A couple months ago, I remember having a conversation with my mother about generic versus brand name prescriptions.  I remember she had read something that said while generic and brand name drugs both have the same active ingredients, the generics are wildly inconsistent with inactive ingredients.  She explained that the generic drugs were being produced at different locations (rather than brand names which are produced by the same manufacturer) and that this difference can affect each refill’s chemistry content. With drugs that often help one condition and almost create another by their side effects, these inactive ingredients (especially ones that fluctuate) should be taken into account as potential causes for variation of these side effects.

In the past few weeks, I have had the misfortune of getting acquainted with a new benefits policy that makes my prescription costs double what they were a few months ago.  Being that I am on a brand named drug, my mother’s first suggestion was to “see if I could switch to a generic.”  Instantly I was reminded of that previous conversation and because I haven’t experienced any side effects and I’m happy with the drug that I’m on, I don’t just want to play with my body’s chemistry because of cost.  So this week, I decided to do my homework.  I wanted to know if this myth about inconsistent inactive ingredients was true, and I wanted to get to the bottom of what the real difference is between generic and brand named drugs.

MD Lynn, a contributor for a Yahoo article, reports:

“The main difference between the brand name versus generic drug prices is likely that the brand name drug has the cost of the research, development, testing, and patent costs built into the drug.”

Basically these big manufacturers spend more for the rights, testing, and advertising that make the consumer pay more.  But Lynn also notes a “smaller” difference: that the two drugs may also look different which can be a cause of different “inert ingredients” (those that give the drug it’s shape, color, taste, but do not interact with how the medication works).   These ingredients, however, may put the user at risk for allergic reaction, which Yahoo explains is why doctors may most likely write the prescription for a brand name drug rather than a generic.

The Food and Drug Administration has declared that generic drugs, while cheaper, must be subject to the same regulations for active ingredients, strengths, form of dose, and route of administration.  In addition, they report this fact: “Research shows that generics work just as well as brand name drugs.”  Except, their explanation of this claim is based on “38 published clinical trials comparing cardiovascular generic drugs to brands.”  So because cardiac medication passes, that means this must be true for all medications?  I’m a little disappointed here, FDA.

Sanjay Gupta, from CNN Health, reported that “there has been some anecdotal evidence suggesting some types of drugs may react significantly differently between the generic and brand.”

And he made the connection that these different reactions could be caused by different inactive ingredients used in the generic version of the drug.  He said it’s not common, but should be something to discuss individually with your doctor.

Finally, in an article published a few years ago, ABC News reported on extreme cases of different reactions in people taking a certain antidepressant.  In fact, the director of Pharmacy Services at the University of Michigan Health System, James Stevenson, was quoted in this article expressing concern over the difference in release times between generic and brands, which caused the inconsistent effects of switching to a generic antidepressant after being on the brand.  This article suggests that the problem is the FDA tests the release time of generic and brand name drugs in a beaker, not through human blood levels.  (This generic for the antidepressant was eventually recalled in 2012.)

Obviously nothing is perfect—even drug companies are bound to make mistakes once and awhile.  It may be the case that some drugs are more likely to be affected by subtle differences of the generic form.  I think whether or not to choose generic over brand name drugs should be something that an individual should research about their specific drug, and, of course, discuss with their doctor.

By:  Rachel Blanzy

(Photo by ckaiserca under a Creative Commons License)