Doctors, nurses, and pharmacists are more likely to buy generics over brand-name medicines. But when it comes to the average consumer, brands are often preferred. A lot of marketing dollars went into creating a perception of quality that sets the brand apart. But for medications whose active ingredients are the same, can your body really tell the difference? And is it worth spending 7x more for the same medication?
I recently needed to buy some over-the-counter analgesics, or pain relief medications. And I was surprised to find that all the retail pharmacies I visited (Guardian, Watsons, and Unity) only sold Panadol®. When I asked the pharmacist if they had any cheaper generic medicines, she pointed to the Panadol®, and said, “This is it”.
Panadol® is the most commonly used over-the-counter analgesic in this region. But it’s active ingredient, Paracetamol, has been around for over 100 years. Patent protection usually lasts 10-20 years. Hence, there should be more generic options available for this medication.
Cost of Panadol vs Generic Paracetamol
The cheapest place I found where I could get both Panadol® and its generic, Paracetomol, was not at a retail pharmacy. It was at a hospital pharmacy.
At the Tan Tock Seng Hospital Pharmacy, the cheapest formulation of Panadol® was $6.86 for 20 caplets. This formulation, according to the Panadol® website was for “everyday pain-relief”. There are as many as 14 formulations, each targeting different populations/symptoms. All the different Panadol® formulations were prominently displayed on a shelf at the TTSH pharmacy.
And on a somewhat obscure and hidden shelf were all the cheap generic medications. Among them, was Paracetomol, at $1.07 for 20 tabs.
The active ingredients and the dosage was exactly the same. Yet the generic was nearly 85% off the usual price of the brand.
Why Singaporeans Aren’t Buying Generics
1. Availability/Convenience. When I lived in the US, it seemed that generics were ubiquitous. Even big stores like Walmart and Amazon had their own generic versions of over-the-counter medications. You’ll even find Paracetomol (called Acetaminophen in the US) at your local 99-cents store or 7-Eleven.
But in Singapore, the retail pharmacies (at least the ones I visited) don’t stock these particular generics. Paracetomol and Ibuprofen are simply unavailable (or hidden). But their branded equivalents (Panadol® and Nurofen®) are easy to find and usually just below the checkout counter.
Even in the hospital or polyclinic pharmacies, the generics are hard to find. But displays of the brand-name pills, all in their colourful packaging, are quite easy to find.
And the more alarming thing was that when I visited a retail pharmacy, the pharmacist there didn’t seem to know that Panadol® is a brand-name pill. When I asked for “a cheaper generic”, they specifically directed me to Panadol®. Apparently, some don’t seem to know that Paracetomol, although not sold at a retail pharmacy, is available at a hospital/clinic pharmacy.
2. Perception. I see ads for Panadol® everywhere, from the bus stand to the MRT Stations. These campaigns help to give the impression that Panadol® is more effective and better than the generic.
But generics and brands have the same active ingredient. They are tested, manufactured, and regulated under the same conditions. So from a chemical and medicinal point of view, they are essentially identical.
Generics are cheaper because someone else spent the money to develop and test the drug. They’re also cheaper because they aren’t marketed in the same way. They don’t come in fancy packaging, and you won’t see an ad on the MRT for them.
The market for analgesics is predicted to have a compound annual growth rate of 7.1% from now until 2022. There is a lot of money to be made on drugs like Panadol® and Nurofen®. So their marketing messages will likely increase. Their growth, particularly in this region, is expected to be very high.
If you regularly buy brand-name medicines, you might want to consider cheaper generics. You can always talk to your doctor or pharmacist if you want to confirm their efficacy and equivalence. And if you’re still convinced that brand-name drugs are better, consider this: the hospitals and polyclinics in Singapore use generic medications for their own patients.
A Note of Caution:
Analgesics are considered “safe” when taken as instructed/prescribed. But they are one of the easiest medications to overdose on. And for some people, an overdose can occur even when taking the recommended amount. Improper use of Panadol® or Paracetamol can lead to liver disease, which in some cases, leads to death. There are also several things, such as alcohol, that might magnify their health risks. Always following the packing instructions and seek medical advice if you are taking it regularly.
Please use caution when taking these over-the-counter medications, and make sure you truly need them. The avoidance of pain is human nature. But tolerance of some pain is also a necessary part of being human.