Here in Miami, there appears to be some incentive going to pharmacists as they press patients to accept generic substitutes for brand named drugs.  This practice may seem fine in the short term as you leave the pharmacy having saved $20.00 on the co-pay but what is the longer term consequence?

One of the most effective eye drops taken by patients following cataract surgery is cortisone.  It reduces inflammation, eliminates pain and promotes healing.  Over the many years of my practice at Miami Eye Center, I have seen patients given generic prednisilone acetate when I had written a prescription for Pred Forte (prednisilone acetate).  What I have seen as a result of this switch is an eye with smoldering inflammation that takes weeks longer to quiet down.  You might ask, “What’s the difference, they are both prednisilone acetate?”  The difference is the liquid in which the active ingredient is suspended.  The brand name drug has a sophisticated formulation that enhances absorption through the cornea, protects the cornea and has a better pH so it does not sting.  All this leads to a better therapeutic effect.  The FDA does not require the generic drugs to prove their therapeutic equivalence.  If you are taking an antibiotic eye drop, you want that active ingredient to penetrate the eye; that is where the generic can let you down. 

Be aware of generic glaucoma drops.  In Miami, my staff and I battle every day with insurance companies and pharmacies to ensure that our patients are given the brand drug.  In this instance we are dealing with a potentially blinding disease. 

This is written as a note of caution.  When the pharmacist next insists on a generic eye drop, check out the price of the real thing (brand); if you can afford the extra expense then pay it and know that you are getting all the “bang for the buck”