From the oped by Rachel Silverman and Amanda Glassman:
Healthy competition from generic drugs is often held up as a “cure” for high drug prices — a shared concern across rich and developing countries alike. For many low- and middle-income countries, however, a new report from the Center for Global Development that we co-authored shows that global markets for generic medicines are failing, leaving the poorest patients without safe and affordable essential medicines.
The first point of failure is drug quality. In wealthy countries, residents can usually trust that all drugs on pharmacy shelves are safe, authentic, and potent. Most families and doctors are happy to opt for quality-assured generics that have been tested for bioequivalence, systematically monitored for adverse events, subject to regular inspection for manufacturing quality, and priced well below their branded competitors. As we describe in the report, in the United States and the United Kingdom, for example, non-branded generic drugs account for more than 80% of all pharmaceutical consumption by volume (and roughly 30% by value).