Take Two: Just How Good Are Generic Meds Anyway?

For indispensable reporting on the coronavirus crisis, the election, and more, subscribe to the Mother Jones Daily newsletter.

A few days ago I wrote a post about generic painkillers and the fact that doctors themselves—who should know better—often don’t use them. “If physicians aren’t really sold on generics in their own personal lives,” I asked, “does this mean they’re not really sold on them in their professional lives too?”

Well, perhaps I got it backwards. A friend sent me a link to a Forbes article from last year about the FDA retracting its approval of a generic version of Wellbutrin:

The episode is bringing momentum to a movement that has been quietly building among many doctors and medical societies that are increasingly willing to ask a question that borders on heresy: Are generics really identical to the branded products they are meant to replicate? To a surprising degree, they say, the answer is no.

If you’re a layperson, this is the way you probably think of generics: They’re the exact same products in different packaging; generics companies can sell such medications for a fraction of the cost of the originals because they don’t have to spend huge sums on drug development and marketing….But generic drugs diverge from the originals far more than most of us believe.

….The FDA’s rules effectively acknowledge that. The agency’s definition of bioequivalence is surprisingly broad: A generic’s maximum concentration of active ingredient in the blood must not fall more than 20% below or 25% above that of the brand name. This means a potential range of 45%, by that measure, among generics labeled as being the same.

In other words, physicians are becoming increasingly concerned about the reliability of prescription generics, so maybe they’re a little bit skeptical about over-the-counter generics too.

Now, I doubt that anyone seriously thinks this applies to aspirin or ibuprofen. There’s nothing proprietary about the formulas for these medications, and everyone knows how to make them just as well as the big guys. Still, I suppose it’s possible that a generalized uncertainty about generic prescription meds could translate into a bit of uncertainty about OTC meds too. And that little bit might be enough to make lots of doctors shrug their shoulders and plunk down an extra dollar or two for a name brand.

I’m just guessing here, of course. Mostly I just thought it was an interesting article and wanted to pass it along.


Headshot of Editor in Chief of Mother Jones, Clara Jeffery

It sure feels that way to me, and here at Mother Jones, we’ve been thinking a lot about what journalism needs to do differently, and how we can have the biggest impact.

We kept coming back to one word: corruption. Democracy and the rule of law being undermined by those with wealth and power for their own gain. So we're launching an ambitious Mother Jones Corruption Project to do deep, time-intensive reporting on systemic corruption, and asking the MoJo community to help crowdfund it.

We aim to hire, build a team, and give them the time and space needed to understand how we got here and how we might get out. We want to dig into the forces and decisions that have allowed massive conflicts of interest, influence peddling, and win-at-all-costs politics to flourish.

It's unlike anything we've done, and we have seed funding to get started, but we're looking to raise $500,000 from readers by July when we'll be making key budgeting decisions—and the more resources we have by then, the deeper we can dig. If our plan sounds good to you, please help kickstart it with a tax-deductible donation today.

Thanks for reading—whether or not you can pitch in today, or ever, I'm glad you're with us.

Signed by Clara Jeffery

Clara Jeffery, Editor-in-Chief

payment methods

We Recommend