Information on 'brand-name' drugs and 'generic' drugs in Canada

What is a “brand name” drug and what is a “generic” drug?

Many new immigrants may not be familiar with generic drugs in Canada.  When they get their prescriptions filled at the pharmacy, they may be surprised that the pharmacist is offering them generic drugs instead of the brand name drugs.  In Canada, the company that first developed the drug will have the sole right to make and sell the drug for a certain period of time. This is called the patent. When the patent ends, other drug manufacturers are allowed to make and sell the same drug. These are called generic drugs and they usually cost much less than brand-name drugs.

In Canada, generic drugs have to be tested and proven to work the same way as the brand name drug before it becomes available for sale.   

Does ODB cover brand name medication?

When both the brand-name and generic drugs are listed on the Ontario drug benefit formulary, then the drug benefit will pay for the lowest cost of the two drugs. You can still choose to receive the brand name medication, however, you may need to pay for the price difference. For example, if ODB covers the generic drug price of $10 and the brand name drug price is $30, then you may have to pay for the difference of $20 out of pocket.

However, if you have tried generic drugs and had adverse reactions to at least 2 different generic drugs, then you can ask your doctor to fill out a side effect reporting form and request for "no substitution" on your prescription. The Ontario Drug Benefit will cover the cost of the brand name drug in this situation. 

What is a 'brand-name' drug payment assistant card? 

Some of the brand name drug companies provide a payment assistance card to pharmacies and doctor's offices to help pay for part of the cost difference between the generic drug and the brand name drug, if the patient chooses to receive a brand name drug. The card contains a series of code numbers which the pharmacist can use to claim payment online while filling a brand name drug prescription.  

However, not all brand name drugs have this type of payment assistance cards and in many cases, the payment may not cover the full cost difference between the generic drug and the brand name drug. 

Are all prescription drugs covered by the Ontario Drug Benefit? 

Sometimes people assume that any drug prescribed by a doctor will be paid for by the Ontario Drug Benefit. We often have to explain that there is a drug formulary that is regularly updated by the government, which determines if a drug will be paid for by the Ontario Drug Benefit. Furthermore, the amount that the government requires you to pay out of pocket depends on the type of Drug Benefit program that you belong to and your reported yearly income. For more information on the Ontario Drug Benefit program, you can visit the following website: https://www.ontario.ca/page/get-coverage-prescription-drugs

If you have any questions regarding your medications, feel free to contact our pharmacist at Custom Care Pharmacy 905-305-0111.