Michael

Motrin was a product from Germany that came to the US when ibuprofen went off patent and was introduced to the US over the counter from Europe.

Pulaski

Ibuprofen was available by prescription only in the UK until, IIRC, February 1983.

augigi

I don't know many who do this - sometimes we write the brand name, but the prescription itself requires you to check "no brand substitution" if you won't accept the generic, and that's a rare day. In fact, I only ever use it for immunosuppression or thyroid meds where the absorption varies between brands. In fact, use of generics helps both prescribers and patients, because 100% of the medications they don't take, don't work - and many, many people can barely afford the $4/month generic meds, let alone the brand names. Prescribing decisions are often based on what the patient can/will afford to take, rather than the most efficacious med for them.

Also to the point about brand v generic - interesting fact, but generic meds are NOT "pharmaceutically identical", actually. I wasn't aware until only several years ago that in order to be approved as a generic, the new drug has to only be "substantially similar" in pharmacokinetics/dynamics (or "therapeutically equivalent") to the brand name drug. For example, although it's the same compound, it can have different binding agents etc, which have different peak action, onset of action, etc. I used to think patients who said "this brand works better for me" were a bit crazy as it was the same drug, but in fact they were likely right.

augigi

1. Antidepressants that need to be taken 2 or 3 times per day are much less effective overall as people simply don't adhere to the therapy.
2. Tricyclics have a very narrow therapeutic window between therapeutic and toxic levels.
3. Tricyclics are easily abused and often fatal if overdose is taken. Very difficult to treat.

It is a shame, as they are very effective and cheap, as you mentioned.

Pulaski

That is Interesting.

Michael

I'm referring to 25 mg dosage or less which seem to work for many people and not 100-150 mg.

Michael

The most common medication that is noticeably different are antifungal medications. Some are very greasy and others are dry and then you have sprays and powders but they all have the same active ingredients but different binding agents or inactive ingredients.

Sally Redux

A doctor told me the generic had to be within 15% of the dosage of the brand name - it sounded like quite a big difference to me (it may not be). Extended-release would also be an important factor, as you mentioned.

sherbert

Back to the OP:

My OH has Crohn's. We are insured through his employer and so far he has had no problem getting and maintaining the same treatment routine as he had before we moved here.

We had a make or break moment when his company said that the health insurance wouldn't kick in until 6 months into his contract. We looked into private expat insurance (almost no one would offer any coverage in the US. The ones that did wouldn't cover anything related to the Crohn's and quoted about GBP 1000 per month for coverage). He then thought he'd 'just pay for treatment' out of pocket until the insurance kicked in. Then we found out that the infusions he has every 6 weeks cost $12,000 a pop. I then put my foot down and he told them that he couldn't accept the position unless he could be insured from the outset. Fortunately they said yes.

He finds the standard of care way higher than back home. Feel free to message me privately if you want more details of treatments etc.

GeoffM

She had her first appointment a couple of days ago. They deduced that she had the same condition as I, that her left eye was normal, her right eye was possibly slightly worse than my right eye (previous doctor said slightly better), and all that took exactly 3 hours to decide.

So given the 60 mile journey each way, that was nearly 6 hours of time to tell us exactly what we already knew. And, having exactly the same condition, do not agree with the suggested long term treatment plan of "straightening the eye" which is absolutely pointless when you have no central vision in that eye. She at least admitted it was for "cosmetic reasons only" which - again in my experience - would actually be extremely detrimental to an eye/brain trying to see the bloody thing. But she's a doctor with perfect eyesight and I'm not her patient with the same condition so WTF do I know.

Yeah, we have really crap insurance at the moment, as I'm aware I've bleated about more than once. And this is a renowned childrens' hospital apparently.

BTW she also spotted a camouflaged animal at LA Zoo long before any of the normal sighted members of our family did, and spots planes in the sky with far more ease than I. I think she'll be ok.