There has been some marketing to present generics as cheap knockoffs of bad quality, leading to many people choosing to pay for the prescribed drug (which will be reimbursed anyway) but it all comes down to the patient's behavior.
The last I've seen drug-related marketing, the message was the exact opposite, with the message being pushed by the Social Security system, since they're the one that would pick up part of the bill if people take the prescribed drug and not the generic.
There was some reporting around these parts recently that generics don't really undergo any kind of efficacy studies, they are assumed to just work, and there's really not much oversight whatsoever.
• for drugs, such agencies verify that new drugs are safe/effective in concept (rather than in any particular manufacturing implementation)
• for food, the agency looks at specific manufacturers and distributors of a food, and—given a particular food they’re claiming to be producing—the agency verifies that their product meets the agency’s own definition of what that named food “should” be (i.e. you can’t sell Cheez Whiz as “cheese” because it doesn’t contain enough [whatever], though you can sell it if you don’t try to call it “cheese”; you can’t sell beef as “beef” if it contains toxic levels of thyroid hormones, though you could sell it as something else, e.g. as a hypothyroidism supplement, since those levels would be expected for that product; etc.)
But, strangely, these agencies don’t have any mandate to to apply the “food”-type rules (checking manufacturers and distributors for their output being within tolerances to a definition) to the drugs—even when those drugs are known to be produced through a process that can leave harmful reagents in them if not cleaned properly.
What’s up with that?
I suspect it's all about who benefits. In the food industry, we've seen the effects, the industry is consolidating and forcing smaller players out.
In the case of generic prescription drugs, those are still very large players. There seems to be a cartel for all but the most common drugs, where manufacturers don't bother competing for market share.
Each one of those formulas is going to contain magnesium, but the magnesium is bound to another molecule. One form of magnesium maybe be more effective than another for any given individual or condition. Some products are labeled as just "Magnesium" and it's unclear what form the magnesium is in.
Then there's a consideration of yield and purity. If you're making a compound through a given process, it's going to yield X amount of the desired compound, and Y amount of something else (other compounds or unconverted materials). Some of this is going to make it into the end product.
If two companies are using totally different processes to create the same end compound, everything is going to be different.
> I think labeling a generic incorrectly would result in pretty heavy fines.
Who's watching? I don't recall hearing much about generic manufacturers of prescription medications facing much scrutiny.
IMO, the practice ought to be made unlawful. Medicine is a life-critical sector. As such regulations need to be the tightest around it.
The exact degree may vary, but it happens everywhere.
Usually the laws and regulators allow prescribers tons of discretion, which is often subject to abuse that costs time/money/outcomes to somebody else.
I live in an expensive neighbourhood in a TIER 1 city in India and can confirm that many general physicians now prescribe medicines by their generic names.
That being said, it doesn't change the fact that the practice is still widespread. For e.g. I have never been to a dermatologist who will not insist on purchasing a particular often over priced brand, many even have their own pharmacy at their clinic.
I'm often shocked by the leniency of laws subject to doctors in India.
All this just applies for public healthcare. Private healthcare is basically an unregulated Wild West.
If only a particular doctor can prescribe his own brand of drugs, does it mean he designs and manufactures them or is there a pool of common recipes from which any pharmacist can make the drug and sell it under very different names ?
I will try to get more info on this. Each company has MR (Medical Representatives) they meet docotor every week on one day and present their schemes and offers.
Drugs prescribed by a Doctor can be bought and is mostly available only from the store he mentions in the prescription.
Big doctors have their own store.
You go anywhere else very rarely you can find the same drug.
Most of the times doctors will prescribe additional 2-3 generic seasonal medicine which you mostly do not need just to achieve targets so that they can claim their gifts (TVs, Foreign Trips, etc.)
This a serious issue in India which no one is batting an eye on.