Moving to Generics – Chemical vs. Therapeutic

Since many in the industry miss the semantics here, I am sure those of you that are consumers could benefit from a couple of points here.

If you are on a brand drug, there are two types of generic opportunities to consider.  One is a chemical substitution.  In this case, the patent has expired on the brand and the same chemical entity is available in a generic form.  In many cases, unless your physician marks DAW (dispense as written), you will get the generic drug (or pay for chosing the brand drug).  The only time I would ever hesitate to do this is on NTI (narrow therapeutic index) drugs where the active ingredients are titrated to your blood – e.g., coumatin.

The other type of generic savings opportunity is a therapeutic substitution.  In this case, there is a generic drug that is therapeutically equivalent to your drug but NOT the same chemical entity.  For example, if you take Lipitor, you might have the same ability to manage your high cholesterol using generic Zocor which became available about a year ago.  In most drug classes (or for most conditions), there is a generic drug available.  Many of these were the former blockbuster drugs in this category. 

It is worth talking to your physician or pharmacist about this.  Additionally, it is worth going to your managed care or PBM website and using their online tools to look up chemical and therapeutic switch opportunities. 

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