On average, prescription drug costs in the U.S. are the highest in the world, but that doesn't mean that there aren't relative bargains to be had.
For example, a recent FDA study shows that generic drugs may in some cases be cheaper in the U.S. than either the brand-name or generic versions of the same drug sold in Canada. Generic drugs account for half of all prescription drugs sold in the U.S.
FDA analysts compared drug prices in the U.S. and Canada for seven best-selling generic prescription drugs for chronic conditions, such as anxiety disorders, seizure disorders, high blood pressure, depression, heart failure, and type 2 diabetes.
"For six of the seven drugs, the U.S. generics were priced lower than the brand-name versions in Canada. Five of the seven U.S. generic drugs were also cheaper than the Canadian generics. Of the remaining two U.S. generic drugs, one (enalapril for high blood pressure) was unavailable in Canada generically, and its Canadian brand-name version was more than five times the price of the U.S. generic equivalent. The other U.S. generic (metformin for type 2 diabetes) sold for less in Canada both as a generic and as a brand name," writes Linda Bren in the July-August 2004 issue of FDA Consumer magazine.
The FDA defines a generic drug as "a copy that is the same as a brand-name drug in dosage, safety, strength, how it is taken, quality, performance, and intended use." Under Federal regulations, generics have to be comparable to the original in all important aspects such as potency, speed of action, duration of drug effect, purity of the compound, and stability (shelf-life).
Generics are cheaper than the originals because the manufacturers don't have the same costs associated with developing and bringing a new drug to market. In addition, because many different manufacturers can produce a generic drug, competition drives the price lower. For example, several different companies in the U.S. and abroad now manufacture the over-the-counter pain reliever ibuprofen, which started life as the prescription drug Motrin. Similarly generic versions of the decongestant pseudoephedrine now crowd drugstore shelves side-by-side with the Sudafed brand.
Generics are available for many popular brand drugs. For the antidepressant Prozac, there is the generic fluoxetine; for the heartburn drug Prilosec, there is the generic omeprazole; and for the cholesterol drug Mevacor, there is the generic lovastatin. Overall, the U.S. Congressional Budget Office estimates that generic drugs save consumers between $8 billion and $10 billion a year at retail pharmacies. But remember, the price of all drugs -- generic and brand name -- varies greatly depending on the pharmacy. Call around to find the best deal for you in your community.
Another point to keep in mind: While the FDA says generics are identical in action and quality to brand drugs, they may contain different inactive ingredients that hold the pill or capsule together. Don't be surprised if the generic looks or smells different than the brand drug.
Many people, however, take prescription drugs for which there are no generic equivalents available in the U.S., generally because they are still under patent (the original maker of a drug has the exclusive right to market it for 20 years after the first patent for the drug is filed). Yet the prices for many of these drugs may be out of reach for many patients who have to pay out of pocket.
Many of the major pharmaceutical companies offer some form of low-cost or no-cost program for patients who meet financial eligibility criteria. In addition, as of this writing, 39 states offer some form of pharmaceutical assistance program.
- Information about state programs can be found at the web site of the National Conference of State Legislatures, at https://www.ncsl.org/programs/health/drugaid.htm.
- The Pharmaceutical Research and Manufacturers of America (PhRMA), a drug industry lobbying organization has launched a web site with interactive tools that can help patients identify assistance programs that may pay some, most, or all of the costs of medication, depending on financial need. The address of the secure site is https://www.helpingpatients.org/Intro.php.
Consumers using these sites or who apply for financial aid should be aware that the companies may ask for detailed information about financial and employment status.