Brand-name vs. generic medications: Which is best?

By Charles E. Crutchfield III, MD

Dr. Crutchfield, I went to pick up a prescription and instead of the brand-name drug my doctor prescribed, the pharmacy gave me a generic drug. Is this ok?

The vast majority of patients experience the same results from a brand or a generic medication. That being said, it is unclear to doctors why, rarely, patients report they respond better or differently to either a brand-name medicine or a generic medicine when they are equivalent.

In fact, brand-name drugs and generic drugs have the same active ingredients in the same exact amounts. The term for this is “bioequivalent.” Some patients are unaware they have the same active ingredients and can get confused. 

Brand-name medicines almost always cost more than generic drugs, and some people mistakenly think that if it costs more, it must work better. Some attribute this to the “placebo effect.” Sometimes the cost difference can be so significant that unless a generic is used, the patient could not afford the medicine. This could mean the difference between sickness and good health.

Although the active ingredients in brand-name and generics are the same, the medicines might not be the same. The differences may be found in the “inactive ingredients.” These include the fillers, colorings, preservatives, and especially in dermatology, the vehicle (cream or ointment) that the medicine is in.

In fact, in dermatology, 40 percent of the effectiveness may be due to the vehicle (cream or ointment) alone. If the cream is good at letting the active ingredient get down deeper in the skin, it can work better.

Because of the differences in the inactive ingredients, some generics may, rarely, not work as well as brand-name medicines. It is also important to make sure you are not taking any new medications that may interfere with the effectiveness of the generic drug. This could lead you to believe that the generic drug is not working as well when, in fact, that may not be the case.

Because of the cost savings, I recommend trying the generic first. If it does not give you the results you are accustomed to, talk with your doctor to work with the pharmacist and get the insurance company’s authorization to use the brand-name medicine.

The bottom line is that you should use the medicine that works best for you. Most of the time, generic medications work just fine and are a better value.

Charles E. Crutchfield III, MD is a board certified dermatologist and Clinical Professor of Dermatology at the University of Minnesota Medical School. He also has a private practice in Eagan, MN. He has been selected as one of the top 10 dermatologists in the U.S. by Black Enterprise magazine and one of the top 21 African American physicians in the U.S. by the Atlanta Post. Dr. Crutchfield is an active member of the Minnesota Association of Black Physicians, MABP.org.