Forced to buy generic medication?

[Lillers]

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.

 

[MichelleCarmen]

Date: 7/10/2009 9:25:54 PM
Author: Lillers
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.

Thanks so much for the info re: some big companies making the generics. Lamictal is made by GlaxoSmithKline so I'll find out if they're related to any of the generic brands. The generic I bought do not look anything like the brand design/color so chances are, I take it, the company isn't connected to the original.

The generic brand I bought is by "Dr. Reddy's Lab." Sounds odd to me. Reminds me of something I'd read out of the newspaper like a street drug lab!

ETA - I just sent a message to GSK asking if they can recommend a generic alternative brand

 

[MichelleCarmen]

Hi everyone,

I found an "AB rated generic equivalent" version of Lamictal. Does that sound like the right type of generic to aim for? I''m going to call pharmacies to find one that carries the lab suggested (Teva).

 

[Hudson_Hawk]

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.

while the active compound is technically the same, the other compounds are not the same. The binders and preservatives are often different, one brand/generic to the next. So while generally generics and brands act the same, some individuals may react differently to the generic. Similarly, some people may not be able to tolerate a brand but can tolerate a generic because of this. For example (OTC in this case). I''m allergic to a particular type of red dye. This dye is found in BRAND Benadryl. I have a horrific reaction to Benadryl. However, I''m not allergic to diphenhydramine, the active ingredient in Benadryl. I can take generic versions of it if the dye isn''t used.

I was a pharmacy tech for 7 years and while things may have changed since then, I recall that your insurance company couldn''t refuse coverage if your doctor wrote specifically for the brand and specified it was for a medically-relevant reason. You might have to get a prior authorization (where the ins actually confirms with the Dr''s office), but with the PA a lower copay would apply.

 

[Hudson_Hawk]

Date: 7/11/2009 1:39:22 PM
Author: MC

Date: 7/10/2009 9:25:54 PM

Author: Lillers

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.

Thanks so much for the info re: some big companies making the generics. Lamictal is made by GlaxoSmithKline so I''ll find out if they''re related to any of the generic brands. The generic I bought do not look anything like the brand design/color so chances are, I take it, the company isn''t connected to the original.


The generic brand I bought is by ''Dr. Reddy''s Lab.'' Sounds odd to me. Reminds me of something I''d read out of the newspaper like a street drug lab!

ETA - I just sent a message to GSK asking if they can recommend a generic alternative brand

Lillers can probably elaborate on this, but you can''t always guarantee that the generic bottle the PharmD or Tech grabs is going to be the same maker month-to-month. Different generic "brands" can be supplied depending on availability.

 

[Hudson_Hawk]

Date: 7/11/2009 3:34:31 PM
Author: MC
Hi everyone,


I found an ''AB rated generic equivalent'' version of Lamictal. Does that sound like the right type of generic to aim for? I''m going to call pharmacies to find one that carries the lab suggested (Teva).

Teva is a very common generic company. I don''t think you''ll have a problem finding it. I would go in and speak with the pharmacist, explain the situation and ask them if they''d make a note to keep that brand in stock so it''s available to you each month. They should be able to add a note in your file that flashes when they refill the Rx stating to use the Teva brand. You might also want to consider calling them each month to refill to remind them that you need the Teva brand. Pharmacies get deliveries every day so the should only need a day or two notice to get it if it''s not in stock.

 

[Allisonfaye]

Do you have Medco by any chance? They are really laying it on thick to buy the generic and I have heard several complaints. Just make sure (check with your doctor) that the medication is exactly the same. I saw something recently in the news how some of the generics were slightly different and therefore, not as effective.

 

[MichelleCarmen]

Date: 7/15/2009 3:48:36 PM
Author: Allisonfaye
Do you have Medco by any chance? They are really laying it on thick to buy the generic and I have heard several complaints. Just make sure (check with your doctor) that the medication is exactly the same. I saw something recently in the news how some of the generics were slightly different and therefore, not as effective.

Nope, I do not have that. I talked to someone who works in pharmaceuticals and she said Teva and Dr. Reddy''s are both reliable.

I haven''t had any problems yet, so unless I do have side effects, I won''t have any shot at convincing my insurance to cover the more expensive brand.

