In the field of pharmaceuticals, Americans have been told that price doesn't matter. Generic drugs are supposed to be identical to their brand name counterparts. For nearly 30 years, we believed this argument. We encouraged people to save money by insisting that their physicians prescribe generics whenever they were available.

All that changed several years ago when some pharmacists started telling us they had doubts about the quality of certain generic products. We also began getting letters from readers who had trouble with their generic prescriptions. Readers have shared their disappointment with generic pain relievers, antidepressants, blood pressure medicines and diabetes drugs. The generic drug manufacturers discount these reports.

Kathleen Jaeger, president and ceo of the Generic Pharmaceutical Association, has written: "To set the record straight, there are no differences between FDA-approved brand and generic medicines. A generic must meet the same high standards as the brand-name drug, with the same safety and effectiveness, same active ingredients, same strength and dosage, same labeling and use and same high quality manufacturing standards."

While we agree with Ms. Jaeger that FDA approval is rigorous, we worry that once drugs are approved and marketed, monitoring is spotty at best. For the most part, the pharmaceutical industry runs on the honor system. The FDA is not capable of analyzing more than a handful of pill bottles from pharmacy shelves each year. As a result, unscrupulous manufacturers or counterfeiters may be slipping substandard generics into the marketplace.

Joe and Terry Graedon

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  1. Tanya
    Durham NC

    I have been on generic lexapro for a while but on occasion, the pharmacist will switch the manufacturer and I get the escitalopram oxalate that has a letter M on it. The last time I took this, it made me so incredibly tired and light headed that I could barely function ( I am on a 10mg dose). It has been a while since this has happened but last week I was given the drug with M on it again and same symptoms are happening. The pharmacist insists it’s the same as other generic (that has an I/G on it), but I just can’t believe this based on symptoms. Has anyone else had a problem with the generic with the M on it? Who is the manufacturer of the one with M on it and how can I report it?

  2. KoricleWA

    I have stories and anecdotes about this subject for days, but as we all know, that won’t make a difference when it comes to enacting real regulatory reform for generics. In an ideal (or even obvious) world, the fact that *thousands* of people have noticed differences in their medication from brand to brand would be enough to, at least, warrant some further investigation into the matter. This post alone is a microcosm of that point – it’s over seven years old, and it is *still* gaining comment-traction, attention, and search-engine-generated results from people who want to know why they’re experiencing differences in their medication from brand to brand.

    As far as statistics go, the number of people who take X-medication and the number of people who have noticed discrepancies in X-medication after switching from name-brand to generic (or after switching from one generic to another) is large enough to make a convincing pie chart. It’s a bit curious that the issue is still present and unchanged after wide speculation and concern. If an average business found a large percentage of its consumers expressing quality-inconsistency, it wouldn’t be long before the business was forced to change… or fold (word-of-mouth, competition, governmental regulation and/or quality control, failure to comply with standards of safety, etc etc etc). So why hasn’t anything changed when this many people have recognized inconsistencies in their prescription medications? The ‘business’ in question is not your ‘average business’. It’s extremely difficult for average folks (even if they are also the business’s primary consumers) to enact large-scale scrutiny/reform/transparency when the business or industry 1. generates significant money (and is therefore responsible for large economic growth), 2. finances scientific research or other studies (which happen to often cross-benefit mutual industries and/or interested parties), or 3. actively participates in a symbiotic relationship with political affiliations. Yet if anyone tries to point this out (that is, “what separates the “average business” from a pharmaceutical company) they’ll be accused of sounding like a conspiracy-fueled, tinfoil-hat-wearing loon.

  3. Brenda

    As of Jan 2 2015, I am now paying almost $300.00 ea month for2 brand name drugs – Maxide and Glucophage. The generics used to work but haven’t for a long time. I have previously had to pay
    more, but the difference is almost $300 compared to $100 ea month. They told me a letter from Dr will not even be considered.
    Thank you for any help.

  4. susan

    You should know that synthroid has never been approved by the FDA because it is a very old drug. I took it for a few years. Then broke out in a rash over all of my body. Culprit after many many tests was Synthroid. Switched to levothyroxine and no problems. Check out the color of the pills that cause issues. I cannot take pills with green dye in them.

  5. Gretchen Saaduddin
    Los Angeles

    Have you heard anything about Metformin by Major Pharmaceuticals not working? For some reason the VA sent my brother many more bottles than he could use of the 1000 mg strength, which he was supposed to break in half and take 1 bid. My mom ran out of hers and was given some of my brothers. His blood sugar never changed at all with this Major Metformin, which I found odd. Before my mom took the VA Major brand, her blood sugar which was quite well controlled with her own prescribed Metformin. It promptly went up to almost 200, and has never gone below 125 previously. Why is this? Is some weird research being done on vets that we know nothing about? With all the recent VA problems I am wondering if I inadvertently uncovered something. They have really been pushing insulin on him, because his blood sugar is so high. Something really stinks here, and I would like to know what is going on.

  6. Juanita
    akron ohio

    seems strange that the price of synthroid and levithroxide have gotten very expensive, I recall when the drug stores were envolved in a class action and in my casse returned me for 100.00 for their tactics when I first had synthroid it was around 6.00 for a 90 day script. If the item is cheap they discontinue the product, not fair tactics

  7. Bettie
    San Antonio TX

    I had been taking Synthroid for about 15 years when I went on Medicare and Tricare for Life and started getting prescriptions from Tricare’s Express scripts. They substituted a generic, and very soon I started gaining weight (I have never had a problem with weight), I couldn’t get enough sleep, and my hair and nails became brittle. I went to my MD who checked my thyroid levels and said they were OK.

    I went online to search for thyroid problems and found lots of reports of the same problem with the generic. I asked my MD for a prescription for the Synthroid brand and my symptoms disappeared within days! Tricare won’t pay for the brand, so I have to pay for it myself. It is quite expensive, almost a dollar a pill.

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