Bipolar: Crazy Mermaid's Blog

The Cost of Generic Drugs VS Name Brands: Lamictal June 9, 2010

The Cost of Generic Drugs versus Name Brands:  Lamictal

Although first approved by the FDA for treatment of  epileptic seizures in December 1994, Lamictal wasn’t approved for maintenance treatment of Bipolar 1 Disorder until June 2003. The first drug since lithium that was approved for this use, it is also used “off-label” for treatment of schizoaffective disorder, Bipolar II Disorder, borderline personality disorder, and Post-Traumatic Stress Disorder.

I was started on Lamictal in the mental hospital to treat the symptoms of Bipolar I, but my supply of medication ran out about 1 week after I was discharged.  When I got my prescription filled for a 30 day supply of Lamictal, I was shocked beyond belief to learn that the cost for that one month supply of 300 mg  was in the neighborhood of $450, or $5,400  a year.

In July 2008, Teva Manufacturing began offering a generic form of Lamictal in the 150 mg doses that I require.  Previously, it only made 25 mg and 50 mg doses, so it wasn’t practical for me to take 12 pills at a time in order to get the required 300 mg dose. When Teva began making the 150 mg pills in July 2008, it became practical to take two of them to equal my 300 mg dose.  At that point, my insurance company insisted that I change from the name brand Lamictal to the generic lamotrigine.  The cost of my medication was reduced from $450 per month to about $150 per month for 300 mg, or about $1,800 per year- a substantial savings of $3,600 a year,  but still out of the realm of most people’s idea of a bargain.

Now, almost 2 years later, I’m paying $14 for a one month supply, or $168 for a year’s supply of yet another generic form of  lamotrigine, this one manufactured by Cadila (Zydus). This drug is available to me through a mail-order prescription drug company, Medco, which is part of our insurance package. So what happened?  How can a drug cost go from $5,400 per year to $168 per year within a two year period of time?

In one word: generics.

But are they safe?  Are the generic formulas the same as the name-brand formulas?

To answer that question, I went onto the Federal Drug Administration’s website http://www.fda.gov/Drugs/DevelopmentApprovalProcess/ucm079068.htm#Reference%20Listed%20Drug to learn how the generic assessment is done. In a nutshell, the generics are tested on people just like the original brand-name drugs were tested, though the number of people they were tested on isn’t as large.  In the end, the FDA decides whether the test results are good enough to grant the manufacturer of the generic form of the drug approval to sell his drug, and makes that determination available online to the general public. In the case of lamotrigine, each dose, by manufacturer, has been tested and approved by the FDA (see http://www.accessdata.fda.gov/scripts/cder/ob/docs/obdetail.cfm?Appl_No=077633&TABLE1=OB_Rx).

In the final analysis, it’s up to the patient to decide whether the generic brand works as well as the name brand, but according to the FDA, the active ingredients are the same.

Is $450 a month an appropriate amount of money to pay for a medication?  Is it appropriate that the cost of the same medication varied from $5,400 a year to $168 a year within a two year period of time?  Is it any wonder that our health care costs are out of control?