I used to believe generic/brand were exactly the same, but they aren’t - nor are they tested to be so. They are required by law to be bio equivalent, but guess what - they aren’t always - and despite for years, and years - well known problems have occurred - most often having to do with time release medications - which is becoming more and more what is being produced due to patenting effects. They can’t protect Ritalin, or Amphetamines anymore - so they add some special coating - some literally containing special holes in them - that are very difficult to reverse engineer.
The FDA and the companies sometimes test -as they did on Wellbutrin - but they did so only at one dose - and guess what - at other doses - the exact same generic versions people were complaining about to “Peoples Pharmacy” were off.
Also bio equivalence doesn’t mean exact. They have a pretty big leeway - about 20% I believe on most drugs (there are some held to a stricter standard).
To me - 80 is not equal to 100.
Also note in that people’s pharmacy editorial half of doctors expressed concerned about the quality of generics in a survey (done by what sounds like a medical journal to me) . A quarter of docs try to avoid them for their own family.
Yes - 25% is in the minority! but these are doctors - this is nothing to be sneezed at - and 50% are “concerned” or whatever the word was.
Now don’t get me wrong - I think the vast majority of stories of generics not working as well are just the same type of stuff you hear about people getting the flu when they got a flu shot.
However - the landscape has changed. Pills aren’t what they used to be. Some of these time released mechanisms are extremely complex. They didn’t exist 10-20 years ago. I am guessing the percentage of people exposed to one of these types of drugs is much, much, much higher than it was when the rules were first written.
I have no problem going into CVS and buying generic Tylenol. There isn’t much to screw up. Maybe I will get 20% less - but my understanding is that 20% is for both brand name and generics - it isn’t that there is a seep rat rule for brand names. It’s just that the brand name using facilities X were able to get approval for that drug - so I think it is more likely to be at the dose the was found “safe and effective”. Especially where coatings come into play.
There have been some cases where generic manufactures have reached agreements with brand names to do their generic for them - as the generics were (in part) having problems reverse engineering the way the pill/injectable/whatever was put together.
Anyway - I have no idea if the drug the OP is talking about is complicated or not - or if their have been complaints or not, but from what I’ve read - more and more docs are believing their patients when they say “generic X” didn’t work for me and are likely to starting writing for the brand name only (if they hear the same from others) when 20 years ago - they would have chalked it up to being in the patients head.
Obviously there isn’t something “magical” about brand names in and of themselves. Some people seem to think there are - and you hear stuff like “well generics don’t work on me”. Obviously those people are kooks, but not everyone who questions generics is.