Brand drugs have edge over generics for serious medical conditions

The generic pharmaceutical industry has done a pretty good job of educating consumers about the financial benefits as well as the safety and efficacy of generic drugs—but there's still room for improvement. When it comes to serious medical conditions, some consumers still prefer a brand medication to a generic.

According to the results of a survey conducted on behalf of Medco Health Solutions Inc. by the market research firm ReedHaldyMcIntosh, 79% of patients would take a generic medication to treat a cold or flu, and 76% would turn to a generic to address heartburn. But only 56% would use a generic drug to treat a more serious ailment such as asthma, and only 52% would opt for a generic to treat diabetes. When it comes to heart disease, the percentage of consumers who would accept a generic agent fell even further—to less than 50%.

The survey, conducted in April, polled 1,000 adult consumers nationwide—490 men and 510 women 18 or older.

With ample evidence that generic medications are safe, effective, and cheaper, why do generics still have an image problem in the eyes of some consumers?

For starters the survey data reveal that advertising may play a key role. Fifty-seven percent of the survey respondents noted that they would be more inclined to choose a generic medication if they saw it advertised. Unfortunately, generic drug companies spend very little money on direct-to-consumer advertising. In contrast, the brand-name giants have huge advertising budgets. They spend a fortune on print and broadcast advertising targeting consumers. And despite huge gains in the marketplace by generic manufacturers in recent years, brand companies still hold the edge when it comes to public perception and recognition.

For example, according to the survey results, when presented with the same co-pay for a generic or brand-name drug, 59% of the respondents said that they would select the brand, 33% preferred the generic, and the rest were undecided. It's only as the cost of the co-pay for the brand drug increased that those respondents said they would be more likely to opt for the generic.

Christine Simmon, VP of public affairs and development for the Generic Pharmaceutical Association (GPhA), said that the Medco study showed that consumers understand the value and effectiveness of generics, "but there's a lingering uncertainty when it comes to the more serious diseases." She added that GPhA is launching a consumer education campaign at the end of the year that directly targets these issues by communicating to consumers that generics are the same medicine and provide similar results as brands at a lower cost for all diseases.

Glen Stettin, M.D., VP and president of Clinical Products for Medco, said that data from the survey are significant because they indicate that despite the growing availability and attention given to generic medications, there is still a misperception regarding the equivalency of generic drugs to brand medications, even though generics have the same active ingredients as their brand-name counterparts. "This misperception leads some consumers to believe incorrectly, that brand medications are better for more severe conditions, even though there is no difference between the brand and generic."

Stettin added that in many cases when patients have serious conditions, they are likely to be treated by a specialist rather than a primary care physician, and specialists, he noted, tend to prescribe more brand medications than generics. "So, we feel further education for physicians—especially specialists—and patients, could be helpful in improving awareness and acceptance [of generics]."

In other survey findings: the percentage of adults who considered themselves knowledgeable about generics almost doubled in the past five years to 19% from 11% in 1999, when a similar survey regarding generic drug use was taken. Also, women were more likely than men to admit that they are knowledgeable about generics (72% of women compared with 55% of men). And 83% of women were also more likely to take a generic drug prescribed by their doctor, versus 78% of men. The survey also revealed that seniors over the age of 65 were the least knowledgeable about generic drugs compared with consumers aged 45-64.

Medco officials noted that the survey indicates there are several initiatives health plans and employers can take to encourage the use of generic drugs in an attempt to lower costs, including increasing patient education about the safety and efficacy of generic medications. Generic incentive programs that offer consumers lower copayments for selecting generics instead of brand drugs is another strategy for driving generic usage (see "Use of generics rising among Blues healthcare plans").