Medication Benefits

This is the term used for any brand-new drug molecule that is researched and developed. The pharmaceutical company receives a patent for the product and has exclusive rights to sell the drug under its brand name for the duration of the patent. This patent protects the manufacturer and allows them to earn back the high costs involved in researching and developing a brand-new drug.

A generic drug is a copy of the original drug that may be sold once a company’s patent on a brand-name drug has expired. Generic drugs have the same active ingredient(s), strength, and dosage form as the original drug. Generic drugs are typically cheaper than the original or brand-name drug, as they don’t have the research and development costs that are incurred by the originating company. Pharmaceutical companies that create generic drugs also create competition and thus drive down the costs of medicines.

The generic drug can have a different shape, colour, coating or flavouring than the original brand-name version. Generic medicines also usually cost less.

Yes. A medicine you can buy without a prescription can be sold under many different brand names and many different store brands, even though it contains the same active ingredient(s). For example, aspirin can be sold as Disprin® or Ecotrin®

Yes. A generic drug is the same as a brand-name drug in dosage, safety, strength, quality, the way it works, the way it is taken, and the way it should be used.

Generic drugs may have a different name and look or taste because of differing inactive ingredients, such as colouring, binding and flavouring. But, by law, the active ingredient(s) in the generic and brand-name products must be exactly the same.

There are stringent regulations around the registration of generic medicine in South Africa. The South African Health Products Regulatory Authority (SAHPRA) requires that generic drugs have the same high quality, strength, purity, and stability as brand-name drugs. SAHPRA also requires post-registration testing and assurance of maintained stability, so the quality, safety, and efficacy over the entire shelf-life period of the product is ensured.

SAHPRA inspects the manufacturing and packaging facilities of companies that produce generic drugs for compliance to international standards and good manufacturing practices. No drugs may be sold without SAHPRA approval.

Creating a drug costs lot of money. Since generic drug makers do not develop a drug from scratch, their cost to bring the drug to the market is less. That’s why generic drugs are usually less expensive than brand-name drugs. Generic drug makers must, however, show that their product performs in the same way as the brand-name drug.

Pharmaceutical companies that create generic drugs compete for market share, which drives down the costs of medicines. A cheap generic drug does not mean an inferior product, as market dynamics and competition often drive the price down, not the quality.

In May 2003, the Medicines and Related Substances Control Amendment Act 90 of 1997 was enacted. It requires that your pharmacist advise you on the availability and benefits of a generic equivalent drug. The pharmacist should dispense a generic equivalent drug unless:

• Your doctor has specifically forbidden substitution of the prescribed medication with a generic equivalent.
• The generic equivalent is more expensive than the prescribed medication.
• The product has been declared non-substitutable by SAHPRA.

You, as the patient, decline the use of a generic product after being briefed by the pharmacist.

If you would like to save money by buying generic medicines instead of brand-name medicines, ask your doctor or pharmacist if there are generic medicines that can be used to substitute your current medication.

Any time you replace one medicine with another, for any reason, make sure you learn what the new medicine looks like and which brand-name medicine it is replacing. This is to avoid accidentally taking the same medicine twice because the brand name and generic pills look different.

Just as we manage costs within our personal budgets, medical schemes manage costs within the scheme budget. A good way to do this is by managing medication costs by using generic drugs.

Generic substitution can reduce the price of your medication and assist you in managing your medication benefit to ensure that you maximise the value of your medical scheme benefits. This helps to contain total medicine expenditure, which, in turn, limits annual contribution increases.

There can be a wide range in the prices of equivalent generic products – some generics are more expensive than others and may be above the MMAP®. By using the most cost-effective generic drug, you can avoid co-payments and your benefits will last longer.

KeyHealth Medical Scheme has chosen to apply MMAP®, an industry standard in generic reference pricing, to ensure that cost-effective, quality products are available to its members. The application of MMAP® stretches your “healthcare rand”, without compromising quality, and makes your benefits last longer.

Always ask your pharmacist or healthcare provider for the most cost-effective generic alternative. This will, in many cases, result in no co-payment or reduce any potential co-payments to you.