Top Generic Bargains and Expensive Alternatives

As a family physician I treat most of the common medical problems seen in office practice. In years not so long ago it was really difficult to treat many conditions effectively because the good drugs needed were incredibly expensive. Many conditions still require expensive brand name medications, but in the last decade or so many of the great drugs developed in the last 25 years have lost their patent and are available as generic bargains. Here are a few of my top favorites:

SSRI Antidepressants: Prior to Prozac the treatment of depression was terribly difficult. Now we have several excellent generic drugs, including fluoxetine, generic for Prozac available. These include citalopram, sertraline, paroxitine and bupropion. Most depression that responds to medication can be treated with one or more of these drugs, many or which are on the $4 / month discount pharmacy programs.

ACE Inhibitors: The angiotensin inhibitors have revolutionized the treatment of congestive heart failure, the protection of renal function in diabetes, and the treatment of hypertension. Almost all are on the discount pharmacy programs now.

Metformin: The first drug used in the treatment of type 2 diabetes is almost always metformin. It is effective, does not cause low blood sugar, may slow the progression of diabetes, and is also on the discount drug programs.

Omeprazole: Prilosec was the first of the proton pump inhibitors (PPIs) to come to market, and is now available both over the counter and by prescription as a generic medication. No other PPIs have been shown superior in treatment of peptic ulcer disease or gastric reflux disease, and this relatively inexpensive medication at $27.70 for #90 20 mg doses is a bargain compared to the branded alternatives. A branded alternative Nexium is $534.37 for #90 40 mg doses.

Beta-blockers: These medications are used to treat high blood pressure and congestive heart failure. Carvedilol (Coreg) has the most data for CHF treatment and is on the discount drug programs.

Thiazide Diuretics: Although these have been generic for over 30 years it remains a mainstay of treatment of hypertension, and is so inexpensive the cost is the cost of filling a prescription, essentially the $4/ month at the discount pharmacies.

Alendronate: Generic for fosamax, this bisphosphate used to treat osteoporosis is now generic, and inexpensive at $17 / 12 weekly doses. This is a great savings over the branded meds like Boniva which costs $360 for 3 monthly tablets. (Costco prices)

Always ask your physician if there is a good generic alternative if you are being prescribed a new medication. Often there may be a great bargain alternative if you just keep us on our toes and ask.