FAQ - What is Gneric
WHAT IS A “BRANDED” MEDICINE?
In its true meaning a Brand name drug is a medicine that’s discovered, developed and marketed by a pharmaceutical company. This is a very long and expensive process as only a miniscule %ge of research and development ultimately leads to a useful new medicine. The whole process takes ten years or more before a new medicine is given approval.
Once a new drug is discovered, the pharmaceutical company files a PATENT to stop other companies making copies and selling the same drug for upto 20 years. Who would spend all that money on the long discovery process if any other company could just copy it once it sees it? The actual costs of producing the pills are tiny in most cases.
Most Medicine sold in India are in fact “Generic” medicines. Until recently India did not recognise Patents in medicines because it wants poor to have access to new medicine and not wait up to 20 years.
Every drug has two names: a generic name that’s the drug’s common scientific name (ALL drugs MUST have this name shown) and a “Brand” name to make it stand out in the market place. For example, Mineral Water is the “Generic” name. Bisleri and Kinley are Brand names. Here is a Medicine example:
In the above pictures Benadryl is the Brand Name. Its Generic name is Diphenhydramine HCL 25mg – Because the name is based on its chemical composition, it is usually a longer and more complex sounding name. Doctors often remember the Brand name more easily – particularly if Company Reps are reminding them.
In its true meaning a Brand name drug is a medicine that’s discovered, developed and marketed by a pharmaceutical company. This is a very long and expensive process as only a miniscule %ge of research and development ultimately leads to a useful new medicine. The whole process takes ten years or more before a new medicine is given approval.
Once a new drug is discovered, the pharmaceutical company files a PATENT to stop other companies making copies and selling the same drug for upto 20 years. Who would spend all that money on the long discovery process if any other company could just copy it once it sees it? The actual costs of producing the pills are tiny in most cases.
Most Medicine sold in India are in fact “Generic” medicines. Until recently India did not recognise Patents in medicines because it wants poor to have access to new medicine and not wait up to 20 years.
Every drug has two names: a generic name that’s the drug’s common scientific name (ALL drugs MUST have this name shown) and a “Brand” name to make it stand out in the market place. For example, Mineral Water is the “Generic” name. Bisleri and Kinley are Brand names. Here is a Medicine example:
In the above pictures Benadryl is the Brand Name. Its Generic name is Diphenhydramine HCL 25mg – Because the name is based on its chemical composition, it is usually a longer and more complex sounding name. Doctors often remember the Brand name more easily – particularly if Company Reps are reminding them.
WHAT IS A “GENERIC” MEDICINE?
In an international context a Generic Medicine is a medicine which has been around a long time and whose patent has expired. At this point anyone with sufficient knowledge is free to make that medicine. However any medicine has to be approved by a local regulator before it can be sold to the public. In India even copies of recent medicines are available as “Generic” – a well-known example is that of Viagra, Manufactured by Pfizer containing Sildenafil Nitrate. A single 100mg Viagra tablet even now costs Rs 594 in India – it costs much more outside India. Numerous “Generic” alternatives containing the exact same active ingredient are available in every medicine shop, starting from just a few Rupees. However no one else but Pfizer can CALL their Sildenfil “Viagra”- they have to give it another name. It is exactly the same as buying a bottle of “Mineral Water” – you can buy Bisleri or you can buy Kinley made by Coca Cola. Most of us wouldn’t care which brand of these two Brands we buy as long as it was from a “reliable” company – particularly, if one costs Rs100 and the other only Rs10. If your asked for a bottle of Bisleri and the shop keeper offered you Kinley chances are you would take it – especialy if Kinley was half the price. But with Medicines, we leave our brains at home and insist on buying “Bisleri” even though it costs us 10 times as much!
The above picture illustrates the point well. Three Brand names of exactly the same medicine [Cetirizine] made by the same company [CIPLA] at wildly different prices!
SO, YOU ARE SAYING THAT NEARLY ALL MEDICINES SOLD IN INDIA ARE GENERIC? IF SO WHAT IS BRANDED?
Yes absolutely. But there are TWO types of Generics. “Branded Generics” and “Generics”. Shortened to “Branded” and “Generics” respectively. Better terms would be “Promoted Generic” for “Branded” and “Unpromoted Generic” for what’s called “Generic”.
