The Generic Levothyroxine Conundrum 

Authors:
Connie Liang, PharmD
Kathleen Pincus, PharmD, BCPS, BCACP

Reviewers:
Michael Kane, PharmD
Stuart T Haines, PharmD, BCPS, BCACP

Citation:
Brito JP, Deng Y, Ross JS, et al. Association Between Generic-to-Generic Levothyroxine Switching and Thyrotropin Levels Among US Adults. JAMA Intern Med. 2022;182(4):418-425.

The Problem

Would you be willing to pay three times more for a brand-name product than a generic equivalent? What if clinical practice guidelines recommend against switching between products? This is the case for thyroid replacement hormone products. As a result, levothyroxine has higher brand-name product dispensing rates than other medications, which exposes patients and the healthcare system to higher costs of care.