero as all meds are free for a year after giving birth) I get the name brand rather than the generic. If I had to pay full-price I would probably just stick with the generic.

In the UK doctors will normally prescribe generics if they are available.

Okay, thanks for the info.  I''m going to take the first dose of generic tomorrow and see what happens.  The problem is if I do not take nearly the exact same amount daily, I have side effects.  I can take about 30 mg +/- and be okay IF I do that a few days in a row.  Any more days than that causes me problems. 

How much are you normally on?

I''m on 125mg a day and find that a 25mg difference is a BIG difference.

I was on 150mg by the end of my pregnancy - they dropped it to 100mg the day I gave birth (my pre-preggo dose) and I had such bad baby blues that the perimaternal psychiatrist upped it to 125mg. I started to feel better within a few days and I think the increase has made a HUGE difference to my stability post-partum.

I also ended up with very severe antenatal depression - and that was following a reduction to 25mg (and my employer deciding to try and make me redundant just after I''d done the reduction) so it proved to me that lamotrigine is a huge factor in keeping me stable, and that I respond to very small increments of that medication so I totally get what you are worried about.

Yep, it's happened to me, but I didn't worry at all. I'm not sure what medicine you're on or what it's for. Mine were all for sinus and allergy related issues, so it wasn't such a huge deal if it was very slightly less effective. If I was on something that could seriously impact my health, I might've been more put out by it.

In general, I'm inclined to believe that the generics are just as good as the name brand; it's just that the patent ran out and other companies were allowed to start making it. I'm not in the pharmaceutical industry though, so that might be wishful thinking.

Ditto what Faith said. The nurses and providers handle it in our office, but I know there are forms they can fill out for you, after you''ve tried the generics for however long. Dr. sends letters sometimes, too, depending on what the insurance company requires. Maybe call your Dr''s office and see what advice they have?

Actually, generic prescription meds can have up to 20% difference from the branded version in the inactive ingredients. Sad but true. I say this as my only allergy on earth is to a coating frequently used in generics. It really is annoying...and costly.

I had a similar situation but found out if the doctor''s prescription says "CANNOT be substituted for generic" the insurance will cover it. Don''t know if all insurance companies accept that but it''s worth a try. Good luck.

Date: 7/9/2009 6:04:50 PM
Author: MC

Date: 7/9/2009 5:53:24 PM
Author: D&T
generic brands are just the same composition as the branded medication. The branded drug label like the Tylenol brand is just a name now and once their patent expire, its fair games for other drug manufacturers to apply and produce generic brand. Next time when your at the grocery store, pick up Tylenol and a generic Acetaminophen bottle and compare their composition. Having taken common medicine in college and my BIL''s confirmatio whos'' a pharmacist always tells me to get generic to avoid the mark up cost.

ETA: i''m sorry meant to say that the ACTIVE composition is the same.

Yeah, with acetaminophen and basic stuff like that I always buy generic and feel they''re comparable. The medication I''m on is much more serious than that, which is why I''m concerned.

the 20% inactive ingredientsis determining factor as to whether it will give you any side effects or works just the same. Maybe try it out and if it doesn''t do it for you then definitely try and get back onto the branded medication.

in order to create any patent, any manufacturer just need to change 20% of the components in the case of medication it is the inactive ingredients that gets modified. when we sold some tools we were able to patent it by changing or modifying 20% of the look/mechanism of the tool.

Date: 7/9/2009 9:01:49 PM
Author: swingirl
I had a similar situation but found out if the doctor''s prescription says ''CANNOT be substituted for generic'' the insurance will cover it. Don''t know if all insurance companies accept that but it''s worth a try. Good luck.

That''s what I was going to suggest. But usually a doc will only do this if you cannot take the generic for some reason i.e., you have a reaction to it.

