Why the Same Drug — Costs So Much More in One Brand

Yes — for chemical generics, that is precisely what CDSCO approval confirms. Before a generic can be sold in India, the manufacturer must prove bioequivalence: that the drug is absorbed at the same rate and amount as the original. The active ingredient is the same molecule at the same dose. The difference is in who made it and when they entered the market, not in the compound itself. If you have any doubt, ask your oncologist to explain what the prescribed version is and why it was chosen for you.

Because biological medicines are far more complex to manufacture than chemical drugs. A chemical molecule can be replicated with high precision; a biological molecule is produced inside living cells, and the manufacturing process directly shapes the final product. Setting up and validating a facility capable of producing a biosimilar requires substantial investment, and the regulatory approval pathway is more demanding than for a chemical generic. Those costs are reflected in the price, even though the biosimilar is still priced lower than the original biological drug.

For most chemical generics, switching between approved versions mid-course is not a clinical concern because bioequivalence is confirmed and the molecule is identical. For biosimilars, the situation is more nuanced — the evidence on switching during treatment is still developing for some medicines, and oncologists may prefer to keep patients on the same version they started with. Do not switch brands without first telling your oncology team. If your pharmacist offers a different version, mention it at your next appointment before accepting the change.

Note the name of the version being offered and ask which manufacturer makes it, then tell your oncology team before accepting the change. Your oncologist can confirm whether it is an approved equivalent for your specific situation. This matters most for biosimilars and for drugs where your team is closely monitoring response. For most standard chemical generics it is unlikely to be a concern, but your team is the right person to confirm that for you individually.

Patent expiry removes the original research cost from the price, but manufacturing, quality testing, regulatory compliance, cold-chain storage, and distribution all cost money regardless of who makes the drug. Some genericised molecules remain relatively expensive because few manufacturers have entered the market, which limits competition. Off-patent does not mean cost-free — it means that one category of cost, the original R&D investment, is no longer in the price. As more makers enter over time, prices generally fall further.

In India, every drug sold legally must be approved by CDSCO and carry a manufacturing licence number on the label. If you are receiving medicines through a hospital or day-care unit, the pharmacy team is responsible for verifying that all drugs are procured through licensed channels. If you are buying from a retail pharmacy, you can ask for the batch number and the manufacturer's name and check CDSCO's online drug database. If anything about the labelling looks unfamiliar or unclear, raise it with your oncology nurse or pharmacist before accepting the medicine.