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.