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September 21, 1979

Drug Substitution

Author Affiliations

Associated Endocrinologists— Northland Thyroid Laboratory Southfield, Mich

JAMA. 1979;242(12):1257. doi:10.1001/jama.1979.03300120011004

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To the Editor.—  I was disturbed by the letter of Roy J. Popkin, MD (241:1890, 1979), expressing concern because some generic drugs have a different size, shape, and color than brand name drugs. He believed that patients were "unnerved" by generic tablets that were easily discernible from the brand name drug. I fail to see this as a problem. If patients are readily aware that they are taking a different manufacturer's drug, they will naturally ask questions. They have to be consulted by the pharmacist before making the generic switch; therefore, the patient is by necessity involved and has a choice in the possible substitution of a generic drug. The patient will logically choose only a generic drug when there are appreciable cost savings that justify the potential risk of switching to a different brand.It is becoming clear that the generic drugs are not always equivalent and that there