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ACOG Issues New Opinion on Brand vs. Generic Oral Contraceptives

July 31, 2007

Washington, DC -- A woman should be able to request and obtain the oral contraceptive that she and her doctor decide best addresses her individual needs, according to a new committee opinion released today by The American College of Obstetricians and Gynecologists (ACOG). If a physician or pharmacist switches a woman's OC prescription for cost, insurance coverage, compliance, or any other reason, she should always be notified.

There are a number of factors that influence the type of OC that a woman chooses to use. "Ob-gyns may prescribe a brand-name OC because of the potential benefits for individual women or prescribe a generic when cost or compliance is an issue. Pharmacists will sometimes substitute a generic equivalent of a branded OC because the generic is less expensive or because a woman's insurance only covers generics," said Steven J. Sondheimer, MD, vice chair of ACOG's Committee on Gynecologic Practice. "But some women are skeptical about using generic medications, and changes in prescriptions can be confusing if a woman is expecting to use a certain type of OC that she is familiar with or has requested," Dr. Sondheimer explained.

"Women should be reassured that generic OCs are a safe and effective birth control option. The US Food and Drug Administration (FDA) considers brand-name OCs and their generic counterparts to be clinically equivalent and interchangeable," Dr. Sondheimer said. FDA-approved generic drugs must contain the same active ingredients and be identical in strength and dosage to the brand-name product, but they may differ in shape, color, flavor, packaging, and shelf life.

"Anecdotal evidence shows that switching between brand name and generic OCs or among different brands or generics may lead to incorrect usage, which can cause side effects and pregnancy. Therefore, if a woman has had better results with a specific brand or generic OC she should be able to request and receive that specific medication," Dr. Sondheimer added.

Cost is a primary factor that women consider when deciding whether to begin or continue using birth control. Most of the more than 90 OC options currently available, and many brands have a generic alternative. Generics are up to 70% less expensive than branded varieties, especially when multiple generic options are available for a particular brand-name OC. The low cost makes generic medications an important alternative for many women, such as those with insurance plans that only cover generic medications and those who pay for their medicines out-of-pocket.

"It is important that a woman be involved in the process of deciding which pill is right for her and informed if any changes are made to her prescription. Additionally, whether cost, preference, or compliance is the main factor in choosing a woman's OCs, ob-gyns should be able to prescribe the pill that is most appropriate for their patients," Dr. Sondheimer noted.

Committee Opinion #375, "Brand vs. Generic Oral Contraceptives," is published in the August 2007 issue of Obstetrics & Gynecology.

The American College of Obstetricians and Gynecologists is the national medical organization representing over 51,000 members who provide health care for women.