By Sue Hubbard, M.D.
If your child takes medications for ADHD, you may notice that your insurance company may either deny coverage for these prescriptions or wants to use a generic version of the medication your child needs to take. It seems that this is becoming more and more prevalent, and I get phone calls from patients asking what they should do.
Medications for ADHD have never been inexpensive and for some families, especially without insurance coverage, they are cost prohibitive. For a child who has been diagnosed with ADHD, it is known that a combination of medication and behavior modification provides the best outcome.
When I begin a child on medication for ADHD, I typically start with a brand name drug and do not use any generics. I explain to the parents that although I am a believer in generic drugs, and use them frequently, I want to make sure that any effects of the drug (positive or negative) are indeed due to medication and are not influenced by a difference in a generic drug.
Once a patient has been on medication and is doing well, if there is a generic available, I will often prescribe it in order to be more cost effective.
Over the years, patients have commented to me that they do not feel as if the generic version of their given ADHD medication is working well. While these are anecdotal reports, they have not been uncommon. In that case, some of my patients have opted to pay for the more expensive brand name medication.
Interestingly, the U.S. Food and Drug Administration recently released an interesting article that says studies have recently found that generic versions of the drug Concerta (by two different manufacturers) “may not provide the same therapeutic benefits for some patients” as does the branded medication. While Concerta has a “drug releasing system” that provides 10 to 12 hours of extended effectiveness, it seems that the generic drugs may release more slowly, and the diminished release rate may not provide the same effect for the patient.
So, if your child is on these medications and has tried a generic version, and you were concerned about their effectiveness, now is the time to discuss with your doctor. This may not be the case for all medications, but it is certainly worth knowing there is now data on this subject.
(Dr. Sue Hubbard is an award-winning pediatrician, medical editor and media host. “The Kid’s Doctor” TV feature can be seen on more than 90 stations across the U.S. Submit questions at http://www.kidsdr.com. The Kid’s Doctor e-book, “Tattoos to Texting: Parenting Today’s Teen,” is now available from Amazon and other e-book vendors.)
