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Why Won’t Pharmacies Fill Prescriptions with Authorized Generic Drugs?

How can you get your pharmacist to fill prescriptions with authorized generic drugs? It's a lot harder than you might think, but worth the effort.
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We are always surprised when health professionals are unfamiliar with the concept of authorized generic drugs. We shouldn’t be. Medical and pharmacy students are not taught that there even are such things. For the most part health professionals are told that generic drugs are the same as brand name drugs. The FDA has promoted that message for years. That’s why most pharmacies purchase the least expensive generic drugs they can find rather than fill prescriptions with authorized generic drugs that are more expensive. After all, why spend more if the FDA says even the cheapest FDA-approved generic drugs are equal to brand name medicines?

Can Your Pharmacist Fill Prescriptions with Authorized Generic Drugs?

This reader wants to know why most pharmacists won’t fill prescriptions with authorized generic drugs:

Q. You have written about “authorized generic” drugs. I can’t find a pharmacy that will fill prescriptions with authorized generic drugs. Can you steer me in the right direction?

A. The makers of authorized generic drugs have negotiated agreements with the brand-name manufacturers so that they can use the exact same “recipe.” Sometimes authorized generic drugs are even made on the same production line as the original brand name medicine.

Reverse-Engineering Generic Drugs:

“Regular” generic drugs are often reverse engineered. That is to say the manufacturer tries to figure out how the brand name company created the original medicine. That information is considered proprietary.

In her best-selling book, Bottle of Lies, Katherine Eban describes the process of reverse-engineering:

“A brand-name drug, no matter how complex or difficult to make, inevitably follows a recipe, such as mix fifteen minutes, granulate, mist until ingredients reach 4 percent moisture content, mix again for thirty minutes. Making a generic version, however, requires figuring out a different recipe, ideally one that is faster to make but produces a similar result. That effort of reverse-engineering is undertaken by process chemists.”

Katherine goes on to describe Rajiv Malik, a process chemist who had worked at the Indian drug company, Ranbaxy. Rajiv was head of formulation development and regulatory affairs. He had mastered the art of reverse-engineering generic drugs based on the brand name formulation.

The book describes Rajiv’s effort to copy the brand name acne drug Accutane. Ranbaxy was planning to market it under the name Sotret. There was only one problem. As production ramped up, the generic drug wasn’t dissolving properly.

Katherine describes what happened next:

“Given the circumstances, the FDA’s regulations required Ranbaxy executives to withdraw the drug from the market and suspend making it until the failures could be remedied…

“The push for profits won out. They chose to continue the launch and conceal the problems from regulators, even as they returned to the laboratory in search of a solution.”

The Budeprion XL 300 Debacle:

Another example of reverse-engineering involved the antidepressant Wellbutrin XL 300. A generic manufacturer wanted to bring out a similar timed-release version. There was a patent on the membrane technology that allowed the active ingredient, bupropion, to be absorbed slowly into the body.

The generic manufacturer had to come up with a different release process. It chose a matrix formulation. The drug was not absorbed in a similar manner as the original brand name medicine.

We badgered the FDA for five years before the agency admitted that the generic Budeprion XL 300 was not “bioequivalent” to the brand name Wellbutrin XL 300. Here is a link to that sad saga in the FDA approval process.

Popular Generic Antidepressant Recalled

Why Don’t Pharmacies Fill Prescriptions with Authorized Generic Drugs?

Once upon a time, independent pharmacists could decide which generic drugs they would stock. Some independent pharmacists still do that. But these days most chain pharmacies, big-box pharmacies, mail-order pharmacies and grocery pharmacies have central buying departments.

They may also use PBMs (pharmacy benefits managers). These organizations cut deals with generic drug companies. When you ask your local chain pharmacist to stock an authorized generic drug, the chances are good that she will look at you with dismay. That’s because she has little control over what generic drugs are placed on the pharmacy shelves.

Finding a list of authorized generic drugs can also be a challenge, and we don’t know of any list that is complete. However, you will find the best list we could assemble on our website at this link. You can also find it in our eGuide to Saving Money on Medicines. Look for it in the Health eGuides section of the website.

Not all medications have an authorized generic available. If you find the drug you are looking for, you will need to ask the pharmacist to order from that manufacturer specifically. Independent pharmacies may be more willing to do this than chains.

