From Generics to Name Brands and Vice Versa?

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It's not unusual to have seizures only at night, or at a particular time of day. I only had them at night while I was growing up.

This is my understanding of generics: Brand name and generics are different, and generics from different manufacturers are different. Generics only have to produce 80-125% blood levels of the brand (in the US, as far as I can discover. I thought they narrowed the range, but I can't find reference to that.). Generics do not have to be compared directly to the brand to be approved. I read that they only have to be compared to another generic of "reference". So, the various generic versions are not even compared to the same standard. I read one application for approval where they gave healthy people some absurdly small amount of a drug to test the levels.

The worst problem is switching back and forth from brand to generic, or from one generic to another.

Some people have problems with them some don't. I took brand my whole life, but have taken generics at times because I didn't have any choice. In some cases I had seizures, but not in others. In some cases I had worse side effects. I've been off brand name Tegretol (carbamazapine) and Felbatol (felbamate) for a year and haven't felt right since. I was on Tegretol my whole life. The felbamate is certainly stronger because it gives me headaches. I had to reduce the dosage, and I think it's still stronger. The carbamazapine is almost certainly weaker. Initially I had a couple seizures, but I seemed ok once I got used to it.

I suspect, but don't know, that there are differences besides strength that affect the way your body reacts to them.

It makes sense that the more you are taking, and the less controlled you are, the more problems you will have with any change. You can find lots of studies saying there are no problems, but I imagine they use stable people on reasonable doses in those studies, not people who have seizures all the time and are on borderline toxic levels of medication.

I get really mad about this because I believe that people with epilepsy deserve to get the best treatment possible, and have a right to the best meds for them, and a right to get exactly the same identical med every time. To me the whole question of exactly what the equivalency is for most people, and whether it creates problems for most people, is academic. If I feel as well as can be expected on one formulation, but worse when switched, I should have a right to take whatever works best. This is particularly the case when the drugs I'm taking are 30 and 40 years old. I should not be paying $250 a month for generics. If drinking a 1/2 cup of coffee for two or three days in a row gives me problems, ANY change in my meds is certainly going to do so.

IMO they should ban the words "the same" when discussing generics, because a different pill made with different ingredients, by a different company, is not "the same" at all, even if it contains nearly the same amount of an identical ingredient.

There isn't any money to be had in proving that substitutions cause problems for some people, so it's not done.


 
Pharmacy / Insurance BS!
I had my Dr send in the approval for the brand name Lamictal. CVS pharmacy received it but didn’t tell us a second approval is needed for the penalty to be waived!
I’m guessing my Dr will be sending the same form to a different department at CVS.
Started this on Sunday. Got ghosted twice by customer service. I was told tonight Tuesday that the second request from the other department was being sent tomorrow. I sent a note to my Dr asking them to keep an eye out for it.

How do you outrun a horse, tiger, lion, and elephant that are chasing you?
Get your drunk ass off of the merry-go-round.😅
 
Pharmacy / Insurance BS!
I had my Dr send in the approval for the brand name Lamictal. CVS pharmacy received it but didn’t tell us a second approval is needed for the penalty to be waived!
I’m guessing my Dr will be sending the same form to a different department at CVS.
Started this on Sunday. Got ghosted twice by customer service. I was told tonight Tuesday that the second request from the other department was being sent tomorrow. I sent a note to my Dr asking them to keep an eye out for it.

How do you outrun a horse, tiger, lion, and elephant that are chasing you?
Get your drunk ass off of the merry-go-round.😅
Yeah, I don't deal with CVS anymore....the reasons are real...
 
A lot of CVS stores are shutting down in my area. Tell your Dr. to override the code for the med and it will be
taken care of and you should get it with no problem.

Wishing you the best of luck and May God Bless You,

Sue
 
Some insurers will only use one Rx fulfillment company (though I assume that's not the case for you HK). My previous insurers would only use CVS Caremark (their online arm) for my meds. I was just switched to another insurer that will only use Optum Rx, another online. Pain to switch all the paperwork for myself and my neuro, but no choice unfortunately.
 
We had to use Optum Rx with one of our insurance companies. From what I recall, it was one of the most expensive online/mail-order pharmacies I've ever had to deal with. At the time, I was only taking Topiramate (400MG/day) & folic acid. They charged us close to $400 for a 3 month supply of meds.
 
CVS never did request a second approval from my doctor. They must have figured it out internally.
I got what I needed and I’m very optimistic it’s going to help.
 
We had to use Optum Rx with one of our insurance companies. From what I recall, it was one of the most expensive online/mail-order pharmacies I've ever had to deal with. At the time, I was only taking Topiramate (400MG/day) & folic acid. They charged us close to $400 for a 3 month supply of meds.

OptumRx itself was garbage to deal with. Did it while working with insurance years ago because that was the "preferred mail order pharmacy" with the insurance. In some ways, it seemed okay for those that had less expensive medications, but there were too many instances of them leaving insulin on the porch and it going bad...way...too...many. I don't know if anything has improved since then, I hope so!
 
I think I've always been on a generic unless there wasn't one made for the med yet. But when one was then I was put on that.

When I was still with my ex all my prescriptions were $8 for up to 3 months, no matter what they were. I was going to CVS then and never had any problems. When we broke up I stayed with CVS for a few more months and after looking for cheaper places to get my meds I saw that CVS was the most expensive.

I live in western Pennsylvania and I use Giant Eagle grocery store pharmacy. The one I go to is the best one I think I've ever used. They always try to find sometime of discount without me having to ask them too. GoodRX and many others for example, they even have their own.

There had even been a prescription I was taking that cost around $400 a month. The pharmacy was having a hard time getting it too. The pharmacist told me that there was one I could take over the counter they could order for me that was about $30 a month. I asked my neuro about it and he said it was fine. I haven't had any problems taking it instead of the prescription one.
 
I've had no issue with name-brands/generics other than cost. When I began taking AEDs, I was on my father's insurance, & they only gave us name-brand meds (he was a hospital employee). After marriage, (once the complex partials started), I had to use name-brand drugs because they were giving me new ones. As soon as the generic version became available, though, I'd be switched to that. Even the generics' copay would be around $300-$350 for a 3-month-supply.
 
Cvs has tried the generic/another brand before in the past when I have been in new places. But one of the reasons I love my neurologist is that she has called up to them and started threatening jobs and stuff. The girl wonders why I like to stick with one cvs whether it is convenient or not
 
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