Rx Information

This section provides some basic information on prescription drugs, their safe use, and the importance of talking with your doctor

Talking With Your Doctor

It’s important for you to know that the information we present in our reports is not meant to substitute for a doctor’s judgment. But we hope it will help your doctor and you arrive at a decision about which drug and dose of a drug is right for you, and which gives you the most value for your health care dollar.

We encourage you to take the information in our reports to your doctor. Individual needs vary and your condition may require special considerations that our reports do not address.

At the same time, bear in mind that many doctors do not routinely take price into account when prescribing medicines. Understandably, you may be reluctant to discuss the cost of medicines with your doctor. But unless you bring it up, your doctors may assume that cost is not a factor for you.

Many people (including physicians) also believe that newer drugs are better. While that’s a natural assumption to make in a society that puts a premium on new things (and is barraged with advertisements for them), the fact is that it’s not always true when it comes to prescription and nonprescription medicines. Studies consistently show that many older medicines, including generics and nonprescription drugs, are as good as–and in some cases better than–newer medicines.

 

Generic Drugs

Prescription drugs come in two basic forms–brand name drugs and generic drugs. Generic drugs are copies of brand medicines whose patents have expired. A generic drug has exactly the same active ingredients as the brand drug it copies. The only difference is price and how the pills look: generics are much less expensive and by law are not allowed to look exactly like the brands they copy (a certain color or shaped pill, for example).

Generics are widely misunderstood. Many people believe that because generics are older, they are not as potent or effective. The truth is that the vast majority of generics continue to be useful medicines even years after their approval, and many remain the preferred first-line treatment even after newer brand competitor medicines emerge. That is why today about half of all prescriptions written in the U.S. are for generics.

Another misconception is that generics are less safe or more likely to be tainted.

This, too, is not true. As the FDA attests in the information it provides on its Web site and in print, generics are every bit as safe as brand-name drugs. The FDA applies the same set of strict rules to generics as to brands. Both must meet exacting specifications for their ingredients and manufacture. FDA requires generics to have the same quality, strength, purity and chemical stability. And generics must work the same way in the body. Both are tracked for their safety over time. Instructions to doctors and patients about the use of generics must be the same as for the brands they copy.

Indeed, a good way to think about generics is as “tried and true.” They have met the test of time–most generics come on the market 12 to 15 years after the brand drug they copy was first approved.

In contrast, it’s not uncommon for doctors and drug companies to find problems with new drugs that come to light only after they are approved. That’s because even though new drugs undergo years of study to prove they are safe and effective, those studies may have involved only several thousand people; once a drug is used by millions or people, new problems can and do crop up.

In some cases, of course, new brand drugs eclipse older generics in terms of both safety and effectiveness. That is to be expected, and reflects medical innovation and progress.

But such advances are not as prevalent as you might believe. In fact, a growing number of experts, doctors, medical and health groups and pharmacists believe that some newer and more expensive brand drugs are overused while many generic drugs are underused.

The reasons for this are complex but the main ones are:

• Brand-name drugs are widely promoted and advertised to doctors, while generic drugs are only minimally promoted. Brand marketing includes one-on-one sales pitches from drug representatives.
• Brand drug makers give doctors millions of doses of the newest drugs to hand out to patients–free. This gets patients taking the newest medicines, which can be the most costly. Some of these will be better than available generics. But many will not.
• Brand drug companies, but not generic companies, give doctors free gifts and often pay their way to seminars and lectures, or even out–of–town conferences, to hear about new drugs.
• Brand-name drug makers pay thousands of doctors every year to either give lectures on the newest drugs or use them as part of clinical studies. Both can be useful enterprises but doctors often get used to prescribing the new drug instead of older reliable drugs.
• Brand drug companies spend tens (or even hundreds) of millions of dollars advertising their drugs directly to the public. Generic firms hardly advertise their drugs at all to the public.

Federal and state laws in the last 20 years have encouraged the development of more generic drugs, and their wider use. For example, most states allow pharmacists to substitute the generic version of a drug when a doctor has written a prescription for the more expensive brand. But in many states, the pharmacists must ask the consumer permission to make the switch. Fearing they will get a drug their trusted doctor did not intend, many consumers still say no.

Our recommendation is that you talk to your doctor about your prescription when it is being written in his or her office. You should inquire whether the prescription is for a brand or generic, and learn why your doctor has prescribed one or the other. If you pay for your medicines out-of-pocket, because you lack insurance coverage for drugs, you should ask your doctor if there is a less expensive generic drug that would work for you.

If a pharmacist suggests substituting a generic, there is no reason to object. We suggest you call your doctor if you are concerned about this switch.

Download our Money Saving Guide: Generic Drugs – What You Need to Know

 

Keeping a Record of Your Prescriptions

It’s wise to keep a written list of all the drugs and supplements you are taking, and to periodically review this list with your doctors.

There are four main reasons to do this:

• First, if you see several doctors, each may not be aware of medicines the others have prescribed.
• Second, since people differ in their response to medications, it is very common for doctors today to prescribe several medicines before finding one that works well or best.
• Third, many people take several prescription medications, non-prescription drugs and dietary supplements at the same time. These can interact in ways that can either reduce the benefit you get from the drug, or be dangerous.
• And fourth, the names of prescription drugs–both generic and brand–are often hard to pronounce and remember.

Always be sure, too, that you understand the dose of the medicine being prescribed for you and how many pills you are expected to take each day. Your doctor should tell you this information. When you fill a prescription at the pharmacy, or if you get it by mail, you may want to check to see that the dose and the number of pills per day on the pill bottle match the amounts that your doctor told you.

 

Splitting Your Pills

Talk with your doctor about splitting your prescription tablets. Pill splitting (usually just in half) is an increasingly common practice and can be a powerful way to save money, especially if you have to take a prescription drug for a long time.

But not all pills can be safely split. You should not split pills without first talking to your doctor. Pill splitting also is best accomplished with a low-cost device (around $5–$10) designed for the purpose, and not with a knife. The device assures that the two halves you produce contain equal doses. With many medicines, taking the correct dose is critical to the drug’s effectiveness and safe use. Using such a device is also safer.

Download our Money Saving Guide: Splitting Pills