Can generic drugs cut India's health care costs? Study reveals massive savings for patients

As chronic diseases such as diabetes, heart disease and cancer become increasingly common in India, the cost of medicines is emerging as one of the country's biggest healthcare challenges. 

A recent study published by Springer Nature found that out-of-pocket expenses (OOPEs)  on medicines account for nearly 70 per cent of India's healthcare expenditure, placing a disproportionate burden on low-income households and rural populations. At the same time, non-communicable diseases accounted for 60 percent of all deaths in India in 2019, up from 30 percent in 1990, according to a 2025 study published in The Lancet. 

Against this backdrop, a nationwide study is making the case for greater use of generic medicines, arguing that affordable alternatives could significantly reduce treatment costs for millions of patients without compromising quality. 

India is already the world's third-largest drug producer. Its domestic pharmaceutical market was valued at $50 billion in FY2024, with generic medicines accounting for 70 per cent of domestic sales. The country also supplies 20 per cent of the world's generic drugs and has more than 600 US FDA-approved manufacturing plants. 

Yet despite their widespread availability, generic medicines continue to face scepticism among many consumers and healthcare providers. 

To address these concerns, Mission for Ethics & Science in Healthcare (MESH), a scientific collective comprising doctors, scientists, researchers, lawyers and journalists, launched the "Citizens Generic vs Branded Drugs Project" to compare the quality and pricing of generic and branded medicines available in India. 

Founded in 2022, MESH works to promote science literacy and counter medical misinformation. The collective said the project was conceived partly because quality testing conducted by regulatory agencies often remains inaccessible to the public, creating uncertainty about the reliability of generic medicines. 

Dr. Shinsmon Jose, a member of MESH, researcher and assistant professor of infectious diseases at the University of Cincinnati, said affordability concerns were central to the initiative.

"When we conceived doing this study, our goal was to be an accessible source of information for the general public and for government agencies across the country. The high cost of branded drugs has forced many from the lower-middle classes to deprioritise the treatment of chronic diseases. Most of these branded drugs have generic options that are much more affordable. However, there's a taboo against generic drugs – fuelled by a dearth of information, unethical practices from manufacturers and the presence of illegal drugs in the market," Dr. Shinsmon said. 

The study analysed 131 samples across 22 categories of essential medicines, including drugs used to treat diabetes, heart disease, infections, gastric disorders, respiratory ailments and pain. 

The samples were sourced from local pharmacies and included premium branded medicines, branded generics sold through networks such as Jan Aushadhi and Dava India, government-supplied medicines and locally manufactured generics.

All samples were tested at Eureka Analytical Services Pvt. Ltd., an FSSAI-notified and US FDA and NABL-accredited laboratory in Haryana. The medicines were assessed on five quality parameters: drug content, dissolution, uniformity, impurities and physical appearance. According to MESH, every generic medicine tested met all quality criteria. 

The price differences, however, were striking. 

The average cost of a branded medicine among the selected samples was Rs 11.17 per tablet. Branded generics averaged Rs 9.12, local generics Rs 5.74 and Jan Aushadhi medicines Rs 2.40 per tablet. 

For commonly prescribed medicines, the gap was even wider.

Pantoprazole, widely used for acidity, costs Rs 1.21 per tablet through Jan Aushadhi compared with Rs 16.82 for the most expensive branded version. Similarly, Atorvastatin, a cholesterol-lowering medicine, was available for Rs 0.88 per tablet through Jan Aushadhi compared with Rs 5-6 for branded alternatives. 

The potential savings become substantial for patients who require lifelong medication. 

The study found that switching from a branded version of UDCA (300 mg) to a Jan Aushadhi equivalent could save a patient Rs 16,621 annually. A patient using a generic version of Rifaximin (400 mg) could reduce monthly expenditure by Rs 2,502. 

‘Generic’ skepticism

Despite these savings, acceptance of generic medicines remains a challenge. Umesh Raja PS (39), who has worked in the pharmaceutical industry for more than two decades and has been distributing medicines for a Jan Aushadhi outlet in Thiruvananthapuram, the capital city of Kerala, for six years, says misconceptions persist. 

"For instance, when we offer a generic drug instead of a doctor-prescribed branded drug, oftentimes the customers turn hostile. They presume that we're merely doing it for the sake of our sales," he said. 

R Ravindran,46, who runs a private medical shop near the Trivandrum Government Medical College, says that doctors' prescribing habits continue to shape consumer behaviour. 

"Even though most of the people who come for treatment at the medical college have the option to buy generic drugs from the government-run stores within the hospital complex, if a doctor has prescribed a branded drug to them, they'll be hesitant to choose an alternative," Ravi said. "It's not profitable for us to keep the generics of such medicines, when the doctors themselves won't prescribe them." 

Experts, however, say confidence in generic medicines ultimately depends on maintaining robust quality controls. A scientist at the Indian Council of Medical Research (ICMR) notes that competitive pressures can sometimes affect manufacturing standards. 

"Once the patent for a medicine expires, market exclusivity comes to an end, and the competition drives down profit margins. To compensate for this, some manufacturers compromise on quality," the scientist, who didn’t want to be identified, said. 

He argued that stronger regulatory oversight and more frequent quality testing are essential to sustain public trust. Senior gastroenterologist Dr. Narendranathan, who has practised medicine for more than 50 years, said doctors tend to prioritise consistency and reliability when prescribing medicines. 

"As doctors, our concern is always quality first; the cost is secondary. Also, if we do prescribe a generic for a particular medicine, we don't know which 'type of generic' the shop will provide the patient. With a branded drug, the doctors don't have to worry about that." 

At the same time, he added, for medical conditions that require consumption of a drug for an extended period of time, if a patient finds it difficult to afford it, he does suggest using a generic alternative to it, that he has verified and trusts. 

For MESH, the findings underline a larger public health issue. As chronic diseases continue to rise and medicines account for a major share of household healthcare spending, wider adoption of quality-assured generic medicines could help improve treatment adherence while reducing the financial burden on patients. 

Dr. Cyriac Abby Philips, a leading Indian Hepatologist and one of the founders of MESH, was the first person to release the details of the study through social media.  

“Drug control authorities across the country should undertake similar testing exercises and make the findings public,” Dr Cyriac said. “This would go a long way in addressing the trust deficit surrounding generic medicines, even though they are affordable and widely available."  

This story is done in collaboration with First Check, which is the health journalism vertical of DataLEADS