Thanks for the input Annie, I always appreciate your input. I believe the flag 'preferred generic' is just a drug insurance term and mainly affects rates but I am not sure. Also I made a typo. The Generic is not for pred. pred is cheap. It for Mestinon (Pyridostigmine). It is about $35 a month for the generic, $295 for Mestinon. That is for 60 mg x3. That could double or triple if I go to more frequent doses and I add the time release dose for night time. That is insurance rates with a Medicare part d. plan. That could itself go up while paying higher rates during the 'doughnut hole'. It may end up being a mute point for me. The mestinon has only had a minor effect for me. I started taking it 2 days before the pred to see. The effect of the pred has been very dramatic. Only side effects has been some diarrhea and I had very little sleep last night. I have had just a little eyelid sag and just a little double vision and that occurred when I was doing to much. yesterday was the 2nd day for pred. I know from this board this could change to much worse side effects very quickly but so far so good.