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About the Author
Joe Graedon is a pharmacologist who has dedicated his career to making drug information understandable to consumers. His best-selling book, The People’s Pharmacy, was published in 1976 and led to a syndicated newspaper column, syndicated public radio show and web site. In 2006, Long Island University awarded him an honorary doctorate as “one of the country's leading drug experts for the consumer.” .
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My husband took brand name Bentyl (dicyclomine hcl) for 30 plus years until it was discontinued in 2017. Most drug stores stock the Merck produced dicyclomine but this generic doesn’t work for him. I have to go to a special pharmacy to have them order Activis/Teva/Watson generic which is the same as the brand name drug. If they ever stop making it I don’t know what we will do.

Should be required reading for all pharmacists, health care providers and consumers. Thanks.

Amazing and disheartening. Thank you for all you do.

Pharmacists don’t use authorized generics unless they must because they are usually more expensive than regular generics. Greenstone was involved with Upjohn. Does it really matter in most cases, and the answer is no. 97% of all active ingredients are manufactured overseas, and that includes active ingredients for brand name drugs.

The retail pharmacists, who are rapidly disappearing from the scene, is told by the insurance companies what to charge, and they have to buy what fits the criteria imposed on them.

How many of the customers who are so unhappy with the high price of prescription drugs would want to pay more to have them made in the USA? Nobody I know.

There are differences in some of the drugs between generic and authorized generics and brand name drugs, but most people do just fine with the generics, and the FDA does find the problems and acts accordingly.

When generic Xanax became available, the only customers who did not want it were those addicts who were reselling it and got more for the brand. Physicians are encouraged to order generics and asking the pharmacist to stock and dispense at a losing price. The authorized generics are a bridge too far in a market they have to work in now.

Lastly, why should medical and pharmacy students be taught about authorized generic drugs? That is the job of the pharmacist who is struggling to keep his business afloat without being told what manufacturer to buy from. Do you ever think to tell a physician what brand of stethescope he should be using or blood pressure cuff?

To get an authorized generic drug, I spoke to my doctor and explained why I wanted one. (It helped that the generic I’d been taking didn’t seem to help at all.) I asked that, in the prescription, she include an instruction to fill with the generic made by such-and-such (the maker).I had gotten the name of the authorized generic from the list the Graedons provided (thank you!). The pharmacy ordered the correct generic, and it came in a couple days.

So it’s worth asking your doctor to prescribe the authorized generic. And I hope that your drug has an authorized generic version!

People’s Pharmacy says readers can find a list of authorized generic drugs on their website, but it’s impossible to find. Help!

I’ve been covering the unfolding saga regarding the Concerta authorized generic — and now the clown car of inferior generics.

For a few months, my blog readers reported being able to get the authorized generic from Janssen’s subsidiary Patriot. (Janssen is the manufacturer of Concerta.)

On my blog, I provided instructions for how they could use the NDC# (the distinct number for each medication at each available dosage). It was working.

https://adhdrollercoaster.org/adhd-medications/authorized-generic-concerta-update-6-1-19/

Then, something happened….companies are not compelled to tell us why anymore….but CVS seems to have struck a deal with Janssen to distribute the brand as a brand — at a generic price. (That is, not an authorized generic.)

So, now the authorized generic is much harder to get at the other outlets…Walgreen’s (which has been the most reliable “good actor” through all this mess), Costco, etc.

It’s a mess out there. And the FDA chief scoffed at FDA scientists’ concerns about bioequivalence for novel delivery-system medications — and opened the floodgates of inferior generics.

People are suffering. Children. Teens. Adults.

It is unconscionable.

I’ve been taking generic Cymbalta for several years now. My pharmacy changed manufacturers without notifying me. I noticed that the new pills were a different color. After calling to find out the manufacturer of the old generic, I called several pharmacies to see if they could get it for me. Only one, a local independent pharmacy, was able to order this.

This is very disheartening. Even if you found an independent chain willing to order the authorized generic, how would it get paid for? Your insurance will only reimburse the pharmacy X amount of dollars, yet their cost would be higher. Either they are willing to take less profit or you would have to make up the difference, and they probably don’t even have a fee schedule for that. Or maybe insurance covers zero if you don’t accept the cheapest generic. Sad because the evidence is clear many cheap generics don’t work the same. Thank you for at least spreading awareness of this issue!

My pharmacy always fill with generic. I think the opposite is true. I have to fight for name brand, and have to check the script before I leave to be sure. Generic brands have a lot of fillers, like gluten, aluminum, and other undesirable ingredients. I literally have to ask for the package inserts, read the ingredient list and point out the differences. I have refused to take a script for this reason and have to threaten to go to the compounding pharmacy in the next town over.

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