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there are often less expensive generic equivalent medications available to replace brand name prescription medications state law allows a pharmacist to substitute a less expensive generic equivalent medication in place of a more costly brand name medication unless you or your physician directs them otherwise if you choose to fill a prescription with a brand name medication and a lower cost generic equivalent is available your cost will be higher you will pay the non-preferred brand name co-payment or coinsurance and or your deductible you may also be charged the cost difference between the brand name and generic drug this is called mandatory generic substitution how does mandatory generic substitution help you generic medications cost less than the branding medications at the pharmacy these generic medications must be approved by the fda as an equivalent medication for what theyre replacing to receive fda approval the generic medication must have the same active ingredients as the br