I used to think that each pharmacy used certain manufacturers. Then a friend of mine noticed that we get the same prescription & even get it filled @ the same place, but for some reason, our prescriptions are both from a different manufacturer.
She said that she's had the kind that I get before & that the kind she gets now is much better (I guess they use a little more of a key ingredient or something). So I'm wondering who made the decision to give her that manufacturer & who made the decision to give me the kind from the other manufacturer.
Who decides that? Does the doctor put something on the prescription to determine this or does the pharmacist choose or is it some other way that it's determined? Could I possibly request a certain manufacturer (the one my friend's prescription comes from, so I know the pharmacy uses them)? If so, would I mention it to, the doctor or the pharmacy? Any info would be appreciated. Thanks!
What determines which manufacturer will be chosen for your prescription?
Question posted by mystic37601 on 10 July 2011
Last updated on 10 January 2025 by Probenzo101
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6 Answers
Hey there! I know this is an extremely old question but it’s still a very relevant and, unfortunately more times than not, it’s a very critical one as well as the FDA is practically nonexistent when it comes to regulating, properly vetting and/or carrying out a drug facility audit, which has given way to a plethora of extremely high risk, sinister and potentially deadly (if not downright unethical) ANDA drug approvals for new generic drugs, and the NDA regulatory “incentives” that are pushing out new, branded drugs, with little to no efficacious, long term clinical benefits or the potential consequences for the drugs that are being approved, marketed, distributed and sold in the country.
This has, consequently affected the health care, pharmaceutical and overall industry as a whole as many patients are being treated for diseases and other adverse events that are caused by this completely abhorrent and unacceptable regulatory management, for lack of a better word.
The actual ANDA, which is the “supposed” applicitory system that allows a drug manufacturer apply for the license to manufacture and sell competitive generic drugs once the branded drug exclusivity period has expired, and the original answer to this question is more or less accurate, or what’s supposed to be anyway. To produce and sell a generic drug, the manufacturer has to show the FDA that the product contains the same chemical ingredient(s) with the same effect, route of administration and the same half life, onset of action and bio-availability within a tolerable variable of 20% and the drugs may contain different shapes, inactive ingredients, sizing and markings, and have the same risks and benefits as the reference drug, but they have to produce documentation of the above conditions (normally through a very small testing process to put it in simple terms) in order to be given the rights to distribute the product to wholesalers and pharmacies in the country. However, as I'm sure over 80% of people who are currently taking a generic prescription are very much aware that this “standard” if you want to call it that, isn’t even being employed by the majority of the drug companies, both new and old. The thing about the above process is that it creates a very large number of loopholes that are being exploited, and to a degree in which the market has never seen before, and to top it off, there are certain new regulatory actions that have been put into effect in the last decade and a half that have allowed manufacturers and/or wholesalers to alter the active pharmaceutical ingredients at a molecular level and claim it as either a “deterrent to prevent abuse” or a host of other variables that are just excuses to create inferior and cheaply manufactured products that are still being able to make it onto the shelves of the pharmacies and hospitals. Without going into an all day spill, I will leave you with this,
Be very, very careful with the medications that you are prescribed, look at the generic or brand, and only use the ones you know for a fact that you are able to tolerate, avoid any and all generic drugs that have been produced in the past ten years, especially when they are not well known companies or companies that have been acquired by a different company, as these mergers have created generics that may look the same, but may be completely different compared to the same ones you have previously taken, do your research and for the love of all things holy, do not trust the first few google results to make a determination. Most of these companies have already had lawsuits, many complaints and thanks to the government, the money they are offering to drug companies to create new innovative drugs, as well as initiatives to be the first to create a generic drug, and to downright lie to patients about the so called efficacy of the drugs, the dosage, and, of course the made up “drug shortage” is a common practice that is here to stay I'm afraid, I'm not saying any of this to throw any sort of hate towards the FDA, as it’s more complex than that and the corruption stems far deeper into the government, but If just one person sees this and applies the logic I've laid out and comes out unharmed and healthy, that’s all I could ask for. I implore you to be vigilant and more paranoid regarding your medications, if the pharmacy doesn’t have the brand you are comfortable in taking, then speak with your physician about writing a DAW (dispense as written) on your prescription, along with the brand you choose, and one last tip, and it’s probably worth looking into local pharmacies instead of relying on the commercial chains to make sure you get the right product you need. A local pharmacy will be more willing to help you but there are some caveats, and it may cost a bit more, but given the alternative, I really would not take a gamble on anything that could potentially jeopardize your health and, more importantly, your life. I hope everyone has a wonderful weekend ahead!
