They All Look the Same to Me

(Did your mother buy you "Official Building 19" cereal?  Mine did.)

I am about to start my second year of my second graduate degree ("20th grade").  Both of my parents went up to Grade 20 and beyond, quitting their jobs when I was five to go to graduate school for a second time.  So I am well acquainted with the lifestyle of the starving grad student.  I grew up eating generic brand cereal— the kind that come in bags rather than boxes and never with toys.  Even today, I often buy store-brand, though I do so begrudgingly (the same attitude applies to eating vegetables).  Generic cereals are powdery, ugly, and gross.  I much prefer my Kellogg’s Special K with Red Berries.  Yet when it comes to drugs, I always choose generic over Special K.

Remember how important it is to take your medications rather than flush them?  A major reason why people are non-adherent is because they can’t afford their medications.  About 1 in 4 American adults report taking less medications than prescribed to save money.  Since cost is a major barrier to adherence, promoting cheaper drugs is one way to improve patient adherence. 

Unlike store brand Plucky Charms, generic medications are cheap in price but not quality.  They only cost less than the brand name alternatives because the companies don’t have the same research & development costs branded manufacturers do.  In exchange for doing the legwork, branded manufacturers get unrivaled sales for about 10 years and set whatever price they want, making butt loads of money.  Generic drugs come on the market after the patent expires.  They are mandated by law to use the same ingredients and formula as their branded alternatives.  Plucky Charms aren’t mandated the same way.  Moreover, studies have demonstrated that generic medications are just as effective as branded drugs, even for classes of medications in which just a small difference can change how a drugs work— so called “narrow therapeutic index” drugs, like those for epilepsy.  Plucky Charms have not stood up to such rigorous testing.  Nobody should have to eat Plucky Charms.  But you should trust your generic drugs.  (And if you're still skeptical, we’ll talk about tricking you into trusting them in a future post).

Policy Implication: Generic drugs are cheap, effective solutions to cost-related underuse.