Improving Adherence to Therapy and Clinical Outcomes While Containing Costs: Opportunities From the Greater Use of Generic Medications

Almost everyone in the United States can agree to the fact that medications are not cheap. Moreover, brand name medications are infamous for being unnecessarily expensive. The issue with expensive medications lies not just within the costs themselves but also within the fact that the costs affect patients’ medication adherence and willingness to receive treatment. Both health care practitioners and patients are often drawn towards brand name products without knowing that the equivalent generic medications may produce equally effective results.

This article describes a study in which researchers conducted a Google Scholar literature review, answering five questions regarding the usage of generic medications, effectiveness of generic medications, and barriers against using generic medications. Articles containing original empirical data that were relevant to each of the key questions were included in this review.

The results of this study demonstrated that many health care providers prescribe brand-name medications when generic versions are available. Furthermore, studies show that when managing common chronic conditions, physicians tend to choose medications that are newer and relatively expensive. “Therapeutic interchange” is the substitution of a similarly effective but less expensive chemical entity to treat the same condition and, when combined with generic substitution, studies have shown that Medicare could save $1.4 billion for patients with diabetes alone.

As I mentioned earlier, high costs are not the only issues in these situations because the impact high costs have on the patients’ medication adherence are just as important of an issue. In a study done on patients initiating therapy in long-term medications, results showed that patients beginning therapy with a generic medication had adherence rates that were 5-7% higher than those initiating therapy with a brand-name drug.

In response to the question, “What is the evidence that brand-name and generic medications have similar clinical effects?” there have been conflicting results. Bioequivalence is defined as “the absence of a significant difference in the availability of the active ingredient at the site of drug action”. While generic versions of bupropion were not found to be bioequivalent to the brand-name version, a meta-analysis of forty-seven studies comparing generic and brand name drugs in nine classes of cardiovascular medications demonstrated that the generic drugs were just as effective as the brand-name equivalents.

The future for generic drug use is still unclear because, while generic drug use has been increasing, there is still a lot of room for even greater use of these medications and for the improvement of health care quality and reduction of costs. The perceptions of patients and health care providers continue to heavily affect the use of generic medications. Many approaches to increasing the use of generic drugs have been proposed, the first one being the development of data demonstrating the safety and effectiveness of generic drugs relative to their brand-name counterparts. I personally am affected by the high costs of brand-drugs and am also guilty of misperceiving generic drugs as being not as effective as their brand-name counterparts. I believe that more concrete data and evidence would play an enormous in increasing generic medication use and medication adherence while substantially decreasing costs.


Choudhry M, Denberg T, Qaseem A. Improving Adherence to Therapy and Clinical Outcomes While Containing Costs: Opportunities From the Greater Use of Generic Medications: Best Practice Advice From the Clinical Guidelines Committee of the American College of Physicians. Ann Intern Med. 2016; 164(1): 41-49


1 thought on “Improving Adherence to Therapy and Clinical Outcomes While Containing Costs: Opportunities From the Greater Use of Generic Medications”

  1. This is a topic that I observe all the time at the pharmacy I work at. Patients will often times ask if the generic medications they are taking are equivalent to brand name drugs and our pharmacists always reassure them that they recommend the generic for treatment. Getting the patient to trust this judgement is important in their adherence. In addition, I witness a lot of “therapeutic interchange.” The issue with this is that it prolongs the time it takes for someone to get a prescription filled, because they must wait for us to contact the doctor for a substitution. I think it is important to influence health care providers’ perceptions of generics to increase their prescribing of them initially. I agree that collecting more data and evidence may contribute to this outcome.

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