By James E. Hamby Jr., Navy Times, Oct 30 2006
Forwarded by

Q: For 27 years, I served my country on active duty and in the reserves. Now I find that same country treats me like a second-class citizen. The health insurance it offers gives me only second-class drugs. Everybody else gets brand-name drugs, but TriCare gives out only generics to our country’s retired troops. Military pharmacies do the same. It’s insulting.

A: It’s not necessary to do a lot of research and quote a bunch of statistics to get agreement from almost everybody that the cost of prescription drugs is very high. If you ask the drug manufacturing industry, you’ll hear about the high cost of research, the number of blind alleys that must be investigated and the occasional lawsuit costing millions. Still, one doesn’t read of drug makers laying off thousands of workers or see pharmacologists and biochemists holding up “homeless” signs at intersections.

To the extent that resolving the problem is possible without paralyzing the industry’s research and development, the most immediate solution to the high prices of drugs is to find cheaper ways to provide them.

Some 75 to 80 years ago, entrepreneurs recognized that the patents were expiring on many drugs whose research and development already had been done. As long as they didn’t use names that had been used previously, they could stir up batches of the same medicines, rename them and sell them much more cheaply than the original developers had been doing for 20 or more years.

The Food and Drug Administration decided it could play, too. With the help of scientists and health care professionals, it devised standards to ensure the purity and effectiveness of those generic drugs.

Today, a generic drug is required by federal law to be an identical copy of the original brand-name drug. It’s the same pill, but with a new shape, color and box. The dosage is the same, as is the strength and quality. The FDA requires them to be the bio and therapeutic equivalent of the brand-name original. It must be possible to use the brand-name drugs and the generic equivalent drugs interchangeably, with no detectable difference except in your pocketbook.

All generic equivalent drugs must be approved by the FDA as safe and effective for their on-label use. There are no second-class drugs. Unlike generic green beans or hand lotion, FDA-approved drugs are as safe and effective, and have the same production standards, as their brand-name ancestors.

So, are generic drugs the solution to prescription drug prices? Of course not. Expensive drug research still has to be conducted and paid for, and the product must be advertised and sold at a profit to pay for the next round of research for new drugs.

Many, if not most, health insurance policies now prefer dispensing generic equivalent drugs, often from a select formulary (its list of covered drugs) for full coverage. The reason is very simple: cost.

The uniformed services now require their pharmacies to stock and dispense generic drugs from a limited formulary when they are available. TriCare has the same rules for both its local retail network of pharmacies and its mail-order prescription plan.

Some physicians still do not trust generic drugs, and some patients experience real, or perceived, differences when they use a generic equivalent drug versus the brand-name form.

TriCare now has three tiers of drugs: generic, brand-name formulary and nonformulary drugs. The patient’s cost share breaks, accordingly, into $3, $9 and $22 categories. If the physician deems it medically necessary for a specific patient to take only a particular brand-name or nonformulary drug, and if the physician can adequately document the medical necessity to take only that drug, TriCare will make it available for $9.

Generic drugs are not “second-class” drugs, and a health benefits plan that gives them preference is not treating you like a second-class citizen. Great care in manufacturing and dispensing generic drugs has been written into federal law to ensure their safety and effectiveness.

See also: TriCare Formulary Update.

For more information about generic drugs, you can go to the Food and Drug Administration Web site at You can write the FDA at U.S. Food and Drug Administration, 5600 Fishers Lane, Rockville, MD 208570001 or call 1-888-INFO FDA (463-6332).


Write to James E. Hamby Jr. at TriCare Help, Times News Service, 6883 Commercial Drive, Springfield, VA 22159; or by sending e-mail to In e-mail, please include the word TriCare in the subject line and do not attach files. If using regular mail, please include an e-mail address if possible to prompt a faster response.