Everyone loves a bargain. Imagine buying a new Mercedes-Benz worth $60,000 for the price of a Hyundai, say around $20,000. As long as the vehicle had Mercedes parts and performed like a Mercedes, you would be thrilled.

In reality, no one gets a 66 percent discount on a new luxury car. Even with the automobile market in desperate shape, no one gives away Mercedes at bargain basement prices.

Most people believe that you get what you pay for. That’s why they are justifiably suspicious when someone offers a Rolex-brand watch over the Internet at a Timex price. The likelihood is pretty high that there is some counterfeiting going on.

When it comes to prescription drugs, however, this law of economics has been suspended. According to the FDA, “A generic drug is identical, or bioequivalent to a brand name drug in dosage form, safety, strength, route of administration, quality, performance characteristics and intended use.”

Despite being identical to its brand-name counterpart, the generic drug costs much less. Now that many discount chains are selling a month’s supply of many popular prescriptions for $4, the savings are truly spectacular.

Take the antidepressant Prozac, for example. A month’s supply would cost around $150. The generic fluoxetine might run about one-tenth as much or roughly $15. But if you shopped at a big-box discount drugstore you could get a 90-day supply for $10. Over three months, the savings would add up to $440. Who wouldn’t want to save 98 percent on prescription drugs?

Some patients and physicians have voiced concern about the quality of generic drugs. The extraordinary savings are only a bargain if the generic is truly identical in safety and effectiveness.

A recent review of generic drug research carried out since 1984 concluded that “generic and brand-name cardiovascular drugs are similar in nearly all clinical outcomes” (Journal of the American Medical Association, Dec 3, 2008).

Although this research is reassuring, it has some limitations. More than half of the studies included in the review were published before 2000 and only about a third were conducted in the U.S.

Before 2000 we had little worry about the quality of generic drugs. We encouraged readers to buy low cost medicines whenever possible. We would still do so if we thought that someone was monitoring the quality of the products on pharmacy shelves.

After 2000 an increasing proportion of generic drugs originated overseas. The weak link in our national drug supply system is that the FDA operates mostly on the honor system. The agency expects manufacturers to be honest. There are few resources devoted to verifying that generic drugs (or even branded products) contain what they claim.

Ever since patients died from a contaminated blood thinner (heparin), Americans have lost faith in government oversight. New reports that minuscule amounts of melamine have been found in baby formula in the U.S. and Canada suggest that Chinese suppliers should not always be trusted.

We’ve been promised a change in Washington come the new year. One change we would like to see is FDA monitoring the quality of imported pharmaceuticals so that Americans can have confidence in the drug supply once again.

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  1. Samuel

    @MB, some generic drugs do have an altered formula, but are close enough to be labeled as a generic. The drug comparison information for each generic drug should be available on the manufacturers website.

  2. T.J.

    I don’t think that all generics are equivalent to name brands.
    I have been taking Toprol XL for 18 years and decided to try the generic when it came out. When I did I took it for two months and my blood pressure wouldn’t stay controlled, heart would race and I just felt bad.
    Went back on name brand and in 2 to 3 days it all leveled out. Later tried another brand of generic in this drug and the same happened. Went back on name brand and it all went back to normal.
    Some drugs may be ok in generic,but this one isn’t.

  3. M.B.

    I take Diovan HCT 160/25mg. My HMO switched me to a generic brand and I developed a serious cough. My doctor had to ask the HMO to allow me to go back on Diovan even though it is not one of the brands they support so now I have to pay almost full price. I go to a big box store where I can get this a little cheaper and without any hassle. My conclusion is that not all generic brands are treated equally and I hope that the FDA will wake up before something really bad happens to us in the U.S.

  4. M.R.O.

    The major problem is that the drug company executives get hired for a short duration by the FDA as decision makers and then get rewarded upon their return to the given drug company. This way, the pharmacy lobby has complete control of over-sight. Also, the government agency, as most government agencies, function in spite of themselves and are truly not interested in the health and safety of the public. All drugs from here and abroad should be tested more strictly and constant random testing by “real” professionals who care should be the standard, not the current exception.

  5. W.M.

    I take Oxycontin for pain due to a gun shot wound to the left thigh, thru the groin and on into my right hip. My Insurance Company wanted me to change from the name brand to the generic form. So I thought why not give it a try and see. Figuring that we all need to save where possible. So I take the Generic form which is Oxycodone, I take my usual dosage and I thought I was going to die.
    I couldn’t hardly breath, my lips felt numb, my head was spinning like a top and it was all I could do to talk and after 4 hours the medicine stopped working. For the next 4 hours I was in severe pain (9) so when it was time to take my meds again I took them again and for the life of me I don’t know what happened next, I do know I woke up in the hospital. I will never take generic Oxycontin again as long as I live. I’m leery about taking generic anything because I firmly believe that this is the medicine that would normally end up in the rejected pile to be redone to the proper control limits.
    When it comes to your health you shouldn’t cut corners. Just a very few short years ago my Insurance Company refused to pay for generic, saying pretty much what I just said and they wanted what they paid for. I don’t eat generic food, I don’t drink generic water and I don’t drive a generic vehicle. So why should I or my family take the risk that I did?

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