A 22-year-old student stated, "I've been on the birth control pill (BCP) for several years. Now my pharmacist wants to give me a generic BCP rather than my regular one. What should I know about these other pills?" It's a good question, and parents should also be concerned about substitution.

The patient who is free of symptoms on a brand pill, then develops problems on a substitution pill, all too often stops the medication. She then makes the next grievous error by failing to use other means of contraception. The result is often unwanted pregnancy. Familiarity with a product also plays an important role in compliance, whether we're dealing with our favourite soap, TV program or BCP. So patients who identify with a brand name are more likely to stay on it, which is the ultimate goal to prevent undesired pregnancies.

To achieve compliance it's also wise to avoid confusing the medical consumer. For instance, in the U.S. some brand name birth control pills now have five generic copycat versions! This means different coloured pills and different packaging both set the stage for possible mix-ups.