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Understanding Generic Drugs: How They Help Protect Your Coverage and Lower Your Costs

Prescription drug costs continue to rise, making it more important than ever to understand the choices available to you. Generic drugs play an important role in helping members manage medication costs while continuing to access safe and effective treatments.

By understanding how generic drugs work, how they are covered under your benefit plan, and when exceptions may apply, you can make informed decisions that help protect both your coverage and your out‑of‑pocket expenses.

What are generic drugs?

A generic drug is an interchangeable version of a brand‑name medication. It contains the same active medicinal ingredient and is considered therapeutically equivalent. While generic drugs may differ in shape, colour, or non‑active ingredients, they work the same way in the body.

The most important thing to know is that generic drugs:

  • Are absorbed into the body at the same rate as brand‑name drugs
  • Deliver the same therapeutic effect
  • Meet the same safety, quality, and effectiveness standards

All drugs sold in Canada must be approved by Health Canada and meet strict regulatory requirements. Both generic and brand‑name drugs are held to the same rigorous standards. Each province also maintains a list of interchangeable generic drugs and their brand‑name equivalents.

Why choose a generic drug?

Today, approximately 65% of brand‑name drugs have an approved generic alternative. When available, choosing a generic drug is an easy and effective way to help make the most of your drug plan.

Using generic drugs can help:

  • Lower your out‑of‑pocket medication costs
  • Minimize the impact of rising drug prices on insurance premiums
  • Support the long‑term sustainability of benefit plans

Example
The estimated monthly cost for brand‑name Celebrex® 200 mg is $129.06, compared to $28.88 for the generic Apo‑Celecoxib 200 mg. By switching to the generic drug, you and your plan could save approximately $1,202.16 per year.

Generic drugs and your plan

Your Medavie Blue Cross drug plan may include features designed to encourage the use of generic drugs where appropriate. These features help ensure that your plan continues to provide value over time.

Depending on your coverage, this may include:

  • Automatic reimbursement up to the cost of the lowest‑priced interchangeable drug
  • Mandatory Generic Substitution, where your pharmacist dispenses the lowest‑cost option when a generic is available

If your healthcare professional prescribes a brand‑name drug and indicates “No Substitution,” your pharmacist may contact them to confirm whether a generic alternative can be used. This helps avoid unnecessary additional costs to you.

We understand that there may be situations where it is medically necessary to remain on a brand‑name medication. In these cases, an exception process is available.

Exception Process

If your healthcare professional determines there is a valid medical reason why a generic drug is not appropriate, they can submit an Exception Request on your behalf.

An exception may be considered when:

  • There is a documented allergy or intolerance to a non‑active ingredient found in the generic drug but not in the brand‑name version (for example, lactose)
  • The drug is being used for the prevention of transplant failure
  • The medication is considered Narrow Therapeutic Index (NTI)

To request an exception, the prescriber or pharmacist can complete the Exception Request form and fax to:

If an exception is approved, a long‑term approval may be added to the member’s file, allowing the brand‑name drug to be reimbursed at the brand price.

For more information about our exception process, please contact our Customer Contact Centre at 1‑800‑667‑4511.