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

Posted by Crazy Mermaid in Bipolar Disorder, Health Insurance and Mental Illness, Healthcare, Medication, mental illness, Mental Illness and Medication.
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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?



1. Sheri - June 10, 2010

I take generics (lamictal included), but always wondered if they were equally effective. Thanks for the information.

2. Dana - June 16, 2010

Thanks for looking into this. I’ve wondered the same thing ever since I went from paying $395 per month for my Lamictal to paying $10 a month for my generic lamotrigine. Not wondered enough I guess to do the research or worried enough to pay the ridiculous non-generic prices. But nonetheless its good to know that the generics go through the same testing and approval processes.

3. Janet Rothstein - June 10, 2012

Just dropped my son off at camp. When we saw the nurse who gets all of his meds from the perscriptions we submit I saw that instead of Lamictal they had lamotrigine instead. I am worried about the different reaction he will have if any on this generic version. We are hours away so I can’t get him the lamictal right away. If someone can advise me please do. The nurse didn’t have a comment other than they didnt notice. “Daw” in the box at the bottom. It is expensive but I don’t want to switch him first day of camp for the generic if there are any side effects for him. I might just go home get them and drive back up. They didn’t include the epi pen I had enclosed a script for either. I had one on me to leave w them. Hope I get a response at some point. I will probably determine what to do by the time I get home.

Crazy Mermaid - June 11, 2012

I agree that dropping him off at camp with a new generic prescription is a bad idea. My advice is to go back home and retrieve the brand name.

4. Lori - November 21, 2014

When I switched from the Lamictal brand to the generic I had seizures. I have had a battle with insurance companies for years in fulfilling the brand name. The insurance company frequently fills my 3 month supply with generics at no charge. I have to ask my doctor to create another prescription that says BRAND NAME ONLY. Now, his first prescription already said it. The insurance company plays ignorant almost every time I reorder. It’s scary!

Why is the generic free and the brand name so much more? Last month I was told that a 3 month supply of Lamictal increased to $900. We saved our money and called to pay and refill it. The insurance company told me that the price for the 3 month supply was $1,700 out of pocket and I was misquoted.

After reading this blog, I am beginning to think the spike in price is because of the fact that my anti-epileptic medicine is now being treated for PTSD, bipolar, etc. It’s a whole new market for the manufacturer.

I would like to hear what other people are experiencing with refilling the Lamictal brand through their insurance company. This is mortgage money! Unfortunately, I make too much money to qualify for a discount from the manufacturer. Has anyone ordered the medication from another country? Please reply…

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