Interesting thread. I just posted in my blog thread how happy I was that I was granted an exception by our insurance for my Estradot patches. Their preference was for me to use generic, so I had to apply for the exception. There is a huge, HUGE difference between the brand name and the generic. Judging from the posts in this thread, my experiences might be relevant.
The generic patches (Sandoz) are enormous. So big that I was only able to use three locations, meaning that they caused more irritation: I was re-using each location every ten days. The Estradot patches are much smaller. I can go a full month before re-using the same bit of skin.
The generic patches use water-soluble adhesive. So they come off in the shower or if you perspire a lot. It makes for easy soap-and-water cleanup, but you don't get the hormone if they don't stick. Estradot patches use an oil-soluble adhesive, so they stick in the shower. They do leave a black "bathtub ring" when you peel them off that soap won't get rid of. But a bit of oil (bath or baby oil) on a makeup pad will take it right off.
The big difference for me, and what caused me to switch, was that the adhesive on the generic is a serious irritant. They would always leave a red spot for a couple of days. It got worse, so after three years, I was applying new patches over bright red, inflamed, painful rashes from the previous week.
My doctor had always prescribed the Estradot patches, but the pharmacy substituted the generic. I asked my doctor to put "no substitutions" on the prescription, and I asked the pharmacy to put the same on my file. That worked well ever since. No more rashes or pain.
The paperwork from the insurance, due to a recent change in providers, was several pages long. It had me document exactly what the problem was with the generic. I had to get my doctor to sign off on it. But they accepted the application, and they granted me an exception.