Date: 7/9/2009 9:41:21 PM
Author: neatfreak

Date: 7/9/2009 9:01:49 PM

Author: swingirl

I had a similar situation but found out if the doctor's prescription says 'CANNOT be substituted for generic' the insurance will cover it. Don't know if all insurance companies accept that but it's worth a try. Good luck.

That's what I was going to suggest. But usually a doc will only do this if you cannot take the generic for some reason i.e., you have a reaction to it.

My doctor has specified no substitutions on the prescription. I had worked with the pharmacy (mail-order) to ensure this was noted on my file -- I thought. Then the pharmaceutical company decided to call the Dr.'s office and ask if they could substitute a generic anyway. Some doctor who has never even met me OKed the substitution, apparently without looking at my file... so I was sent three month's worth of a generic drug that doesn't do what it's supposed to for me. Yes, most companies will cover the cost of brand name meds -- thought sometimes at a higher cost than the generic -- but they seem to be set up to provide the generic whenever possible. You have to be on your toes when dealing with insurance-specified pharmacies!

I''m on 250 mg per day!  Quite a bit. . .

I called my insurance company and the guy was utterly useless   He sat there in silence after I told him what happened and I had to ask, "are you still there?"  Grrr. . .then he put me on hold, then after, said I had to call another company (Express Scripts) and even though he had the phone number, he wasn''t allowed to give it to me (?) and that I had to get the # from my dr. (but, I found it online). . . So, then I called the office and the receptionist (who''s worked there a LONG time and knows her stuff) said that basically, once my insurance insists on generic, there is little that can be done.  She said she hasn''t heard of any problems with the generic form and said re: side effects, "we''ll cross that bridge when we get to it."

Normally, I''m okay with generics because I''m not on any other daily medications - I have an RX for generic Xanax but only take it once or twice a week before bed. 

Like Pandora, I depend upon Lamictal and finding out the new stuff isn''t the same is disturbing to me. 

Another thing to research, depending on your company (we''re with Atena) is that you may have an "allowance"...it''s a seperate card that covers tons of medical expenses --- I think it was $450.00 pp in your household.  This can be spent at your lesiure on whatever you want so long as it''s health care related.  We can use it on Excedrine, Prilosec, I bought prescription sunglasses.  If your plan has something like this, you can use it cover the difference in the medicine if you really want your name brand prescription. 

in order to create any patent, any manufacturer just need to change 20% of the components in the case of medication it is the inactive ingredients that gets modified. when we sold some tools we were able to patent it by changing or modifying 20% of the look/mechanism of the tool.

This is 20% incorrect, and if your patent attorney told you this, they were wrong. A patentable invention is novel and non-obvious, in addition to myriad other requirements. There is no % change over the prior art.

Patenting generic drugs is very complicated, but there are provisions in place (the Hatch-Waxman Act) to bring generic versions of patented compounds to market very quickly. The API, or active pharmaceutical ingredient, will be the same. Although the composition and "inactive" (sort of a misnomer) ingredients, such as dyes, can vary. These are where people see side effects, although they are very rare - but not to belittle anyone''s experience with generics. The FDA regulates these drugs and requires that they are "bioequivalent," meaning the same API delivered in the same way with the same results.

It is possible that the 20% that you guys are talking to refers to the bioequivalence. Bioequivalence must not vary by more than 20% from the mean absorption. While this sounds large, it is statistically insignificant.

All that being said, I''m more familiar with the science/law and less with the insurance issue. I would imagine as insurers and the government tighten their belts, it will become harder and harder for people with legitimate reactions to generic meds to change over to regular. This is because, in part, some people just assume "generic = bad" and demand that their carrier pay for the extremely expensive name brand. I would likely make that same assumption were I not familiar with the area. People often request to be switched for no other reason than this. Or simply assume that their new problem is due to a med switch, when it is something else entirely. It makes it so much harder for those who cannot take the generics. The media is very reactionary on generics, and I''m not sure why.

