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Pharmaceutical quality and cost-effectiveness of branded versus generic medicines across 22 drug types and 8 therapeutic categories: a citizen-funded comparative study from regulated retail outlets in Kerala, India

Philips CA, Theruvath AH, Sreemohan A, Baby A, Jose S, Philips M, Philip T, Ramesh C

Frontiers in pharmacology, 2026

Abstract

Background: Despite India's status as a global pharmaceutical hub, skepticism regarding the quality of generic medicines persists among healthcare professionals and the public. This study aimed to comprehensively evaluate the pharmaceutical quality and cost-effectiveness of branded versus generic medicines to address these concerns and inform healthcare policy.

Methods: In a cross-sectional analytical study, 131 samples of 22 essential medicines across 8 therapeutic categories were procured using convenience sampling from 7 diverse source categories of licensed retail outlets in Kerala, India, including government, private generic, and branded outlets. Samples underwent rigorous testing for description, dosage uniformity, dissolution, impurities, and assay content in an accredited laboratory according to Indian Pharmacopoeia 2022 standards. Cost-effectiveness was analysed using unit pricing and price ratios.

Results: All 131 samples (100%) met all pharmacopeial standards, demonstrating pharmaceutical equivalence across all quality parameters, regardless of whether they were generic, brand, or priced differently. Generic medicines were, on average, 48.6% cheaper than branded equivalents. The study revealed substantial price disparities, with the most expensive branded products costing up to 13.9 times as much as the lowest-priced generics. Government-run Jan Aushadhi outlets consistently offered the most affordable options across 81.8% of medicine categories tested in the…

How strong is the evidence?

Evidence Hub reads this as a cross-sectional. Its evidence level is 4 of 5 (Low · observational). Observational designs can show an association but not prove cause.

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