Summary
This article implies that physician's have no justifiable reason for prescribing brand-name drugs. Unfortunately, it's not that simple.
Analysis
The article doesn't distinguish between generic substitution of a specific brand-name drug and generic substitution within a class for a similar but non-identical brand-name drug. In the first case, there are several potential adverse consequences related to generic substitution of a specific brand-name drug. Although the brand-name drug and generic drug may be bioequivalent, the brand-name drug is often a slow or timed release formulation that allows once daily dosing and improves medication compliance that will deteriorate with generic drug substitution. The patient may get a different brand of generic drug at each refill. This may create problems with pill identification and possible duplicate dosing. Bioequivalence does not necessarily imply identical bioavailability in an individual patient. Different brands of generic drugs at each refill (with bioequivalence but not identical bioavailability) may result in problems in achieving stable drug levels or drug effects. In the second case, and in addition to the above potential problems, generic substitution within a drug class may result in problematic adverse drug-drug interactions with the generic drug substitution that weren’t present with the original brand-name drug.
