All you need to know about substitute medicine

Have you ever wondered why people are so particular about the purity of their gold? They check for hallmarks, compare prices across jewelers, and ensure they’re getting exactly what they pay for. But when it comes to medicines – something that impacts our health- we do not apply the same level of scrutiny. 

When you buy gold, what matters most? The purity of the metal, not the name of the jeweler. Similarly, in the world of medicine, what truly matters is the active ingredient – the “pure gold” within each pill – rather than the brand name on the package. 

This brings us to an important concept in healthcare: substitute medicines. Just as you might choose between different gold jewelry pieces based on your budget without compromising on quality, you can often choose between different versions of the same medicine. But what exactly are these substitutes? Read on to discover this hidden gem in healthcare that you might have missed until now. 

What are Substitute Medicines? 

A substitute medicine is a medication that can replace the one prescribed by the doctor. To understand substitute medicines in more depth, let us explore the types of substitutes: 

1- Generic substitute: Imagine buying gold: whether you purchase it from an upscale showroom or a local jeweler, 22-karat gold remains 22-karat gold. Generic substitutes work the same way – whether it’s branded Crocin or simple Paracetamol, the healing power remains identical. Different names, the same golden standard of care. 

2- Therapeutic substitute: Think of it like exchanging your cherished gold necklace for a silver bracelet. Both may have the same value, but they are not the same item. That’s therapeutic substitution – where medicines like lisinopril and enalapril are different materials but have the same effect in protecting your heart. 

Also Read: Learning About Generic Medicines

Advantage of Generic Substitute Medicine 

Below are listed some of the advantages of generic substitution: 

(i) Pocket-friendly: Generic medicines offer a cost-effective alternative to brand-name drugs. When patients must pay out-of-pocket for medications, choosing generics can help them afford and complete their prescribed treatment, since these versions become available after patent expiration at significantly lower prices while maintaining the same therapeutic benefits. 

(ii) Generic substitute effectiveness = Innovator drug effectiveness: Generic medicine is equally effective compared to branded medicine.

(iii) Easy availability: Due to the marketing chain, doctors may prescribe a brand only available in a few pharmacies – whereas the drugs are available everywhere. 

After considering the advantages, we also need to be cautious in situations where you should be careful with generic substitution this takes us to……….. 

Situations Where You Should be Careful With Generic Substitution 

If you are prescribed medication for the conditions listed below, you should be cautious when taking a generic substitute: 

1. Biological Products: The manufacturing of biological product is an intricate process and a slight variation in the manufacturing can lead to death

2. Narrow therapeutic index- Narrow therapeutic index drugs, like antiepileptics, psychotropics, and thyroid medications, require precise dosing, as even small changes can lead to toxicity, therefore, making careful administration essential. 

Though the government pushes for generic substitution, India still lacks in this area, despite the potential for significant cost savings and improved access to affordable healthcare. 

Also Read: Narrow Therapeutic Index Medicine Explained: Risk and How to Stay Safe  

Why India Lacks in Generic Substitution 

In the past, when Indian medicines were often substandard or adulterated, generic substitutions were feared, as they could harm or even kill. This problem still exists to this date. 

In 2002, doctors were mandated to prescribe generics, but without penalties, the law was ignored. It wasn’t until 2023, when punishments were enforced, that led to doctor’s protest- ironic outcry over a law that had been in place for over a decade. 

But the main issue that should draw our attention is- that doctors do not trust generic medicine and this can be because of: 

1. No confidence in pharmacists: Doctors hold power in the pharmaceutical marketing chain by influencing which drugs reach patients through their prescriptions, with pharmaceutical companies often targeting them to prescribe branded products. Due to this law, the power may shift to pharmacists, as big companies would commission pharmacists instead of doctors.  

2. Lack of knowledge: Doctors often lack full awareness of the medicines they prescribe. Do they know if it’s a marketed generic or the original innovator drug? In India, very few prescribe innovator medicines. A study in Patna found that 73.4% of primary healthcare doctors were unaware that generics are just off-patent branded drugs, believing they may be less effective. Only 26.6% knew the truth—that generics work just as well as branded medicines. This lack of awareness can affect patient care and erode trust in the healthcare system.  

3. Influence of Medical representative: When doctors prescribe generic medicines instead of branded ones, they lose the incentives and commissions offered by pharmaceutical companies through their medical representatives – a financial motivation that often influences prescribing patterns at the expense of patient affordability.  

4. Quality issue- Doctors often distrust generic medicines due to concerns about quality, but they may not realize that the medicine they prescribe could be flagged by CDSCO on their portal the following month or maybe a fake medicine.
   
   Also Read: Why Do Doctors Prescribe Branded Medicine? 

The Answer is Tested Substitutes 

The doctors claim, “generic medicines’ quality cannot be trusted,” is only 50% correct. The other 50% of the reality is that branded medicines’ quality cannot always be trusted either. In November 2024, the CDSCO declared nearly 70 medicine substandard, many of which were from notable brands like CIPLA and Torrent Pharma. 

In such a scenario, whether you’re rich, middle class, or poor, no one can truly trust any medicine unless it’s been tested. Pharmaceutical companies in India often focus more on declaring their medicines fit on paper than ensuring their quality. Sometimes, they even relabel expired medicines to cover their losses, compromising trust and safety.

When you trust the purity of gold only after checking its hallmark certificate, why not check a medicine’s test report before purchasing it? After all, investing in your health is just like investing in gold. SayaCare is the first e-pharmacy of its kind, providing medicine only after testing it in an NABL-accredited laboratory. We deliver the medicine only when it is declared fit, because trusted hai toh bharosa hai. 

Conclusion 

When generic medicines could make healthcare affordable for millions, many doctors resist prescribing them – choosing profits over patients. While some pharmaceutical companies continue to prioritize paperwork over quality, SayaCare stands apart. We don’t just promise quality – we prove it.

 Every medicine we provide is first tested by NABL-certified laboratories, and then provided to you at your doorstep, because we believe your health should never be compromised by cost. With SayaCare, you get genuine, tested medicines at prices that make quality healthcare truly accessible to all.