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Do you buy brand-names or generic?

When you go to the pharmacy or big-box retailer do you choose brand-name or off-brand generic over the counter medications and pills even with the same active ingredients?

This kind of thing enthralls me.  I love you NPR. 

Why do people choose what they choose when given the option of the same product in different packaging?  

Some of you are SO. INSISTENT

"I MUST HAVE THIS BRAND!"  

"It is the ONLY ONE!"

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Don't EVEN bring it to crazy-town with mayonnaise.   But we're taking about medication today.

My line of thinking (…when making that choice in the aisle) goes to:

  • Is is *exactly the same?*
  • Does it have the same efficacy?
  • Is the generic brand safe and effective?

When side-by-side store branded pills versus big brands aren't all that different, same active ingredients, similar labeling, the only thing that stands out to many of us is the pricing.  So why do you choose the more expensive product, if you do?

If I am being completely honest, I don't buy off-brand super inexpensive pills from big box retailers like Wal-Mart (…or a Dollar Store, shiver!) because quite frankly I am terrified at the potential of an eighty-eight cent price point and where THAT came from.  It's not that I am a brand snob, but just, no.  I read the packaging of every side-by-side product and if the ingredients match by percentage and you can see the source — I do not mind paying less per pill.

I will admit for some things I have brandsnobbery  (…but even so much less lately and not really. I have even downgraded to generic huge tubs of coffee.  RIP Starbucks at home, entirely.  Thanks to blogging not being so, uh, lucrative, don't quit your dayjobs!)  But not for over the counter medications.  I bought approximately three boxes of generic gas medications, gut-fail medications and the like prior-to and during my trip to Portland last week because of desperation and it worked and kept me from ROTTING ON A PLANE THANK YOU VERY MUCH.

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NPR

Why does anyone buy Bayer aspirin — or Tylenol, or Advil — when, almost always, there's a bottle of cheaper generic pills, with the same active ingredient, sitting right next to the brand-name pills?

Matthew Gentzkow, an economist at the University of Chicago's Booth school, recently tried to answer this question. Along with a few colleagues, Gentzkow set out to test a hypothesis: Maybe people buy the brand-name pills because they just don't know that the generic version is basically the same thing.

"We came up with what is probably the simplest idea you've ever heard of," Gentzkow says. "Let's just look and see if people who are well-informed about these things still pay extra to buy brands."

In other words, do doctors, nurses and pharmacists pay extra for Tylenol instead of acetaminophen, or buy Advil instead of ibuprofen?

Gentzkow and his colleagues looked at a huge dataset of over 66 million shopping trips and found that, "lo and behold, nurses, doctors and pharmacists are much less likely to buy brands than average consumers," Gentzkow says. (Their findings are written up here.)

Pharmacists, for example, bought generics 90 percent of the time, compared with about 70 percent of the time for the overall population. "In a world where everyone was as well-informed as pharmacist or nurse, the market share of the brands would be much, much smaller than it is today," Gentzkow says.

I asked several people who had a bottle of Bayer or Tylenol or Advil at home why they'd bought the brand name. One guy told me he didn't want his wife to think he was cheap. A woman told me Bayer reminded her of her grandmother. Another guy, a lawyer, said he just didn't want to spend the time to figure it out, and decided it was worth the extra couple bucks to buy the brand.

In general, we often buy brands when we lack information — when, like that lawyer, we decide it's easier to spend the extra money rather than try to figure out what's what.

Jesse Shapiro, one of the co-authors of the headache paper, told me he buys Heinz ketchup rather than the generic brand. He likes Heinz. He thinks it's better than the generic, but he's not sure. "I couldn't promise that, if you blindfolded me, I could tell them apart," he says.

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Restaurant Discounts For Gastric Bypass Patients May Send Mixed Messages

Please do not give me a reason to patronize restaurants with low-quality food options.  MM needs no reason ON THIS EARTH to step foot in a Golden Corral, Olive Garden, Red Lobster, etc… EVER

Nor do MMs kids.  EVER.  I do not need a trough of pasta, fried seafood or oily iceberg lettuce based salad.

MM Does Not Endorse The Use Of WLS Discount Cards For Food.   We have to learn to eat like normal people.  Having an excuse to pay less for crappy food does not teach us anything.

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NPR - n.pr/UEF2qA

All of these reduced appetites might seem like bad news for the restaurant business, but surgeon-distributed food discount cards aim to make dining out cheaper and more practical for gastric bypass patients.

But is this kind of encouragement really a good idea?

To accommodate the patients' reduced stomach volumes, the cards, called WLS (Weight Loss Surgery) cards, ask restaurants to allow patients to order a smaller portion of food for a discounted price.

These cards aren't a new phenomenon — they've been around in the U.S. at least since the 1990s, and a similar discount programwas proposed to city council members in Campinas, Brazil, earlier this year. 

And like the surgery itself, the WLS cards have grown in popularity, says Ann Rogers, director at the Penn State Surgical Weight Loss Program. "Now there's so much word of mouth about it, that if we forget to give them out [after surgery], the patient says, 'What about those discount cards?' " Rogers says.

Some popular U.S. restaurants accept the cards. For example, Cracker Barrel restaurants allow patients to order from the inexpensive children's menu or order a lunch-sized portion for dinner. In a statement issued to the Salt, Olive Garden and Red Lobster restaurants say they are happy to do the same.

Even "all-you-can-eat" buffet restaurant Golden Corral provides a discounted buffet price upon seeing a proof-of-surgery card in some locations.

Though gastric bypass surgery leaves the patient with a stomach pouch only about the size of an egg, restaurants, especially buffets, still spell trouble for many patients. Unlimited portions and heavily processed, quickly digestible foods that keep patients from feeling full make it difficult to keep the weight off, says Rogers.

Golden Corral could not provide a spokesperson to respond to our inquiries, but it and other companies have made efforts in recent years to add healthier choices to their buffet offerings.

Even if the patient makes better choices, however, friends and family who come along may not do the same. "I definitely discourage patients from going to buffet-style restaurants — it's a danger for everybody," Rogers says.

In fact, Rogers says she discourages her patients from eating at any restaurant. So why distribute a discount card that seems to encourage dining out?

Rogers says it's OK for patients to use the WLS card and splurge at the buffet every once in a while, and the card also encourages them to order smaller meals at other restaurants. If patients make healthy choices about 75 percent of the time, they'll keep the weight off, she says.

But just as the buffet can have negative family health consequences, patients who are diligent about eating well a majority of the time can encourage healthy habits among friends and family. Rogers says patients who attend regular follow-up appointments, some featuring weigh-ins and healthy cooking classes, retain their lost weight about 70 percent of the time.

"For most of our patients, when the patients change their habits, it changes the eating habits of the whole household. It's pretty educational," she says.

Changing habits is critical, she says. It's a myth that the stomach surgery is a permanent weight loss cure. After surgery, "the [hunger] hormones go down and stay down for a year or two. But, slowly, the hunger starts to come back," Rogers says.