Can’t tell your Panadol® from paracetamol, Nurofen® from ibuprofen, or Zyrtec® from cetirizine?
Even though research has shown that generic medications work just as well, there are plenty of Singaporeans who still prefer "brand name" drugs.
If you belong to this group, or have ever felt baffled by the many names a medicine can have, this post is for you!
Buying medication from Guardian/Watsons vs the polyclinic
Say your nose is runny and you need something to dry it up because you don’t want mucus going all over your face at your date tonight.
Go to a retail chain pharmacy and you might pick up an antihistamine (dries up a runny nose and settles allergies) like Zyrtec®. You’ve watched its TV commercials and seen public buses go past plastered with its advertisements.
Pay for it and you are on your way to a wonderful evening.
A week later, you visit a polyclinic for a health check and decide to purchase some of the same medicine again to avoid your mucus ruining your date once more.
The pharmacist there says they don’t carry the brand you requested for, but is happy to sell you "another" product which to you, looks totally different from what you bought earlier (this doesn’t even come in a nice glossy box, tsk).
Before getting antsy, let me reassure you that those two products very likely contain the same active ingredient – which in this case, is cetirizine.
Yes, it's all about the active ingredient!
Active ingredients are what give medicines the power to heal as these molecules are the substances which facilitate its beneficial effects.
Because finding a good molecule can sometimes take pharmaceutical companies up to 10 years to discover and develop, these firms go on to patent the product.
Patent protection usually lasts 10 years, and can go up to 20 years in some countries (since it did take them that long to discover it in the first place, let’s be fair!).
During this time, the original producer of this medicine can pick out a name for it (tadah, the brand name!) and have exclusive rights to sell this product.
So how exactly do medications get their names?
Naming a medicine can be challenging - much like naming a baby, you want the name to be inspiring and memorable. At the same time, there are safety conventions so that you don't run the risk of mixing up two similar-sounding medicine names.
There's good fun to be had at times - for example, Zyrtec® contains cetirizine. Spell Zyrtec® backwards, C-E-T-R-Y-Z … what does that sound like? (cetirizzz-ine! I'm not entirely sure if this was the motivation behind the name, but this was my brainwave on a quiet afternoon staring at a box of Zyrtec®).
If you’re a bigger name geek than me, CNN takes a deep dive: http://edition.cnn.com/2016/11/25/health/art-of-drug-naming/
Why do brand name medications cost more than generics?
Brand name medicines tend to be more pricey because of the large capital investment made by the company to discover and develop the molecule into a product you can actually consume.
Once the patent expires, the original developer no longer has exclusive rights. This is when many generic manufacturing companies rush in to "copy" the product.
In order for a medicine to be approved to be a generic version of the brand name product, health regulators have strict regulations in place (yes, so essentially it's the same).
The generic manufacturer needs to prove bioequivalence, meaning it not only contains the same active ingredient, but is absorbed in your body the same way. By extension, it's assumed that the generic product behaves similarly in the body to the original brand name one.
Generic manufacturers skip the arduous, costly, and sometimes fruitless process of discovering a new drug molecule and testing it for safe and effective use in patients. Because of these "savings", generic manufacturers are typically able to sell their generic medicines to you at a much more economical price.
Most countries opt to fund a generic version of a medication for use in public institutions when appropriate, including Singapore, which is a reason why you often find them supplied in polyclinics and public hospitals.
Why do Singaporeans still prefer "brand name" medications?
Surprisingly (or not), brand names usually still make good sales despite patent expiry due to a variety of reasons, from "there must be something different with the branded product", to "I tried the generic and it didn’t seem to work" and of course, personal idiosyncrasies – for some people, it just works better!
Brand names also tend to stick around in people’s minds as drug companies can afford more extensive advertising so that you never forget they're still around!
I hope this helps you make a more informed decision the next time you buy your medication. If anything, don’t forget you can always discuss it with your pharmacist or doctor!
And yes, if you want to save some money, either purchase your meds from the hospital/polyclinic pharmacy (as explained in this doctor hacks post here), or try asking to buy a generic version of the medication from the Watsons/Guardian pharmacy counter.