How to Ask Your Doctor About Generic Alternatives for Lower-Cost Medications

Switching to a generic version of your medication can save you hundreds - sometimes thousands - of pounds a year. But if you’ve ever walked out of the pharmacy with a bill that made you pause, you know how hard it can be to even bring up the topic with your doctor. The good news? It’s not only okay to ask - it’s smart. And most doctors expect it.

Why generics are just as good as brand-name drugs

Generic drugs aren’t cheap imitations. They’re exact copies of brand-name medicines in every way that matters: the same active ingredient, the same strength, the same way your body absorbs it. The UK’s Medicines and Healthcare products Regulatory Agency (MHRA) and the US FDA require generics to prove they work the same way in your body. That means if your brand-name pill delivers 10mg of lisinopril into your bloodstream over 24 hours, the generic does too - within a 5% margin of error.

What’s different? The colour, shape, or filler ingredients. Those don’t affect how the drug works. You might notice your pill looks different after switching - that’s normal. It’s not a different drug. It’s just made by a different company.

For 95% of medications, generics are just as safe and effective. Studies from the British Medical Journal and the NHS show no difference in outcomes for conditions like high blood pressure, diabetes, depression, or cholesterol when patients switch to generics. The only exceptions? A small group of drugs called ‘narrow therapeutic index’ (NTI) medicines - things like warfarin, levothyroxine, or certain epilepsy drugs. For these, even tiny changes in blood levels can matter. But even then, switching between generic brands isn’t automatically risky - it’s about consistency. If you’re stable on one generic, stick with it.

How much money can you really save?

The numbers speak for themselves. A 30-day supply of brand-name Nexium (esomeprazole) might cost £120. The generic omeprazole? Around £4. That’s 97% cheaper. For statins like atorvastatin, the savings are similar: £110 for Lipitor vs £5 for the generic. Over a year, that’s £1,000+ saved.

And it’s not just cash. If you’re on a prescription prepayment certificate (PPC), using generics means you stretch your monthly fee further. If you pay per item, every generic you switch to cuts your total bill. The NHS estimates that generic prescriptions save the health service over £1.5 billion a year - and those savings help keep the system running for everyone.

When you should ask - and when to wait

Don’t wait until you’re at the pharmacy counter. That’s too late. If your doctor writes a prescription, they’ve already made the choice. Ask during your appointment.

Bring your current prescription with you. If you’ve been on a brand-name drug for a while, say something like: “I’ve been on this for X months and it’s working well, but I’ve heard generics are much cheaper. Is there a generic version available for this?”

If your doctor says no, ask why. Not just “is there one?” - ask “Is there a medical reason I shouldn’t use the generic?” Most of the time, the answer is no. But if they mention NTI drugs, ask which ones. There are fewer than 20 commonly prescribed drugs in this category. If your drug isn’t one of them, the answer is likely: no reason to avoid the cheaper option.

Also ask: “If a generic isn’t available now, when might one be?” Patents expire all the time. A drug you’re on today might have a generic coming in six months. You don’t have to rush - but you should know.

What to say - and what not to say

How you ask matters. Saying “Can I get the generic?” sounds like you’re just trying to cut costs. Saying “I want the most effective treatment at the best price - can we explore generics?” turns it into a partnership.

Doctors aren’t paid to push brand-name drugs. But they’re busy. Many don’t keep up with every new generic that hits the market. Your question helps them. In fact, the British Medical Association encourages doctors to routinely discuss cost-effective options with patients.

Avoid phrases like:

• “I heard generics don’t work.” - That’s a myth. The evidence says otherwise.
• “My friend had side effects on the generic.” - Side effects from inactive ingredients are rare, and usually mild. If you’ve had issues before, say so - but don’t assume it applies to every drug.

What if your doctor says no?

Sometimes, they’ll say: “This brand is more reliable.” Or: “I’ve seen better results with this one.” That’s usually about habit, not science.

Ask: “Is this because of the drug’s therapeutic index?” If they say yes, ask for the name of the drug. Then ask: “Is there a specific generic brand you’d recommend if we switch?” For NTI drugs, consistency matters. If you start on one generic, stick with that same manufacturer.

If they still refuse without a clear medical reason, ask for a second opinion - or talk to your pharmacist. Pharmacists know which generics are available, which ones your insurance covers, and which ones have been approved for substitution. They can often contact your doctor on your behalf to suggest an alternative.

How your pharmacy fits into this

In the UK, pharmacists can legally swap a brand-name drug for a generic unless your doctor writes “Do Not Substitute” on the prescription. That’s standard practice. But here’s the catch: many people don’t know this. They assume the pharmacy gave them the brand name because that’s what the doctor ordered.

When you pick up your prescription, check the label. Does it say “generic” or the name of the manufacturer? If you expected a brand and got a generic, that’s fine - unless your doctor specifically said no. If you’re unsure, ask the pharmacist: “Is this the generic version? Is that okay with my prescription?”

Pharmacists are your allies here. They see cost differences every day. If you’re paying out of pocket, they’ll often suggest the cheapest option - even if it’s not the one your doctor named.

Real stories, real savings

One patient in Manchester switched from brand-name levothyroxine to a generic version and saved £130 a year. She had been on it for 8 years. Her thyroid levels stayed perfectly stable.

A man with high blood pressure switched from brand-name ramipril to generic ramipril. His BP didn’t change. His monthly bill dropped from £58 to £3. He started filling his prescriptions every three months instead of monthly - because he could afford it.

Another patient with depression switched from branded sertraline to generic. He had mild nausea for two days - then nothing. His mood stayed the same. He now recommends the switch to everyone.

These aren’t outliers. They’re the norm.

What if you’ve had a bad experience?

Some people report feeling different on generics - more tired, more anxious, or a new side effect. Rarely, it’s because of the inactive ingredients (like dyes or fillers). If you notice a change, track it. Write down when it started, what you’re feeling, and how long it lasts.

Then go back to your doctor. Say: “I switched to the generic and noticed [symptom]. I’d like to try the brand again, or maybe a different generic.” Sometimes, switching to a different generic manufacturer helps - because their fillers are different.

Don’t stop your medication. Don’t assume the generic is “weak.” But do speak up. Your body’s response matters.

Next steps: What to do today

1. Check your current prescriptions. Look up your drugs on the NHS website or the MHRA’s database. See if generics are available.

2. Write down your questions. Before your next appointment, jot down: “Is there a generic for [drug]?” “Is there a reason I shouldn’t switch?” “When might a generic become available?”

3. Ask at your next visit. Don’t wait for your doctor to bring it up. Be the one to start the conversation.

4. Talk to your pharmacist. They know what’s cheapest, what’s covered, and what’s been switched by others.

5. Track your savings. Keep a note of what you paid before and after. You might be surprised.

Generic drugs aren’t second-rate. They’re the smart choice for most people. You’re not compromising your health - you’re protecting your wallet. And in a world where healthcare costs keep rising, that’s not just practical. It’s powerful.