Ask Lemmy

One of the big things I don't see mentioned here is that while the "active ingredient" in the medication is the same, all the other stuff in it is not. This also includes the binding agents that hold the med together and also the release mechanisms that control how/when the medicine is absorbed into your body.

For example, generic extended release amphetamine salts don't release into your body in the same way Adderall XR does, despite being the same medication. While the patent on the drug has expired, the patent on the proprietary release mechanism has not expired. So generics can't copy it. This could cause the generic to not work as well for some people, or some people could have a reaction to those different ingredients.

Edited: fixed spelling

Because I use a real programming language, tell me what a T is and I'll start caring

It’s rare, but some people do have adverse reactions to generics, and have to use the name brands.

In addition to the reasons other people mention, placebo is a helluva drug. If you believe the name brand is better, it may actually become more effective for you even if the active ingredients are the same as the generic.

It all depends on the generics. I buy generic cereal. But only certain ones because other ones I have tried aren't the same as the name brand and I like the name brand. Sometimes it's as simple as texture difference or a difference in flavor.

In the case of my epi-pens, the generic injectors don't work exactly the same and that can be a bit much in an emergency where your throat is swelling shut or you're having difficulty breathing.

In the case of something over the counter, I'd still wager things like mouth feel, smell, or other sensory factors are a reason. Like for instance, I prefer the smooth coating on Advil to the matte coating on Motrin or other ibuprofen generic meds.

The generic Advil don't have the candy coating.

I grew up in a poor household, relative to the other kids I went to school with. While I was in public school, I was bullied for not wearing name brand clothing and because all of my school supplies and snacks and everything was generic brand. I became extremely self-conscious about it, and was always trying to hide what I had, or if I found name brand packaging for something in the trash or on the floor, I'd grab it so I could repackage my stuff and pretend like I totally had name brand stuff. As a young adult when I went to college, I only ever aimed for buying name brand stuff, but it was really hard to do so, considering I was still broke...

Anyways, I eventually matured a little more and realized kids are cruel and the whole thing was dumb. I exclusively go with generic everything now and am, always trying to get the best deal, and I even went back to buying second-hand clothes, cause why not?

All that to say, maybe some people had similar experiences and just never grew out of it.

In fact, I do prefer to buy generics. There are dozens of us!

I'm guessing it's because of concerns about quality control.

Not to be super-pessimistic but the pharmaceutical industry seems to based upon encouraging awareness and promotion of name brands. Advertising and incentivizing doctors to prescribe promotes a system where the average patient has a hard time understanding and navigating, especially where the patient wants the best opportunity to treat a significant impact to their wellness.

For the most part, I choose the generic version for pharmaceuticals where available, but there are a few exceptions. For example, for something like a nasal spray, the generic version's dispensing mechanism may be inferior?

Many generic meds are made in filthy factories with no quality control.

https://www.bostonglobe.com/2024/06/17/metro/dozens-of-cvs-generic-drug-recalls-expose-link-to-tainted-factories/

The FDA is slacking on testing generics for quality assurance, but third parties and other countries are revealing problems.

https://www.forbes.com/sites/arthurkellermann/2024/01/10/we-should-test-generic-drugs-to-assure-safety-the-fda-hates-the-idea/

https://www.statnews.com/2024/08/12/fda-withdraw-approval-400-plus-tainted-drugs/

In Canada we have generics and we still scare smoothbrainers about how the generics will give you a shitty ass compared to the full Branded version just to keep them in the ecosystem

And then we make it so you can't fill all your prescriptions on the same day, so now you gotta set calendar reminders for when each one is due for a refill

Though there are in some cases specific reasons to use certain brands, its usually just due to marketing, branding, and near total ignorance.

In Denmark the pharmacies are required to offer the genetic version. I generally take it. I know that a lot of elderly can get confused if their medicine changes, so that's one reason for choosing the brand name.

My mom had medicare and a good secondary. Looking back, i should have requested name brands for her. With generic, there are often a couple of different patterns (size, shape, color) that you get and it makes it really difficult for older people to take their meds correctly.

Where I live (Germany), it's fairly common to buy the generics. Not everyone does it, but enough people. They're available and oftentimes it's the exact same ingredients inside, just a different packaging and brand name on it. And a third of the price or so. I think it's more that people buy what they're used to. And if you just ask for Aspirin (which is a brand name here), the pharmacist is going to hand you that, and not the generic. So it's a bit more effort to add half a sentence to deliberately ask for the cheap one.

Their reasons will remain a mystery. If they don't want to tell you, you'll just never know.

As for me, I use generic medications whenever I have to pay for it out of pocket. If insurance covers it, I'm not putting in the effort to make sure I get generic.

There is significantly less oversight on generics vs brand. As a medical provider I have seen numerous examples of generics not working nearly as well as brand and I have switched patients back to brand. YMMV.

People don't? The only drugs I use are generics, where I live they usually cost half the price or less and work just as the original does, I've never had problems so this is news to me. Maybe things are different elsewhere?

KISS and YAGNI

Perception that the generic brands don't work as well or are lower quality. I had a co-worker who maintained that the generic version of his prescription drug didn't work at all for him (this was back when France passed a law that is generic version of your medicine existed, the branded version wouldn't be fully covered by the state health insurance, so lots of people were complaining about them)

Training

Doesn't it kinda depend on what the doctor writes on the prescription? I've had both doctors who just put the brand name on there but also doctors who insist on writing down the generic version.
Either way, I don't really see any point in arguing with them about whichever one they prefer? The medicines generally do work the same.