Same Quality, 14X Price: Study Finds No Difference Between Branded and Generic Drugs
New Delhi: A citizen-led study on medicine prices and quality has delivered a clear warning for India's healthcare system: the real problem is not the quality of medicines, but the widespread distrust of affordable drugs, as laboratory testing found that all 131 medicines examined, whether expensive branded drugs or low-cost generics, met Indian Pharmacopoeia quality standards, even when prices differed by up to 14 times for the same medicine.
The study was led and publicly shared by hepatologist Dr Cyriac Abby Philips, widely known online as The Liver Doc. Using his X (formerly Twitter) account, he explained how the testing showed a sharp gap in prices despite medicines being equal in quality.
STAY WITH ME.
— TheLiverDoc™ (@theliverdoc) January 4, 2026
A few years ago, a patient was referred to me because he was diagnosed with complicated cirrhosis. He had an infection which led to a condition called hepatic encephalopathy (brain failure due to high ammonia levels). The treatment largely involved ammonia reducing… pic.twitter.com/d6wzN74QSm
Based entirely on findings from the Citizen’s Generic vs. Branded Drugs Quality Project, the study examined 131 commonly used medicines collected from across the country. These included expensive branded drugs, branded generics, local generics and government-supplied medicines. All samples were tested at an accredited laboratory. The result was striking, every single medicine met Indian Pharmacopoeia quality standards, regardless of price or source.
At the same time, the study showed that the cost of the same medicine could vary by as much as 14 times, raising serious questions about how medicine pricing affects patient care.
A Popular Belief, Clearly Disproved
The study directly challenges a belief commonly heard among patients and even healthcare providers: “government medicines are weak” and “cheap medicines do not work.” The evidence shows this belief is wrong.
As the study notes, the active medicine does not change with the brand name. When quality standards are met, medicines perform the same. What changes is the amount patients are forced to pay.
One comparison makes this clear. Liver tablets from a well-known brand cost Rs 61 per bottle. The same medicine from a Jan Aushadhi store costs Rs 16. Laboratory testing found no quality difference between the two.
When Fear Becomes Harmful
The study also highlights how fear of cheaper medicines can seriously harm patients. One case describes a patient with severe liver disease who was prescribed an expensive branded drug, rifaximin, costing ₹2,520 per month. Unable to afford it and afraid that cheaper options would not work, the patient stopped treatment.
The doctor also hesitated to prescribe a generic alternative, worried about being blamed if the patient’s condition worsened. The result was a medical emergency, followed by an ₹80,000 hospital bill.
According to the study, this outcome was caused not by poor-quality medicine, but by fear, misinformation and high drug prices.
How the Medicines Were Tested
To find out whether cheaper medicines were truly inferior, the study tested drugs used for heart disease, diabetes, infections, liver disorders, pain and allergies. These medicines were collected from top-selling brands, branded generics, trade or local generics and government supply systems such as Jan Aushadhi and Kerala’s medical services.
All 131 samples were tested at an NABL and ISO-certified laboratory. Each medicine was checked for five Indian Pharmacopoeia quality requirements: correct drug content, proper release in the body, uniform dosage, absence of harmful impurities and acceptable physical quality.
The conclusion was clear: every tested medicine passed all quality checks.
Average drug content was 99.45%. Branded medicines averaged 101.35%, while generics averaged 99.10%. The study states that this difference does not affect safety or effectiveness.
Same Quality, Very Different Prices
While quality was consistent, pricing differences were extreme. On average, branded tablets cost ₹11.17 each. Branded generics cost ₹9.12. Local generics cost ₹5.74. Jan Aushadhi tablets cost just ₹2.40.
The study notes that Indians spend 62–69% of their healthcare expenses on medicines, often believing higher prices mean better treatment. However, the study shows that 100% of tested generic medicines met quality standards, even when they were far cheaper.
For acidity treatment, pantoprazole tablets ranged from ₹16.82 for a branded option to ₹1.21 from Jan Aushadhi. For cholesterol treatment, atorvastatin ranged from ₹5.67 to ₹0.88. In both cases, the medicines were of equal quality.
Jan Aushadhi Offers the Lowest Prices
Among all suppliers studied, Jan Aushadhi emerged as the most affordable. It provided the lowest-priced option for 18 out of 22 medicines tested—about 82% of the total.
Savings per tablet were significant: ₹45.54 for UDCA, ₹27.80 for rifaximin, ₹16.74 for montelukast and over ₹15 for several other commonly used medicines. For patients on long-term treatment, this adds up to thousands of rupees saved each year.
The study also issues a warning. A pharmacy chain marketed as Generics Aadhaar Pharmacy was found to be consistently more expensive than other generic sources, particularly Jan Aushadhi. For some medicines, prices were 67% to 887% higher, despite being promoted as a low-cost option.
The study cautions patients not to assume that all stores using the word “generic” actually offer affordable medicines.
A Clear Public Health Message
The study’s conclusion is simple and urgent. There is no quality difference between branded and generic medicines tested in this project. There is a huge difference in price. When medicines are unaffordable, patients skip doses or stop treatment, leading to serious illness and expensive hospital care.
The organisers do not call for price controls. Instead, they urge greater transparency—easy access to quality data, clear price information and policies that allow pharmacists to offer verified generic substitutes.
Conducted by The Mission for Ethics and Science in Healthcare (MESH), the project's central message is hard to ignore: affordable medicines can be just as safe and effective as expensive brands.
Susmita Roy, B pharm, M pharm Pharmacology, graduated from Gurunanak Institute of Pharmaceutical Science and Technology with a bachelor's degree in Pharmacy. She is currently working as an assistant professor at Haldia Institute of Pharmacy in West Bengal. She has been part of Medical Dialogues since March 2021.
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