Generic medication vs the original – are you suffering from the ‘nocebo effect’?

The nocebo effect might be the reason you do not feel better on your generic medication.

We all love saving some money especially when it comes to those hefty medication bills, so going for the generic version is a no-brainer, but are generics as effective as the original?

According to Pharma Dynamics, currently about 56% of prescriptions in South Africa are for generics, which can save up to 80% on your bill, yet some people complain of side effects and slower results when using generics compared to the original.

Several studies found that generic substitution may be associated with a powerful phenomenon known as the ‘nocebo effect’ where patients are so convinced that a medication disagrees with them that they start experiencing reduced efficacy and have imagined side effects.

Suffering from the nocebo effect?

Pharma Dynamics spokesperson Mariska van Aswegen said both the nocebo and placebo effects suggest the power of the mind, but should not be confused with one another.

“In placebo, our expectation of feeling better can lead to real physiological changes in our bodies, while patients who read about the negative side effects of a certain medication may be primed to notice these symptoms in their own bodies, described as the nocebo effect,” said Van Aswegen.

“Once a brand-name product comes off patent, a generic medicine manufacturer must ensure that the medication they are producing contains the same active ingredient(s) as the brand-name product, in the same dosage form, at the same dose or concentration and for the same route of administration.”

Van Aswegen said that patients who are anxious or stressed are more likely to suffer from the nocebo effect.

However, Ballito Medical Centre’s Dr Helena Nothnagel said she tries to avoid prescribing generics.

“Unless my patient specifically asks for a generic, I will always go with original medication because I feel it is generally better,” said Dr Nothnagel.

The only alternative she agreed with are clones.

“I love clones – generic medication made by the same company that makes the original. Generics are often made to look like clones, so you have to be very careful that you get the right one.

“I also make sure to write “no substitutions” on my scripts, as pharmacists often give you a generic instead of the original, so this note will prevent that from happening.”

Elana Geist

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