I can totally understand your concerns.  I don''t really have any advice to give but here''s an article I recently came across that opened my eyes to just how dangerous generic drugs can be.  It''s kinda long, but it''s a good read.

http://www.self.com/health/2009/06/dangers-of-generic-drugs

Certainly does raise some valid concerns!  I hope you''re able to get it sorted out quickly!  Insurance companies are NEVER fun to talk with.

See if you can have your Dr. call both Express Scripts and your insurance company if you experience anything unusual. Lamictal is one of the few drugs we will waive MAC pricing on due to the overwhelming number of patients experiencing break-thru seizures. We know these members are not merely stating dissatisfaction just to keep the name brand as our case management team follows inpatient members and we have seen enough of an increase in complications with our members who suffer from a seizure disorder that we have taken action. This is only for members who are using the drug to control seizures and we require a letter of medical necessity but if you meet those criteria you can obtain a waiver. I really hope we are not unique in doing this for our members and other companies are recognizing this serious problem for members.

I wish you the best of luck with getting better coverage!

Date: 7/9/2009 11:54:33 PM
Author: luvmyhalo
I can totally understand your concerns. I don''t really have any advice to give but here''s an article I recently came across that opened my eyes to just how dangerous generic drugs can be. It''s kinda long, but it''s a good read.


http://www.self.com/health/2009/06/dangers-of-generic-drugs


Certainly does raise some valid concerns! I hope you''re able to get it sorted out quickly! Insurance companies are NEVER fun to talk with.

Thank you for providing a link to that article, LMH.

Many people react to dyes and "inactive" ingredients in name-brand and generic meds. And many people incorrectly read causation into a stoppage or start in a drug with cessation in clinical symptoms. As the woman reported in self magazine illustrates, some people may react to drugs. Or symptoms come and go. It looks like we''ll never know in her case. Anectodally, with a n of 1, many people will report problems when there are none. Note that a placebo drug often cures many symptoms - people interpret causation when there is none. The power of suggestion is strong!

In a drug like Lamotrigine that is often chewed, dose-delivery is important and I believe (but am not positive) that brand-switching should be closely monitored.

I do not work for generic pharma (could not be further from the truth). But the problems with generics are overreported, mis-understood, and keep many people from having access to affordable medicines. At the same time, there are a small number of patients who suffer side effects when they are switched from name brand to generic (and more who suffer from side effects when switched from name-brand --> different name brand, note that those do not get reported in the popular media in the same way). Those patients should have the opportunity to receive safe, effective medicine without a bureocracy.

I don''t work for generic pharma (couldn''t be further from the truth). And I''m not a doctor. But I''m very familiar with the generic pharma regulations. Also note that many name-brand manufacturers have a generic "alter-ego" that manufacturers generics of another name-brand company after successfully "defeating" their competitor''s patent. So what you think is a bad "generic" is frequently a Pfizer compound.

studyer83: I understand what you're saying about "unfounded concerns," conclusions about causation, and "symptoms come and go."

I also know what happened to me. The drug I had been using for five-ten years was treating my condition and keeping my symptoms at bay.

I didn't even register the fact that I was switched to a generic. I was not concerned and didn't give it a second thought when I started using the new bottle.

Admittedly my dosing is always somewhat inconsistent and erratic -- that's just me -- but I don't think it was any more so with the generic pills than with the brand name pills.

What I experienced once the brand name drugs were no longer in my system, and my body was relying on the generic version, was not side effects. It was a case of the drug not having any effect -- it was not controlling what it was supposed to control. And yes, the condition the drug was supposed to control is life-threatening.

I can't rule out the possibility that my mind was somehow involved in triggering the symptoms or in how I interpreted them. All I can say for sure is that I wasn't dwelling on the generic vs. brand name drug question -- I didn't figure that out as a possible cause until later -- and that I did find myself dealing with symptoms that had been controlled when I was taking the brand name drugs. And it should go without saying that I would not be taking this drug if I did not need to do so.