In an international context a Generic Medicine is a medicine which has been around a long time and whose patent has expired. At this point anyone with sufficient knowledge is free to make that medicine. However any medicine has to be approved by a local regulator before it can be sold to the public. In India even copies of recent medicines are available as “Generic” – a well-known example is that of Viagra, Manufactured by Pfizer containing Sildenafil Nitrate. A single 100mg Viagra tablet even now costs Rs 594 in India – it costs much more outside India. Numerous “Generic” alternatives containing the exact same active ingredient are available in every medicine shop, starting from just a few Rupees. However no one else but Pfizer can CALL their Sildenfil “Viagra”- they have to give it another name. It is exactly the same as buying a bottle of “Mineral Water” – you can buy Bisleri or you can buy Kinley made by Coca Cola. Most of us wouldn’t care which brand of these two Brands we buy as long as it was from a “reliable” company – particularly, if one costs Rs100 and the other only Rs10. If your asked for a bottle of Bisleri and the shop keeper offered you Kinley chances are you would take it – especialy if Kinley was half the price. But with Medicines, we leave our brains at home and insist on buying “Bisleri” even though it costs us 10 times as much!
The above picture illustrates the point well. Three Brand names of exactly the same medicine [Cetirizine] made by the same company [CIPLA] at wildly different prices!
SO, YOU ARE SAYING THAT NEARLY ALL MEDICINES SOLD IN INDIA ARE GENERIC? IF SO WHAT IS BRANDED?
Yes absolutely. But there are TWO types of Generics. “Branded Generics” and “Generics”. Shortened to “Branded” and “Generics” respectively. Better terms would be “Promoted Generic” for “Branded” and “Unpromoted Generic” for what’s called “Generic”.
WHAT IS A “PROMOTED GENERIC” (“Branded”)
Promoted Generics are Medicines that are made by well-known companies. They promote their OWN label (“Brand”) of the generic product. How do they promote it? – Firstly, they package it nicely. Secondly, they pay “Medical Reps” to visit every doctor they can to “promote” their medicine. They hope that the Doctor will remember their “Brand” rather than their competitors. Strangely, in India “Promoted Generics” are termed “Branded” and even more curiously “Ethical”. They are rightly expensive because even though the production cost is very small (probably 1-5% of selling price for most medicines) the distribution costs (multiple layers of wholesalers), promotion costs (sending reps to doctors, arranging conferences, foreign trips), margin for the manufacturer and finally a 15-25% margin for the retailer accounts for the balance. In the above picture Alerid is the Promoted Generic - chances areyou have heard of it!
HOW IS AN “UNPROMOTED GENERIC” DIFFERENT?
You guessed it. Like “Promoted Generics” they also cost little to produce. What is different is that little or no money is spent on “promoting” these medicines. It is made by the same companies as above (and others) often using the same machinery. However the Medical Reps do not “motivate” doctors to prescribe these. There is no flash advertising and it is often in boring packaging. But make no mistake, it is exactly the same medicine licenced by the regulator. In the above picture Cetcip and Okacet are unpromoted generics. Notice the huge gap between the wholesale price and MRP.
The following chart summarises the vrious types discussed above.
BUT I HAVE CHECKED – WHAT YOU CALL “UNPROMOTED GENERIC” COSTS NEARLY AS MUCH AS THE BRANDED!
Yes, you are right. Now we understand the difference – let’s revert to calling them “Branded” and “Generic” to save confusion. The retail margin on Indian Generics in India is astronomical – the MRP is anything from 2x to 15x the wholesale cost. I checked over 130 “essential” Generic medicines with a local wholesaler. The weighted average margin was 88% and the average markup was 467% - By contrast Branded has a Margin of around 20-25%. So, what’s going on? So the MRP of Cetcip and Okacet is not much different from Alerid.
I don’t know what’s going on and why the retail margins are so huge. I could share my thoughts with you but it serves no purpose. For whatever reasons the MRP of Generics from even relatively unknown companies (with some notable exceptions – for example Mankind) are close to, and in some cases even higher than Branded!
Surely it is perverse that a medicine that is out of patent which costs well below Rs 2/strip to produce, sells at upto Rs39/strip.
Promoted Generics are Medicines that are made by well-known companies. They promote their OWN label (“Brand”) of the generic product. How do they promote it? – Firstly, they package it nicely. Secondly, they pay “Medical Reps” to visit every doctor they can to “promote” their medicine. They hope that the Doctor will remember their “Brand” rather than their competitors. Strangely, in India “Promoted Generics” are termed “Branded” and even more curiously “Ethical”. They are rightly expensive because even though the production cost is very small (probably 1-5% of selling price for most medicines) the distribution costs (multiple layers of wholesalers), promotion costs (sending reps to doctors, arranging conferences, foreign trips), margin for the manufacturer and finally a 15-25% margin for the retailer accounts for the balance. In the above picture Alerid is the Promoted Generic - chances areyou have heard of it!
