Is newer or more expensive better?

I do not necessarily think so.  While in training I was given the advice to not be the first physician prescribing a drug, nor the last.  There is some wisdom in that. 

Our society values brand-name products and is often swayed by marketing that a new drug is somehow better.  Many “new” drugs are new only in formulation—a sustained release or long acting preparations.  This is a patent-extending measure to make the pharmaceutical company more money.   Renamed drugs with new indications are considered “new” and a new brand name means that a generic equivalent cannot be provided. 

Family physicians are uniquely positioned to know the disease entities and their first-line therapy.  I  suggest time-tested drugs, many of which are available in generic form.  The risk and benefits of generic drugs are well-known because the drugs have been around longer.  An analysis combining 38 studies showed no evidence that branded preparations were superior to generic.

 I tell my patients that my family takes generic medication, many look at me in disbelief.   I tell my husband, newer is not better. . . he appreciates that.