What happens if a generic version of a drug is available?

When a generic version of a drug is available, it often leads to considerations regarding formulary inclusion. A formulary is a list of medications that are preferred and typically covered by insurance plans. If a generic version is available, it might not be necessary to include the brand name drug on the formulary because the generic is generally more cost-effective. This means that the formulary could prioritize the generic medication over the brand name due to cost savings for both the insurer and the patient. Therefore, the availability of a generic may result in the brand name drug not being included in the formulary list, as the purpose of the formulary is to provide effective options that are also economically favorable.

In contrast, the other options do not accurately reflect what occurs when a generic is available. While brand name drugs may sometimes be preferred, their inclusion is not guaranteed and can depend on formulary decisions. Insurance costs for medications typically favor generics, which may lead to a lower out-of-pocket cost rather than full coverage of a higher-cost brand. Additionally, categorizing a drug as urgent is unrelated to whether a generic is available; urgency is typically based on medical necessity rather than the type of medication.