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All of the questions raised about generic drugs can be applied to the non generic drugs.

Most pharmacists trust the FDA to assure generic drug quality - yes, but also the non generics.

Understaffing means there’s not enough time for thoughtful conversations with customers about generic drug quality - yes, but also non generics.

How Do We Know Generic Drugs Are as Good as Brand Name Drugs?

We don't know if the Brand name drugs are as good as the generics.

drug quality is important, but, the distinction between generic and non generic is pretty meaningless here.

"the agency naively relies on generic manufacturers to submit truthful data." - yes, but also the non-generics, and the FAA does the same with airplanes and the FCC does the same with telecoms, and, and, ...
> If I were to discuss generic drug quality privately with other pharmacists, their first reaction would probably be that customers who complain about the effectiveness of generic drugs are kooks, or those customers are simply imagining a difference between generics and brand name drugs.

This explains it all.

I've been in the pharmacy business for years and can tell you pharmacists are uneducated about it. They're so uneducated they don't understand how foolish they are and will make fun of you for saying it doesn't work as well or they'll label you as an addict or crazy.

> > In contrast, pharmacists have no way of verifying that a generic blood pressure pill is adequately lowering the patient’s blood pressure. We don’t have time to physically take the blood pressure of all of our customers who take drugs for that condition, nor would customers or physicians stand for pharmacists acting like policemen to see whether our customers are truthful about generic drugs.

Huh? Most pharmacies I’ve been in have automatic blood pressure machines.

Patients may have their own.

The biggest problem with this example is the lack of blinding: a patient writhing about being switched to a generic will see their BP go up while tested.

I think a lot of pharmacists disdain for patients’ complaints about genetics is that few complaints are received from drugs where the effects are easily measured, but common when the drugs are hard to measure or in therapeutic categories that tend to lose effect over time (hello opiates).

Meanwhile, the issues impacting genetics should be seen across therapeutic categories a lot more evenly.

(Unless the generic manufacturers realize this and cut back on API/formulation expense on the hard-to-measure products, but risking a recall is a big risk to take).