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March 8, 1999

Generic Substitution and Optimal Patient Care

Arch Intern Med. 1999;159(5):429-433. doi:10.1001/archinte.159.5.429

IT WOULD BE HARD to find anyone who disagrees that all health care practitioners should be concerned with the efficacy, safety, and cost of treatments provided to their patients. Most would also agree that the first 2 considerations should usually outweigh the third. However, today's climate in health care often seems to be focused increasingly on cost as the primary driver of care. As the economics become increasingly visible to the public and payers, the producers and consumers of health care often find themselves on opposing sides of positions related to fundings. Therefore, it is ever important that information used to make decisions related to the financing of care be unbiased and as easy as possible to understand. This ideal does not always occur. One area where passion and promotion rather than evidence are increasingly influencing decisions relates to the substitution of Food and Drug Administration (FDA)–approved generic equivalents for brand name medicines.