Footnote Frivolity***, Money Matters

Saving money with generic medicines

While you might be congratulating yourself on avoiding the dentist’s for another consecutive year, it’s the regular health expenses, such as medication, that add up. We Australians are lucky enough to live in a country where medicines are subsidised, but even with the Government’s contribution, a particular medicine can cost you up to $35.40 per month or $424.80 per year.

It’s possible to get a better deal by shopping around or bulk-buying from discounters but there’s something to be said about supporting the local*, since they’ll often give you free advice/recommendations, saving you a trip to the doctor’s.

Wherever you choose to go, consider buying generic. Generics are often cheaper than innovators because their companies do not spend so much money on research, development and advertising. Also, to take advantage of the misconception that costly means quality, innovators sometimes price themselves higher than generics.

But are generic medicines the same as their branded counterparts? Yes, if you’re in Australia. Pharmacists cannot substitute brands unless they are listed as interchangeable by the Pharmaceutical Benefits Scheme (PBS), it is safe for the patient, and the prescriber hasn’t prohibited the swap.

Different brands of the same medication are only interchangeable when they meet the same standards:

The Therapeutic Goods Administration (TGA) requires that generic medicines meet the same quality criteria and manufacturing standards as original brands. The TGA also requires evidence of bioequivalence – that is, a generic medicine must have an equivalent drug plasma-concentration profile to the original brand or market leader. (via NPS)

For those who don’t speak pharmacologese, bioequivalence is a way of showing equivalent clinical effectiveness. A review of 38 clinical trials comparing the effect of generic versus branded cardiovascular drugs supports the use of bioequivalence data (via NPS), so ‘[o]n scientific grounds there is no reason to be concerned about substituting a generic product for a branded product that is flagged as being bioequivalent’ (via Australian Prescriber).

Hence buy generic medicines when you can.

However, there are some instances where you should not buy generic:

  • When you’re easily confused by brand-swapping. You might end up taking two brands of the same thing or you might not recognise a dispensing/prescribing error (i.e. wrong strength of medication) because the box looks different anyway.
  • When your medication has a ‘low therapeutic index’. Some medicines (i.e. digoxin) are a bit touch and go, and the slightest change can cause the medication to not work or have more side effects.
  • When you are allergic to an inactive ingredient (i.e dyes or fillers) or have a special dietary requirement (i.e. no animal products). Different brands of the same medication may have differences in inactive ingredients, even though the active ingredient is exactly the same. For instance, one brand may have gluten whilst another may be gluten free, so it’s always a good idea to check with your pharmacist even if you decide to go with the innovator brand.

Even if you can’t have certain inactive ingredients or if you’re on a medicine with a low therapeutic index, you can still opt for the generic that is marketed by the innovator. Microgynon and Levlen both come from the same manufacturer; not only are they bioequivalent, they’re identical; why pay more for the Microgynon?

*I work in an independent pharmacy so I am somewhat against the chain discounter model. It’s a bit anti-thrift, I know, but hey, support local businesses, y’all.

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