HOW IS AN “UNPROMOTED GENERIC” DIFFERENT?
You guessed it. Like “Promoted Generics” they also cost little to produce. What is different is that little or no money is spent on “promoting” these medicines. It is made by the same companies as above (and others) often using the same machinery. However the Medical Reps do not “motivate” doctors to prescribe these. There is no flash advertising and it is often in boring packaging. But make no mistake, it is exactly the same medicine licenced by the regulator. In the above picture Cetcip and Okacet are unpromoted generics. Notice the huge gap between the wholesale price and MRP.
The following chart summarises the vrious types discussed above.
BUT I HAVE CHECKED – WHAT YOU CALL “UNPROMOTED GENERIC” COSTS NEARLY AS MUCH AS THE BRANDED!
Yes, you are right. Now we understand the difference – let’s revert to calling them “Branded” and “Generic” to save confusion. The retail margin on Indian Generics in India is astronomical – the MRP is anything from 2x to 15x the wholesale cost. I checked over 130 “essential” Generic medicines with a local wholesaler. The weighted average margin was 88% and the average markup was 467% - By contrast Branded has a Margin of around 20-25%. So, what’s going on? So the MRP of Cetcip and Okacet is not much different from Alerid.
I don’t know what’s going on and why the retail margins are so huge. I could share my thoughts with you but it serves no purpose. For whatever reasons the MRP of Generics from even relatively unknown companies (with some notable exceptions – for example Mankind) are close to, and in some cases even higher than Branded!
Surely it is perverse that a medicine that is out of patent which costs well below Rs 2/strip to produce, sells at upto Rs39/strip.
HOW DO I FIND A CHEAPER GENERIC VERSION OF THE BRAND I AM TAKING?
Most medicines (over 90%) for common ailment have cheaper MRP generics. However, some medicines are only available as Branded. Some medicines are manufactured by 100s of companies.
There are two stages:
- Step 1: Find the Generic Name of the drug: See the Benadryl example above. The easiest way to do this is by looking at a strip of the medicine. Otherwise use Google or one of the websites listed below;
- Step 2: Find the lowest MRP Generic Brand from a good reputable manufacturer. Mankind often has one of the cheapest MRPs. Use the Generic Name to find your Generic Brand at Life Medico – this is likely to be the cheapest way
Thanks to Internet and socially minded people/institutions there are a number of resources that help you to find cheaper alternatives just a click away. The best I have found are:
www.Mydawaii.com is an easy to use website and a good app for finding cheaper MRP medicines.
https://www.healthkartplus.com/ - very simple to use although prices seem to be out of date. Just put in the name of your medicine and it suggests alternatives.
www.medguideindia.com If you want to find Generic equivalent to your branded product go to: http://medguideindia.com/show_brand.php and put your medicine name in “Brand Name” Box. If you don’t find your Brand, look for the chemical name and type it here: http://medguideindia.com/show_generics.php
http://www.medindia.net/drug-price/ is another site
ARE GENERIC MEDICINES ARE AS GOOD AS BRANDED
When a generic drug is approved, it has to meet standards established by FDA with respect to identity, strength, quality, purity and potency.
Generic Drugs and Branded drugs are manufactured in the same fashion, following validated manufacturing processes, complying with Good Manufacturing practices and schedule "M" requirements. FDA considers Generic Drugs to be identical, bioequivalent, to a branded drugs in dosage form, safety, efficacy, route of administration We only stock generic Medicine well known reputable companies – they also make Branded products. The list of medicines on this website shows what Brand we are supplying. Yes Generic medicines are as good as branded medicines.
In fact in UK and many parts of Europe and USA a large proportion of the medicines consumed are Generics made in India or China. In the ultra cautious USA vast quantities of Indian Generic Medicines are consumed.
DO SAME COMPANIES MAKE BOTH BRANDED AND GENERIC?
There are a number of Indian Companies who manufacture both branded and generic drugs. They promote branded drugs in India but market the generic drugs in developed nations like USA, UK and other countries.
Over 80% of Generic Medicines produced in India are exported to many developed countries, but in in India Generic Medicines are often seen as the “second best”.
WHY CAN’T I FIND GOOD QUALITY CHEAP GENERIC AT EVERY CHEMIST?
This is a good question. Pharmacists keep in stock what the doctors prescribe. In India Doctors generally prescribe by the Brand name rather than the Chemical Name. So the Pharmacists only keep what the doctors prescribe. Then, there are hundreds of generic equivalents made by tens of different companies. So there is a vicious cycles – Doctors don’t prescribe it and so the Medicine shops don’t keep it. Medicine shops don’t keep it (despite huge margins) because the Indian doctors don’t prescribe it.