Hopefully in a few months, all still is good and I can be thankful that I''m saving the $150-175 I was paying every month *after* insurance paid 1/2.

 

[Lillers]

We fill LOTS of prescriptions with Teva generics. Its great that you got a recommendation from the company. I''m sure any pharmacy you go to would be glad to help you out. Just make sure you call a few days before you run out, because they *may* have to special order it for you each month. They can elaborate on all of that because each pharmacy is run differently.
AB Rating is a good thing. The "A" means it passed testing to be considered equal to the active ingredient in the brand name. The B just means its a tablet. You can google "FDA Orange Book" and they have plenty of information on their website about brand and generic equivalents. Many states require pharmacists to consult this book before they are allowed to substitute. Its built into the computer systems at many chain pharmacies even.
I really hope the generic works out for you, because that sure is a lot of $$ of save each month!

 

[ams0124]

MC,

I don't know much about prescription drugs, generic vs. brand name but I do have some personal related experience with Lamictal that I thought I might share...

My sister has epilepsy, and takes a combination of meds to control her grand mal seizures...Lamictal being one of them. When the generic version was made available her insurance company did the same as yours and forced her to switch if she didn't want to pay the full price of Lamictal...I can't remember which version it was...I think maybe it also started with an "L" or was pronounced very similar?

but anyway 5 days after her beginning the generic version she had her first grand mal seizure in 10 years...she could have died. The doctors at the hospital told her it was stress...she continued taking the generic version...two weeks later she had another seizure...again, could have died. It took multiple documents from her regular doctor to the insurance company, and several other complaints from different people that she was finally able to switch back to Lamictal for her regular co pay.

My mom was relentless with trying to get this sorted out and it took months! It was the worst my sister had been since being diagnosed. She had more seizures in 4 months then she had in the entire time before she was diagnosed. It was almost like the generic version was making her worse. She's back on Lamictal and has been seizure free again

I know everyone reacts differently to medications, and my sister's reaction could be somewhat isolated...but I thought I would just put it out there.

Please be careful with this generic version. I'm biased for sure, but it really scares me when people say they are taking the generic version of anything let alone Lamictal.

 

[MichelleCarmen]

Your poor sister. How scary! I''m glad her insurance has decided to cover the brand name again! Epilepsy is simply one disorder that insurance companies are idiots to not realize needs the best form of medication that works!

I''m on the med for mood stablization (mostly it keeps me from feeling depressed during the winter and slighly less hyper during the summer). For a few days I was feeling fine, but now I''ve developed a slightly case of anxiety and my OCD is coming back a bit. It was mostly gone for the last six years! I''m not sure if it''s breakthrough anxiety or withdrawl from the Lamictal.

The generic that you were looking for the name of is Lamotrigine.

 

[orbaya]

I am on Lamictal also, for seizures. My doctor checks the brand name only box on the prescription so that''s what I''ve always had. I''ve paid $50 for a 3 month supply for years, and then a few months ago they tried to charge me over $500! I went through my doctor''s office to appeal that, but the insurance company denied it, saying that I would have to try the generic and see if I had any reactions first. Well, I''m pregnant and I''m not going to mess with medications right now. My pharmacy found that if I got the 200mg pills instead of the 100mg, it was less pills so I had to pay $320 for 3 months. So I decided to do that. A few weeks ago, I was expecting to pay the same amount, but I was only charged $50, and I did get the brand name so I''m not sure what happened.

I''ve done a lot of research on the generic version of Lamictal and there haven''t been many good reviews, so I refuse to go on it. I can''t risk having a seizure...it''s not good for the baby, plus I would lose my driver''s license for 6 months, among other things. So even if I end up having to pay $300, it''s worth it to me. Hopefully it stays at $50 though.

 

[orbaya]

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!

I take Lamical for seizures, and have always taken the brand name because that is what my doctor requests on the prescriptions. My pricing jumped from $50 for 3 months to over $500! My doctor''s office tried to appeal that for me, but insurance said no, I''d have to try the generic for 1 month first. I''ve done a lot of research on the generic brand and it scares me and so I refuse to try it. I cannot risk having a breakthrough seizure (I haven''t had one in 9 years!) because I am pregnant, and I would lose my driver''s license for 6 months. For some reason the last time I got my prescription filled, I was only charged the $50 again, so I don''t know what''s that about.