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October 30, 1972

Drug Antisubstitution Laws-Reply

JAMA. 1972;222(5):583. doi:10.1001/jama.1972.03210050055020

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To the Editor.—  The entire phenomenon of generic medications arose as an "economic lifesaver" for the pharmacist and the patient. What a poor substitute for therapeutic efficacy! As a subscriber to The Journal, Medical World News, Drug Intelligence, and Clinical Pharmacy, I have to this day yet to see a so-called "branded" generic recalled for any reason. All recalls have been the supposed "economic lifesavers"—the cheap (in more ways than one, evidently), generic preparations of digoxin, ampicillin, papaverine, quinidine—and the list goes on to include scores of other potentially life-saving and life-prolonging drugs. I have seen a preparation of generic digoxin recalled that was found to possess only 32% of the stated potency, and another that was 181% superpotent. Because of this evident lack of any quality control, I cannot place any confidence at all in these products. The only reason ever advanced in support of such products is the