In other words. the generic just did not work. I wasn't dealing with side effects, I was relying on a drug that did not do what it was supposed to do.

I certainly don't want to insinuate that generic medications never work and should be avoided at all costs. I know how expensive prescription drugs can be (my parents truly struggle with paying for their medications.) However, I also think it's prudent for people who need medications to be aware that a generic formulation might not work as well as the brand name formula, and to pay attention when they are switched to a generic, or among generics manufactured by different companies.

WIth medicine, as with diamonds, knowledge is power.

Date: 7/9/2009 10:17:41 PM
Author: studyer83

in order to create any patent, any manufacturer just need to change 20% of the components in the case of medication it is the inactive ingredients that gets modified. when we sold some tools we were able to patent it by changing or modifying 20% of the look/mechanism of the tool.

This is 20% incorrect, and if your patent attorney told you this, they were wrong. A patentable invention is novel and non-obvious, in addition to myriad other requirements. There is no % change over the prior art.

Patenting generic drugs is very complicated, but there are provisions in place (the Hatch-Waxman Act) to bring generic versions of patented compounds to market very quickly. The API, or active pharmaceutical ingredient, will be the same. Although the composition and ''inactive'' (sort of a misnomer) ingredients, such as dyes, can vary. These are where people see side effects, although they are very rare - but not to belittle anyone''s experience with generics. The FDA regulates these drugs and requires that they are ''bioequivalent,'' meaning the same API delivered in the same way with the same results.

It is possible that the 20% that you guys are talking to refers to the bioequivalence. Bioequivalence must not vary by more than 20% from the mean absorption. While this sounds large, it is statistically insignificant.

All that being said, I''m more familiar with the science/law and less with the insurance issue. I would imagine as insurers and the government tighten their belts, it will become harder and harder for people with legitimate reactions to generic meds to change over to regular. This is because, in part, some people just assume ''generic = bad'' and demand that their carrier pay for the extremely expensive name brand. I would likely make that same assumption were I not familiar with the area. People often request to be switched for no other reason than this. Or simply assume that their new problem is due to a med switch, when it is something else entirely. It makes it so much harder for those who cannot take the generics. The media is very reactionary on generics, and I''m not sure why.

Well our prior business partner did all the patenting work, so I know it was 20% modification from another tools line and it was trademarked as well, I wouldn''t say I''m 20% incorrect. But we''re talking about medicaton ingredients, and I''m not in the field so I won''t comment further.  

VRBeauty:

The API, or active pharmaceutical ingredient, is not only the same, but has to be absorbed equivalently. These are FDA requirements and they are closely enforced, but as with everything in life, some things can not go as expected. Your reaction is unfortunate, rare, and terrible. I certainly do not want to belittle your experience. I hope my post didn''t seem snarky or rude. By no means am I saying that nobody can ever have a poor outcome with generic drugs -- or any drugs.

I''m sure we all have areas where we know quite a bit due to our job or just an interest. When we see errors or just misconceptions made by the general public or the media, they can be frustrating. And so often, the public cannot help but misunderstand because the media or reporting is so bad! Whenever I see one of those areas, I tend to just want to just let people know, but I certainly don''t want anyone to feel like I''m correcting them. I personally always (well, usually!) enjoy learning about such things. But it always makes me wonder about the areas where I''m sorely misinformed, because I''m sure there are plenty.

This is a diamond forum, after all.....so many here have likely had that experience :)


D&T:

Perhaps the 20% that you were told was just a simple, shorthand way of explaining why your invention was patentable over existing prior art (the earlier tool)? All inventions generally incorporate some prior art and improvements are patentable. I just wanted to say that there is no percentage change requirement in patent law, not to say that you were not told that. Your invention must be novel over one reference or prior tool and not an obvious combination of two references or tools in the prior art to receive a patent. There is really no way of quantifying how different an invention is, but to the extent that it is possible, the differences could be quite low! Congrats on the patent by the way, innovation is a tedious process :)

Trademarks are actually quite different (and fun!) than patents. Whereas a patent protects the utility of your invention against copying for a limited term, a trademark protects the goodwill of a brand name against confusingly similar imitations. And a trademark only provides protection for that goowdwill, which is what consumers associate with your brand when they see your mark. A trademark cannot protect the functional elements of any trademark. So, your trademark protected the name and to a certain extent the "look" of the tool, as explained below!