WHY DO DOCTORS PRESCRIBE BRAND NAMES RATHER THAN BY CHEMICAL NAME?
Another good question! In fact, the Indian Medical Council (Professional Conduct, Etiquette and Ethics) Regulations 2002 [Doctors’ own professional body] mandates that “Every physician should, as far as possible, prescribe drugs with generic name and he/she shall ensure that there is a rational prescription and use of drugs”.
There are many reasons why doctors do not follow the above requirement. Here are some from my survey of doctors:
It is this vicious circle we are trying to break by asking shops to STOCK AND SELL GENERIC MEDICINES FROM WELL KNOWN REPUTABLE COMPANIES AND OFFERING THEM AT BETWEEN 50-85% OFF FROM THEIR MRP.
There are a number of Indian Companies who manufacture both branded and generic drugs. They promote branded drugs in India but market the generic drugs in developed nations like USA, UK and other countries.
Over 80% of Generic Medicines produced in India are exported to many developed countries, but in in India Generic Medicines are often seen as the “second best”.
WHY CAN’T I FIND GOOD QUALITY CHEAP GENERIC AT EVERY CHEMIST?
This is a good question. Pharmacists keep in stock what the doctors prescribe. In India Doctors generally prescribe by the Brand name rather than the Chemical Name. So the Pharmacists only keep what the doctors prescribe. Then, there are hundreds of generic equivalents made by tens of different companies. So there is a vicious cycles – Doctors don’t prescribe it and so the Medicine shops don’t keep it. Medicine shops don’t keep it (despite huge margins) because the Indian doctors don’t prescribe it.
WHY DO DOCTORS PRESCRIBE BRAND NAMES RATHER THAN BY CHEMICAL NAME?
Another good question! In fact, the Indian Medical Council (Professional Conduct, Etiquette and Ethics) Regulations 2002 [Doctors’ own professional body] mandates that “Every physician should, as far as possible, prescribe drugs with generic name and he/she shall ensure that there is a rational prescription and use of drugs”.
There are many reasons why doctors do not follow the above requirement. Here are some from my survey of doctors:
- It is easier for them to remember the Brand names rather than Chemical names
- They have confidence in the Brand names – they do not trust medicines made by small unknown companies. If they prescribe by Chemical names they have no control over what the Pharmacy will give them.
- There is no benefit to the patient by prescribing by Generic name as most generic medicines’ MRP is close to the MRP of Brands. Some are even more.
It is this vicious circle we are trying to break by asking shops to STOCK AND SELL GENERIC MEDICINES FROM WELL KNOWN REPUTABLE COMPANIES AND OFFERING THEM AT BETWEEN 50-85% OFF FROM THEIR MRP.
WHAT KEY AREAS IS GENERIC MEDICINE AVAILABLE FOR?
HOW POPULAR IS GENERIC MEDICINE OUTSIDE INDIA?
Did you know that in some US states (Florida, Hawaii, Kentucky, Maine, Massachusetts and 9 other states) and in the UK the if the doctor has prescribed a Branded Drug and there is a generic available, the pharmacist HAS to change it to the lowest cost generic. In remaining US states the pharmacist MAY change to generic. [source: http://aspe.hhs.gov/sp/reports/2010/genericdrugs/ib.shtml#apa]
In 2013, 80% of prescriptions in the US were for Unbranded Generics and a further 6% for Branded Generics [source: statistica.com]
The top eight global pharmaceutical markets—the United States, Germany, France, the United Kingdom, Canada, Italy, Spain and Japan—account for 80.0 per cent of the total generics market.” - See more at: http://www.pharmacytimes.com/publications/issue/2012/April2012/Generic-Drug-Trends-Whats-Next-#sthash.kBROdE9A.dpuf
In 2013-14 The rate of GENERIC prescribing in Scotland was 83.2% [source: https://isdscotland.scot.nhs.uk/Health-Topics/Prescribing-and-Medicines/Publications/2014-06-24/2014-06-24-Prescribing-PrescriptionCostAnalysis-Report.pdf]
Market competition from generic drugs is saving public and private healthcare payers more than $1 billion every other day, according to the IMS Institute. Generic drug use has saved $1.1 trillion over the past decade for the U.S. healthcare market. [source: http://managedhealthcareexecutive.modernmedicine.com/managed-healthcare-executive/content/tags/catamaran-2013-drug-trend-data/keep-specialty-and-generic-?page=full]
OK I AM CONVINCED - GENERICS ARE THE SAME AS BRANDED BUT CHEAPER. DO YOU HAVE EVERY MEDICINE?