You can also ask the pharmacy which manufacturers they carry or can get from their distributor. I do this all the time when looking for my citalopram or for my trazodone which I use for sleep. CVS carries 2 different ones. One works well for me and the other one did not. Even though I let them know which one I prefer and they put it in their computer, they filled it with the wrong one again last time, which I didn't open until I got home. Next time, i will ask to see them before paying. I caught it one other time at the register and they went back and refilled it with the one I requested. I was most appreciative! If you let them know that a certain manufacturer works for you, they will let you know if they can or cannot get it, then you call around looking for it. Good luck!
Pharmacies work with a specific distributor, and each distributor will carry whatever they decide to purchase, usually the cheapest form of generics. Some generics are definately better than others. The FDA approves generics if their active ingredients are shown to be between 80-125% of the brand name, but the generics can also use inferior binders which make up the rest of the pill. If you know that your pharmacy has a distributor that carries both manufactuers of the same generic med then you can ask your physician to request the better manufacturer on your prescription along with "no substitutes". Good luck, this is a huge problem, because so many generics carried by the most common pharmacies all use the same distributers who buy cheap junk, and our insurances will only pay for scripts from the pharmacies who buy from those distributors. It's criminal, as peoples lives are shaken.
You could potentially get a different generic made by a different inferior manufacturer every month. I read blogs from moms whose kids were taking generic ritalin and were fine for months then suddenly their old behaviors came back and they got kicked out of school all because of a change in the manufacturer of the generic med.
It HAS been implied that some doctors will write a note implying "Grade A" and if in fact the pharmacy is filling weaker/stronger/different generics for different people or situations (probably based on their own opinions of possible interactions with other medications).
This particular case was noted a few times when CVS gave everyone Mylan brand several years ago causing withdrawal in some cases for this generic medication, and everyone complained. Finally doctors started writing "Class A" or "Grade A" or "Type A" in the subtle corner which caused a different generic to be given.
Perhaps the A just stood for Actavis generics (AKA "purepac").
Who knows, does any pharmacists or Pharm Techs know if generics are ranked by +/- percentage of medication compared to the brand name, and how much is actually absorbed as a result of inactive ingredients?
If you are speaking of generics brands, I have found it depends on the pharmacy. Walgreens usually stick to certain generic brands, probably for a larger discount from the manufacturer. I stopped using Walgreens for this very reason,. I now use CVS exclusively because I can chose the brand that works best for me. An example of this was when I was on Methadone for chrontic pain, Walgreens would not carry the Roxanne brand which was the only generic that seemed closest to the Name Brand in effectiveness. I found this true with Xanax which I still take, that walgreens would not give me a comparable generic so went to CVS, & they will order whatever brand you prefer. On Xanax I use Purepac as my generic. Hope this helps answer your question. Sometimes you might have to try different ones to find the one that suits your needs. I, & my husband have found this to be true. Best of luck to you...
CVS is just like Walgreens except you've been lucky with the specific manufacturers of the generics you take. I have read many blogs where people complain of CVS, Walgreens, Rite Aide, Walmart, Fred Meyers, and more because they all use the same "distributors", and those distributors determine which generic manufacturers are available to those pharmacies. So the first question to ask your pharmacy is " what distributor do they use?" Then find a reportedly good generic manufacturer from blogs for your generic med and find out if that distributor buys or carries that manufacturer, by calling your pharmacy, or you can call the manufacturer and ask what pharmacies and/or distributors do they sell to. It's a complicated and manipulative system, that's making all these new cheap generic manufacturers tons of money. It has to change!
Are you sure they are exactly the same, same drug, same mg, everything? You are right in that most pharmacies use whichever manufacturer offers the best price on the large quantities of drug they buy but they may get a certain mg of the same med from one manufacturer and another mg from a different manufacturer. If you both take EXACTLY the same med, same mg, everything then you could request they fill your prescription with the pills with the manufacturer your friend uses. I would almost bet that something between the two are different though. The only other thing may be that one is the brand name and the other is the generic. Drs can indicate on a prescription if a generic can be used or not. One of you may have the Dr indicating that a generic can be used and the other may be indicating to use only brand name.
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