So, for example, if Diet Coke invents a new sweetener for Diet Coke and decides to sell it in a new bottle.....they could patent the new sweetener if it was novel and non-obvious(although they might instead choose trade secret protection, but its an either/or thing!!). They could apply for a trademark for the name of the new sweetener if nobody else was using the name in commmerce. The patent would protect against others who manufacture the sweetener, the compound itself. The trademark would protect against others who sell anything--sweeetener or not--with a confusingly similar name. But it provides no protection for the compound. The new bottle could be patented to the extent that it is "useful," so perhaps, it contains thermal sensitive ink that changes color when it is old. The decorative aspects of the bottle, such as its shape, could be protected against copying by a design patent. And if consumers see the bottle and think -- aahh, thats the new Diet Coke -- a trademark can be taken out against the bottle! But it only protects those associations, the goodwill.

Whew! As you can tell, Im a mega-dork in this area. Its not really a thrilling dinner party conversation, sometimes I wish I was in a field that was more interesting
Its not very interesting to many people, but it keeps me busy

Date: 7/10/2009 2:36:24 AM
Author: VRBeauty
However, I also think it''s prudent for people who need medications to be aware that a generic formulation might not work as well as the brand name formula, and to pay attention when they are switched to a generic, or among generics manufactured by different companies.

WIth medicine, as with diamonds, knowledge is power.

Agreed as to both :)

And its hard to pay attention, the bottles all look the same and the switch seems passive. But with "news" reports saying that they can be 20% different -- its hard to get the knowledge!! Not to beat an incredibly boring dead horse, but the 20% has to do with a statistically insignificance from a mean absorption - a complicated pharmacokinetic area. When a reporter sees "20%" its totally understanding that he might hone in on it. And if I were to read the article, I''d freak out too!!

Date: 7/10/2009 10:10:00 AM
Author: studyer83
VRBeauty:

The API, or active pharmaceutical ingredient, is not only the same, but has to be absorbed equivalently. These are FDA requirements and they are closely enforced, but as with everything in life, some things can not go as expected. Your reaction is unfortunate, rare, and terrible. I certainly do not want to belittle your experience. I hope my post didn''t seem snarky or rude. By no means am I saying that nobody can ever have a poor outcome with generic drugs -- or any drugs.

I''m sure we all have areas where we know quite a bit due to our job or just an interest. When we see errors or just misconceptions made by the general public or the media, they can be frustrating. And so often, the public cannot help but misunderstand because the media or reporting is so bad! Whenever I see one of those areas, I tend to just want to just let people know, but I certainly don''t want anyone to feel like I''m correcting them. I personally always (well, usually!) enjoy learning about such things. But it always makes me wonder about the areas where I''m sorely misinformed, because I''m sure there are plenty.

This is a diamond forum, after all.....so many here have likely had that experience :)


D&T:

Perhaps the 20% that you were told was just a simple, shorthand way of explaining why your invention was patentable over existing prior art (the earlier tool)? All inventions generally incorporate some prior art and improvements are patentable. I just wanted to say that there is no percentage change requirement in patent law, not to say that you were not told that. Your invention must be novel over one reference or prior tool and not an obvious combination of two references or tools in the prior art to receive a patent. There is really no way of quantifying how different an invention is, but to the extent that it is possible, the differences could be quite low! Congrats on the patent by the way, innovation is a tedious process :)

Trademarks are actually quite different (and fun!) than patents. Whereas a patent protects the utility of your invention against copying for a limited term, a trademark protects the goodwill of a brand name against confusingly similar imitations. And a trademark only provides protection for that goowdwill, which is what consumers associate with your brand when they see your mark. A trademark cannot protect the functional elements of any trademark. So, your trademark protected the name and to a certain extent the ''look'' of the tool, as explained below!

