The high cost of some prescription drugs continues to trigger media attention. These stories tend to focus on chronically ill patients who require lifetime use of one or more drugs, or on older folks whose fixed income is challenged when they need several drugs to maintain health. I choose not to get into a philosophical discussion about the reasons why costs for many drugs are often higher in the US than in other countries. Even I find myself comparing the cost for a prescription in the US to what I'd have to pay for the same medication in Mexico or Canada. So far, most my needs have been met by using a generic equivalent to a brand-name product.

New drugs are developed and released under patent protection. This protection is, in effect, in exchange for the investment dedicated to research, development, marketing and promotion by a pharmaceutical company if the effects of the drug warrant entry into the market. When the patent expires, manufacturers can apply to the FDA to sell generic versions which cannot look the same as the original but must use the same active ingredients, work the same way as the original drugs and have the same risks and benefits as their brand-name counterparts. These manufacturers, who don't have the costs listed above, are also in competition with one another so the price of generic equivalents drop. Ironically, brand-name firms are responsible for manufacturing approximately 50 percent of generic drugs.

When your doctor writes on the prescription form that a specific brand name drug is required, your pharmacist cannot substitute a generic drug. However, your pharmacist can talk to your physician about alternatives. It's difficult to keep up with the daily changes in the drug market so your physician may not be aware of a lower cost alternative.

If you find yourself considering alternative sources for your over the counter or prescription drug there are a few guidelines you should consider.

• 1. Although, by law, generic equivalents to brand name prescription products must be identical to the original version, it's wise to check with your pharmacist when you're attempting to purchase a generic equivalent to an over the counter product. Typically, over the counter generic products have an equivalency statement on its packaging. For example, many 500 mgm. acetaminophen products say "equivalent to Tylenol 500 mg."
• 2. Make sure all generic drugs in tablet or capsule form have markings on them. This branding allows you to identify the source of your substitute in case you or your health care professional have any questions about the product.
• 3. Although generics must be identical to the original brand-name product, it's wise, when you have a chronic illness, to buy the same generic to assure consistency.
• 4. Personally, I believe brand-name products remain the best choice when you are using patches, topical steroids and timed-release tablets or capsules.
• 5. Most importantly, be aware of the growth of availability of counterfeit drugs. Criminals are wise to the fact that there are enormous profits to be made in fake pharmaceuticals. Although most people are savvy enough not to buy a drug from a street broker or the back of someone's car, there are unscrupulous pharmacists setting up closed door pharmacies that are marketed as private sources for your medications. Although they account for only a small percentage of the pharmacy market, getting only one fake prescription can change your life. Your best bet is a high profile, reputable pharmacy. Beyond that, buying all your medications at the same place assures your drugs are cross referenced for interactions and your pharmacist can be your best advocate for your good health.

Depending on your prescription needs, the savings you reap from generic equivalents can be significant. Before you shop elsewhere, consult with your pharmacist to compare and evaluate your choices so you get the right medication at the best possible price.