What are the main factors a patient should consider when choosing a brand of medication?
In Australia, people will only be offered a choice when the brands are bioequivalent, meaning they contain the same active ingredient (i.e. the chemical in the medicine that makes it work) and have been proven to work the same in the body. Ultimately the choice lies with the consumer which can depend on their personal circumstances.
Price is obviously one factor that influences choice. Others may include the size and shape of the packaging and whether or not the brand you choose is readily available.
For example, if you are taking multiple medicines, choosing brands which have similar packaging may increase the risk of you mixing your medicines up and making a mistake. And if a pharmacy doesn’t have in stock the brand your doctor has prescribed, choosing the alternative brand enables you to get your medicine when you need it.
People with allergies or intolerances to substances such as gluten or lactose, or who choose to avoid certain substances for cultural or medical reasons may have their choice restricted if a brand contains these substances as excipients or inactive ingredients (these are used during the manufacturing process for various reasons and include such things as binders, fillers or coatings).
How do you rate the importance of these factors?
Bioequivalence is clearly the most important factor. The same safety and quality standards are applied to all medicines regardless of their brand or cost so consumers can confidently make a choice, knowing they will get the same health benefits no matter which brand they choose.
The importance of other factors will be highly dependent on individual circumstances. For example, if you have an allergy to something that may be included as an inactive ingredient, then being aware of this, and always checking what the inactive ingredients are before choosing an alternative brand, will be a very important factor.
What are the main reasons behind the difference in price of the different brands of medications?
In Australia, the government subsidises medicines listed on the Pharmaceutical Benefits Scheme (PBS). When two brands of the same medicine are listed on the scheme, the Government will subsidise both brands to the same amount. Sometimes the medicine manufacturer will place an additional cost on its medicine, called a brand premium. This may make its brand more expensive than other brands.
Pharmacies can also place a mark up on the storage and handling of PBS-listed medicines. This may differ from place to place, so it’s worth shopping around if cost is an important consideration.
It was recently reported that a number of medicines will increase in price this week. What is the reason for this?
This week in Australia the price of a number of medicines increased due to an increase in the brand premium. As mentioned previously, this is a mark up set by the medicine’s manufacturer and normally passed on to the consumer.
Which medications will be affected by this increase in price?
There are 85 brands whose price will be affected. These brands are listed on the PBS website www.pbs.gov.au along with a list of less expensive bioequivalent brands which may be available to choose from.
Where can people go to find advice on which medicine to choose?
The best source of advice is your GP, pharmacist or other health professional. They will be able to help you make a choice based on your individual circumstances.
NPS MedicineWise has tools, information and tips for consumers on how to make a safe and confident choice between medicine brands at http://www.nps.org.au/bemedicinewise/brand_choices
Once a patient starts on one brand of medication, can they switch to another brand?
For most medicines, it’s up to the medicine user which brand they choose. However in some cases your doctor made advise that you stick with the original brand they prescribed.
Some people may not want to switch brands to avoid confusion. It’s also best not to switch brands too frequently especially if you take several different medicines, You doctor may also advise that you don’t change brands if you have certain medical conditions: your doctor will explain this to you if that’s the case.
If you are thinking about switching brands, speak to your health professional first who will help you make a safe decision.
So if someone decides to use a different brand of their medicine, what can they do to avoid mix ups and mistakes with their other medicines?
Always check the active ingredient in your medicines so you know exactly what you’re taking. This will help you avoid doubling up with other medicines that contain the same active ingredient which can accidently happen, for example, if you have two different brands of the same medicine at home.
Recording all the names of your medicines on a Medicines List can help you, your doctor and pharmacist keep track of your medicines and choice of brands. Keeping track of what you’re taking is really important, considering the number of brands for commonly prescribed medicines that are available to consumers has increased this year.
Keeping a Medicines List is a handy way to remember the active ingredient name in your medicines and brand choices too. If you are offered a different brand, you can check the active ingredient on the pack against that contained in your usual brand as detailed on your list, so you can be confident it will work in the same way.
You can order or print out an NPS Medicines List from the NPS website, or download it free on your iPhone from the App Store.
Would you like to make any further comments?
NPS MedicineWise has developed five questions to ask when you are offered an alternative brand of medicine:
- Is it okay for me to choose a different brand of my medicine?
- What are the benefits and disadvantages for me if I use a different brand?
- Is there a difference in cost?
- Which of my usual medicines does this replace?
- What is the active ingredient in my medicine?
Where can readers find more information?
NPS MedicineWise has information and resources to help consumers make a safe and confident choice between medicine brands available online at http://www.nps.org.au/bemedicinewise/brand_choices.
About Dr Lynn Weekes
Dr Lynn Weekes is the inaugural CEO of NPS MedicineWise. Since 1998, Lynn’s leadership and strategic direction have guided NPS in implementing quality use of medicines, and more recently medical tests, across the health sector and the wider community.
Lynn originally practiced as a pharmacist in hospital and research settings. She holds a doctorate in community medicine, and as part of her thesis developed indicators for quality use of medicines in hospitals and for drug and therapeutics committees that are widely used, both in Australia and internationally.
Prior to joining NPS, Lynn was the Executive Officer of the NSW Therapeutic Assessment Group where she was involved in drug use practice, evaluation and policy. Lynn sits on various national boards and committees, including the Medication Safety Taskforce of the Quality and Safety Council of Australia, the Intentional Misuse of Pharmaceuticals Committee of the Australian Pharmaceutical Advisory Council and the Australian Prescriber Editorial Executive Committee, and she is a former chair of the Society of Hospital Pharmacists, NSW Branch.