A normal medicine shop keeps thousands of items. We aim to have only around 300 items in our list. WHY? Firstly, we only offer generic alternatives for the most commonly used medicines. There are some medicines where the Indian Government has controlled prices - their prices are low anyway. However, the most important reason is that a given medicine is made by HUNDREDS of different companies - each has its own "Brand" name. So a pharmaist has to keep many different brands of the same medicine- for 250 different medicines thats 25,000 different Brands! We stock only one brand (cheapest reputable brand we can find). We hope to meet 90-95% of requests with just 250 medicines.
I HAVE LOOKED BUT I CAN'T FIND MY MEDICINE. WHAT SHOULD I DO?
There are some medicines that are only produced by a small number of companies and their prices are very similar. Under the Generic scheme we only offer medicines where we can reduce the price significantly. If you don't find your medicine in our list please one of the websites under "Links" to see if many companies make that medicine - you can switch to a cheaper Brand - Mankind often has much cheaper prices than other brands. If you think we should add a medicine to our list please use the "CONTACT" page to send us the details and we will review our list and update as necessary.
MY QUESTIONS – Why is it that Generic medicines are good enough for some of the richest and most safety conscious nations in the World but in India people are hesitant? Why do Indian poor take loans to buy Branded medicine when they could buy the same medicine for a fraction of the cost? Why is the average retail margin for generic medicine is around 80% despite there being numerous companies that make generics? Aisa Kyuu?
Did you know that in some US states (Florida, Hawaii, Kentucky, Maine, Massachusetts and 9 other states) and in the UK the if the doctor has prescribed a Branded Drug and there is a generic available, the pharmacist HAS to change it to the lowest cost generic. In remaining US states the pharmacist MAY change to generic. [source: http://aspe.hhs.gov/sp/reports/2010/genericdrugs/ib.shtml#apa]
In 2013, 80% of prescriptions in the US were for Unbranded Generics and a further 6% for Branded Generics [source: statistica.com]
The top eight global pharmaceutical markets—the United States, Germany, France, the United Kingdom, Canada, Italy, Spain and Japan—account for 80.0 per cent of the total generics market.” - See more at: http://www.pharmacytimes.com/publications/issue/2012/April2012/Generic-Drug-Trends-Whats-Next-#sthash.kBROdE9A.dpuf
In 2013-14 The rate of GENERIC prescribing in Scotland was 83.2% [source: https://isdscotland.scot.nhs.uk/Health-Topics/Prescribing-and-Medicines/Publications/2014-06-24/2014-06-24-Prescribing-PrescriptionCostAnalysis-Report.pdf]
Market competition from generic drugs is saving public and private healthcare payers more than $1 billion every other day, according to the IMS Institute. Generic drug use has saved $1.1 trillion over the past decade for the U.S. healthcare market. [source: http://managedhealthcareexecutive.modernmedicine.com/managed-healthcare-executive/content/tags/catamaran-2013-drug-trend-data/keep-specialty-and-generic-?page=full]
OK I AM CONVINCED - GENERICS ARE THE SAME AS BRANDED BUT CHEAPER. DO YOU HAVE EVERY MEDICINE?
A normal medicine shop keeps thousands of items. We aim to have only around 300 items in our list. WHY? Firstly, we only offer generic alternatives for the most commonly used medicines. There are some medicines where the Indian Government has controlled prices - their prices are low anyway. However, the most important reason is that a given medicine is made by HUNDREDS of different companies - each has its own "Brand" name. So a pharmaist has to keep many different brands of the same medicine- for 250 different medicines thats 25,000 different Brands! We stock only one brand (cheapest reputable brand we can find). We hope to meet 90-95% of requests with just 250 medicines.
I HAVE LOOKED BUT I CAN'T FIND MY MEDICINE. WHAT SHOULD I DO?
There are some medicines that are only produced by a small number of companies and their prices are very similar. Under the Generic scheme we only offer medicines where we can reduce the price significantly. If you don't find your medicine in our list please one of the websites under "Links" to see if many companies make that medicine - you can switch to a cheaper Brand - Mankind often has much cheaper prices than other brands. If you think we should add a medicine to our list please use the "CONTACT" page to send us the details and we will review our list and update as necessary.
MY QUESTIONS – Why is it that Generic medicines are good enough for some of the richest and most safety conscious nations in the World but in India people are hesitant? Why do Indian poor take loans to buy Branded medicine when they could buy the same medicine for a fraction of the cost? Why is the average retail margin for generic medicine is around 80% despite there being numerous companies that make generics? Aisa Kyuu?