When you go to pick up your prescription for a medicine you've been on for some time, it may look different to the last prescription you had dispensed and may have a different name on the box. What's going on? Could the pharmacist have given you the wrong medicine?
It's always a good idea to check your medicines carefully, but the difference is likely to be because you've been given a version of the same medicine with the same active ingredient but with a different name.
For example, someone who is prescribed a statin to lower their cholesterol to reduce the risk of heart disease may have initially been prescribed Zocor (the brand name for one type of statin, simvastatin) and then been switched to the generic equivalent, simvastatin. They both contain the same medicine and have the same clinical effect, but may be made by different manufacturers and so have different names.
It's rather like being able to buy branded washing powder and a supermarket’s equivalent: it does the same job, but the supermarket’s own-make washing powder is much cheaper.
Why do medicines have brand and generic names?
During the first few years that a new medicine becomes available, it's usually marketed as a branded medicine, under the name given by the pharmaceutical company that developed it.
Companies take out patents on each new drug they discover to ensure that they're able to regain the money (typically £500million) they spend on its development and then make a profit. Having a patent means a company has a monopoly on producing a medicine for a certain time, usually up to 20 years in the UK, in exchange for sharing information about the medicine and how it's produced.
On average, it takes the first 10 to 12 years of this period to develop a medicine and obtain a licence, so the company then has the remaining years during which it has sole rights to produce and sell the medicine, which it markets as a branded medicine. An example of a branded medicine is Lipitor, a statin used to lower cholesterol.
Once the patent protection has expired, other companies can produce generic copies of the medicine. Generic medicines are usually cheaper because there are fewer research and development costs but they contain the same active ingredient as the branded products.
Generic medicines go through the same stringent safety and quality requirements demanded of the original branded product.
Why do doctors and other health professionals prescribe medicines using the generic name?
Prescribers are encouraged to prescribe medicines by their generic name because such medicines are as effective as their branded equivalents but can cost up to 80 per cent less. This frees up NHS resources to pay for other treatments. It also gives the pharmacist the widest choice of products from which to dispense. This is important, especially if there's a shortage of a particular product.
More than 80 per cent of all prescriptions for NHS patients in England are now written generically.
Generic prescribing is becoming particularly common for statins, widely prescribed medicines that lower cholesterol as part of reducing the risk of heart disease. This is because generic versions of some of these medicines are now available at a much lower cost than their branded equivalent. For example, generic simvastatin (20mg), a type of statin, costs £0.55 for a pack of 28 in January 2008, compared with approximately £25 for a pack of 28 of the branded version.
Cases where the generics may have different activity
There are a small number of special cases where it's considered important that you remain on the branded medicine that you've been previously prescribed because it's the most suitable product. For example:
- Epilepsy medicines: these should be treated with care because different formulations may have small variations in absorption that can result in large differences in their therapeutic effect. Prescribers may decide that the branded version of lamotrigine (Lamictal) is more suitable than the generic version.
- Modified-release preparations of nifedipine, diltiazem and verapamil, used to treat heart conditions. A branded version may sometimes be a better option than the generic equivalent.
- Modified-release theophylline.
- EC Mesalazine.
- Beclometasone dipropionate CFC-free inhalers to treat asthma. There are two inhalers available containing the same active substance (beclometasone dipropionate), but they're not exactly the same, so you should not change from one to the other without discussing it with a prescriber or pharmacist.
- Any product where the generic name could cause confusion, such as hormone replacement therapy (HRT) and insulins.