Generic vs brand-name medicines in the U.S.: what is the difference?

Updated 2026-10-06 · Reviewed for accuracy by the EKO Labs team. Educational only; not medical advice.

In the U.S., the same medicine can have a brand name (for example, Victoza®) and a generic name (liraglutide). Many patients, especially people who moved from another country, are surprised by how often U.S. pharmacies fill prescriptions with generics. This guide explains what a generic is, how the FDA approves it and how it differs from a compounded medicineCompounded medicine a version prepared by a licensed pharmacy for a specific patient's prescription. It is not itself FDA-approved.. It is general information; your pharmacist can tell you exactly what you received.

Brand name vs generic name

Every medicine has an active ingredient with a generic (nonproprietary) name, such as semaglutide, liraglutide or metformin. The brand name is the trade name a manufacturer gives its product, such as Ozempic® or Victoza®. The same active ingredient can be sold under more than one brand name for different uses: semaglutide, for example, is sold as Ozempic® and Wegovy®.

What an FDA-approved generic must match

A generic medicine is approved by the FDA through an Abbreviated New Drug Application (ANDA). According to the FDA, an approved generic must:

• have the same active ingredient as the brand-name medicineBrand-name medicine the version sold by the company that got FDA approval, for example Ozempic® or Mounjaro®.
• have the same strength, dosage form (such as a tablet or an injection) and route of administration
• be bioequivalent, meaning it delivers the active ingredient to the body in the same way
• be made under the same strict manufacturing standards
• have the same labelPrescribing information (label) the official FDA document for a medicine, with its uses, warnings and side effects. information as the brand, with certain exceptions

The FDA states that approved generics work in the same way and provide the same clinical benefit and risks as their brand-name counterparts.

Why a generic can look different

The FDA allows minor differences in appearance between a generic and the brand, such as color. These differences do not affect how the medicine works. If a refill looks different from your last one and nobody explained why, ask your pharmacist before you use it.

How to check if a generic exists: the Orange Book

The FDA's Orange Book (Approved Drug Products with Therapeutic Equivalence Evaluations) lists approved medicines and shows which generics the FDA considers therapeutically equivalent to a brand. Anyone can search it for free on the FDA website. For example, on December 23, 2024 the FDA approved the first generic of Victoza® (liraglutide injection), a once-daily GLP-1GLP-1 (glucagon-like peptide-1) a hormone the gut releases after eating. It helps release insulin, slows stomach emptying and signals fullness. medicine for type 2 diabetes. Whether a generic exists is different for each medicine, so check the Orange Book or ask your pharmacist.

Biologics are different: biosimilars

Some medicines, such as insulins, are regulated as biologics. Their follow-on versions are called biosimilars, and some are approved as interchangeable. The FDA lists them in the Purple Book, not in the Orange Book.

Can the pharmacy switch my brand to a generic?

Generic substitution is set by state pharmacy laws. In general, a pharmacist may dispense a therapeutically equivalent generic instead of the brand unless the prescriber indicates that the brand is medically necessary (often marked "dispense as written"). Rules differ from state to state, and insurance plans often prefer generics. If you want the brand, talk with your doctor and your insurance plan.

A generic is not the same as a compounded medicine

A compounded medicine is prepared by a licensed pharmacy for an individual patient. It is not FDA-approvedFDA-approved the FDA reviewed the medicine's safety and effectiveness for a specific use., and the FDA does not review it for safety, effectiveness or quality before it is made. An FDA-approved generic has been reviewed and approved by the FDA. Never call a compounded medicine a generic.

What about cost?

The FDA reports that competition from generics usually lowers prices: in FDA analyses, one generic competitor lowered prices by about 30%, and five competitors by nearly 85%. What you pay depends on your pharmacy and your insurance.

Questions to ask your pharmacist

• Is this the brand-name medicine, a generic or a compounded medicine?
• Is there an FDA-approved generic for my medicine?
• Why does this refill look different from the last one?
• Does my insurance cover the brand, the generic or both?

At EKO Labs, our team can help you understand your prescription in Portuguese or English by phone. EKO Labs does not publish dosing instructions.

Sources: FDA, Generic Drug Facts and Generic Drugs: Questions & Answers; FDA Orange Book (Approved Drug Products with Therapeutic Equivalence Evaluations) and FDA Purple Book; FDA press announcement of December 23, 2024 on the first generic of a once-daily GLP-1 injection (liraglutide). This guide is general information, not medical advice.