So, for example, if Diet Coke invents a new sweetener for Diet Coke and decides to sell it in a new bottle.....they could patent the new sweetener if it was novel and non-obvious(although they might instead choose trade secret protection, but its an either/or thing!!). They could apply for a trademark for the name of the new sweetener if nobody else was using the name in commmerce. The patent would protect against others who manufacture the sweetener, the compound itself. The trademark would protect against others who sell anything--sweeetener or not--with a confusingly similar name. But it provides no protection for the compound. The new bottle could be patented to the extent that it is ''useful,'' so perhaps, it contains thermal sensitive ink that changes color when it is old. The decorative aspects of the bottle, such as its shape, could be protected against copying by a design patent. And if consumers see the bottle and think -- aahh, thats the new Diet Coke -- a trademark can be taken out against the bottle! But it only protects those associations, the goodwill.

Whew! As you can tell, Im a mega-dork in this area. Its not really a thrilling dinner party conversation, sometimes I wish I was in a field that was more interesting
Its not very interesting to many people, but it keeps me busy

it is an interesting filed - I find it fascinating thanks for your comments and I do like to learn from others as well, it has been fun to trademark a few logos myself. SOrry MC - Threadjack Over

Date: 7/10/2009 12:04:45 AM
Author: Keepingthefaith21
See if you can have your Dr. call both Express Scripts and your insurance company if you experience anything unusual. Lamictal is one of the few drugs we will waive MAC pricing on due to the overwhelming number of patients experiencing break-thru seizures. We know these members are not merely stating dissatisfaction just to keep the name brand as our case management team follows inpatient members and we have seen enough of an increase in complications with our members who suffer from a seizure disorder that we have taken action. This is only for members who are using the drug to control seizures and we require a letter of medical necessity but if you meet those criteria you can obtain a waiver. I really hope we are not unique in doing this for our members and other companies are recognizing this serious problem for members.

I wish you the best of luck with getting better coverage!

It's prescribed as a mood stablizer rather than for epilepsy/seizures.  I am taking a high enough amount that if the generic doesn't have the full amount, I could have withdraw problems.

I'll know within three to five days if the generic isn't working because once I tried to reduce my dosage of the brand name (went down 25 mg every other week) from 250 to 200 and noticed severe problems!

I see a lot of this day-to-day, as I am a pharmacist. On paper, generic drugs must be bioequivalent (meaning similar absorption in the body) as the brand names. These tests are done in the lab (not in people), and I can never say for sure that each patient is going to react as well to the generic as they do to the brand. I always comply with prescribers'' and patients'' requests for brand-name medications. Unfortunately, insurance companies do not always feel the same way about that.

That said, many big name companies (Pfizer, Lilly, GlaxoSmithKline, etc.) also own companies that produce generics. Often times, the generic medication is made by the exact same company as the brand. It even looks the same, they just don''t stamp the name on it, or they change it to a different color. I also feel there are more reputable generic companies than others.

All in all, its worth doing your research on any medication you take. You are the person taking your medication, and if you feel unsafe or unwilling to take a generic, than the brand-name is the better option for you. It will be very difficult to get your ins. to pay for it, but its worth a try! See if your pharmacy can help-I often call insurance for my patients.

In addition, that article isn''t very accurate in many aspects. I am licensed in more than one state, and the MD always has the discretion to choose a brand name. We also are required to ask the patient if a substitution is okay. I think it portrays generics in a bad light, and for most people, they work just as well and are much less expensive.

I hope that helps! If you have any questions about anything, please ask.