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Generic Medication Coverage

​Generic medications have the same active ingredient and dosage and work in exactly the same way as their brand-name counterpart. On average, generic drugs usually cost less. Therefore, using generic drugs instead of a brand-name drug is one of the easiest ways to reduce your prescription copayment or coinsurance costs

FDA Approval Process

When the patent on a brand-name drug expires, other drug manufacturers can apply to the FDA to make a generic version of the drug. The US Food and Drug Administration (FDA) must review and approve generic medications before they are made available to the public. Generic medications must be the same strength and dosage, be therapeutically equivalent, and or have the same active ingredient as their brand-name counterpart.

Inclusion in a Plan’s Drug Formulary

Generally, all medications recently approved by the FDA are considered for inclusion in a plan’s formulary, which is periodically reviewed by insurance plans. The evaluation often includes a literature review and, at times, expert opinions. Safety, efficacy, comparisons with medications currently on the formulary, contraindications, and cost are some of the things considered in determining what medications to include in the formulary. 

Talk with Your Pediatrician

You should discuss any questions or concerns you have with your pediatrician. He will help determine whether a generic medication is appropriate for your child.

Additional Resources

Last Updated
American Academy of Pediatrics (Copyright © 2013)
The information contained on this Web site should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.
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