[brightsize]

A data point from the USA: I take a very low dose of lamotrigene extended-release (mild epilepsy). The brand-name cost of this was $1200-$1400 per month. The recently available generic version of this costs nearly $400/mo. And this is, again, for a very low dose. For someone with a moderate or severe seizure (or bipolor - it's used for that too) disorder, the cost might be 4-5x this.

While one might argue that the name-brand version costs so much because of high R&D costs (dubious in my opinion), it's difficult to make that argument for the generic. It's expensive because the manufacturer can get away with it -- it's very much needed by the patients but the market is sufficiently limited in size that few potential competitors choose to target it.

Generics can be inexpensive if the drug in question has a very large market - statins for example. But if not, and you don't work for a company that provides health insurance with prescription drug coverage, a drug you need may well be a drug that you cannot get because of its cost.

[kevitron]

That's insane. I take the generic lamotrigine, but even at a high dose it's something like $36/month here in Canada. I have a half-decent private insurance policy, but at US prices I'd burn through my yearly prescription rebate limit in a month.

[jmct]

While your point is also good, I really wanted to know the case where the a generic equivalent isn't even available (despite being more effective).

The OP's anecdote seems to imply that there are situations where only inferior proprietary drugs are available. Which, in my opinion, would be impossible to defend, no matter how much of a fan of the free market one might be.

[zo1]

You mean, this "lamotrigene":

http://www2.costco.com/Pharmacy/DrugInfo.aspx?p=1&SearchTerm...

The one that costs $17.22 for 50 100mg tablets? Sounds like you might be getting ripped off wherever you bought your medicine.

[brightsize]

You're looking at the non-extended-release tablets, which are reasonably cheap these days.

I just called Costco for you, and the price of 30 generic 200mg extended-release tablets is $397 for members and $408 for non-members.

Edit: spelling