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Many patients still assume branded drugs are better, when in fact, generics can deliver the same outcomes at a fraction of the cost 

by AZALEA AZUAR & NURNABIHAH DINI 

THERE is a growing need to raise awareness about the effectiveness of generic drugs amid the increasing cost of healthcare. 

A 2022 survey by the UCSI Poll Research Centre survey involving 1,060 Malaysian adults found that while 61% recognised that generic drugs contain the same active ingredients as branded medicines, fewer were confident in their safety and effectiveness. 

Manulife Holdings Bhd CEO Vibha Coburn said the discussion on generics drugs has already gained strong momentum across both government and private sectors. 

“There is a lot of talk about using generics to reduce the cost of healthcare,” she told The 

Malaysian Reserve (TMR). While she cautioned that generics are “not a silver bullet for better healthcare,” she emphasised that they remain a crucial component in making healthcare more affordable. Manulife Investment Management (M) Bhd CEO Jason Chong added that brand loyalty and poor awareness continue to hinder wider adoption. “Many patients still assume branded drugs are better, when in fact, generics can deliver the same outcomes at a fraction of the cost,” he told TMR. 

Greater education and policy enforcement are needed to shift these behaviours. 

“A lot of generic drugs today are actually of pretty good quality. My own mother, who is in her 80s, is on generics, and it has helped lower her medical costs,” he said. 

Chong also highlighted that Malaysia’s public healthcare system, which relies heavily on generics, remains an important safety net. 

“Treatment at government hospitals is almost free, and generics are commonly prescribed. The only downside is longer waiting times, but the system is still very valuable,” he said. 

Since March 2015, Malaysia has adopted the ASEAN Guideline for the Conduct of Bioequivalence Studies. This guideline helps drug regulators ensure that generic drug are safe, effective and high-quality alternatives to branded ones. 

The process involves testing generic and original drugs on a small group of healthy volunteers. After each dose, doctors take blood samples over several hours to see how the body absorbs and processes the drugs. 

The key measurement is how much of the drug enters the bloodstream, how quickly it does so, and how long it remains there. 

A generic is considered “bioequivalent” if it performs nearly the same as the original drug in the body, delivering the same amount of active ingredient at a similar rate and duration. 

For most medications, the generic’s performance must fall within 80% to 125% of the original drug’s results to be approved. 

Malaysian Pharmacists Society (MPS) president Prof Amrahi Buang said all medicines, whether branded or generic, must be registered with the National Pharmaceutical Regulatory Agency (NPRA). 

He said the perception of generics being inferior is incorrect. If a product passes NPRA’s registration process, which he described as rigorous, it has met the same strict standards required of branded medicines. 

“It can take up to a year to register your product because we are talking about control,” he told TMR. 

Cost-saving for Chronic Illness Patients

National Cancer Society Malaysia (NCSM) deputy director Dr Vignesvari Subramaniam emphasised that the discussion around generics goes beyond cost savings — it is also about maintaining consistent care for patients with chronic conditions. 

Many patients still believe generics are less effective or lower in quality than branded medications, leading to hesitation in making the switch. 

“Patients need reassurance that generics are not inferior. They contain the same active ingredients and offer comparable therapeutic outcomes. The differences lie mainly in branding, packaging and public perception,” she told TMR. 

For cancer care especially, expenses extend far beyond medication, including diagnostic tests, consultations and follow-up treatments. In this context, using generics can help reduce overall costs and allow more resources to be directed toward other critical aspects of care. 

“When people are on long-term medication, whether for diabetes, hypertension or cancer, the savings from generics can be redirected to other aspects of care. 

“This means fewer patients are forced to skip treatments or delay follow-ups due to financial constraints.” 

Dr Vignesvari added that broader adoption of generics could help reduce inequality in access to medication, particularly among lower-income groups who are most affected by rising healthcare costs. “If patients cannot afford the branded version, they may discontinue treatment, leading to poorer health outcomes and even higher costs over time.

“Generics are a great equaliser, they enable more patients to stay on track with their treatment,” she said. However, she cautioned that policy support and strong communication from healthcare providers are essentials to building trust. “Doctors and pharmacists play a crucial role in explaining the options. Simply prescribing is not enough, patients need to understand the value and safety of generics,” she said.

Dr Vignesvari added that awareness campaigns led by the government, medical associations and NGOs can help change perceptions, particularly in communities with strong brand loyalty. 

“Education is vital. We need to normalise generics as the first choice, not the alternative.” 

Meanwhile, Universiti Putra Malaysia’s (UPM) Malaysian Research Institute on Ageing (MyAgeing) head of Medical Gerontology and Gerontechnology Laboratory Dr Nur Hafidah Ishak emphasised how generics directly influence health outcomes, especially for patients with chronic illnesses. 

She highlighted the financial and health equity benefits of making affordable medications widely accessible. 

“For chronic conditions, the cost burden is recurring and cumulative. Generic medication can prevent significant expenses and ensure patients maintain access to treatment. It also helps reduce inequality in health outcomes.” 

While generic medicines help keep healthcare affordable, policies must also ensure quality, eliminate unnecessary administrative hurdles that increase costs and maintain transparency in regulations and practices. 

Brand Loyalty Remains 

Although awareness of generic drugs is increasing, brand loyalty still remains. 

NCSM MD Dr Murallitharan Munisamy said marketing plays a major role for over-the-counter (OTC) drugs. However, these drugs are often near the end of their patent life or deprioritised by the manufacturers. 

“The advertising does not come from the drug companies. It actually comes from retailers who promote the drugs that offer them the largest profit margin,” he told TMR. 

Moreover, consumers have little influence over the prescription drug market, as doctors ultimately decide what to prescribe. As a result, marketing is directed indirectly at physicians. 

While the prescription drug market is highly regulated, Dr Murallitharan believes more education is needed for prescribers, as many physicians still show strong brand loyalty and a preference for certain drugs. 

Generic drug companies typically operate on low profit margins, which helps keep prices affordable. However, increasing marketing budgets raises the cost of the drugs. 

In other words, a bigger marketing budget may persuade pre-scribers to change their habits, but it also means the drug can no longer be offered at such a low price. This creates a challenging balance between affordability and promotion. 

“Malaysia manufactures many generics, it struggle to promote them effectively within our own market,” he added. 

No Generics-first Policy at Private Hospitals

In November 2024, Health Minister Datuk Seri Dr Dzulkefly Ahmad reportedly said the National Heart Institute (IJN) has agreed to replace innovative medicines with generic alternatives for public patients to help reduce government healthcare costs. 

He explained that the ministry follows a generic-first policy for treatment. 

Meanwhile, on May 16 this year, CodeBlue reported that IJN is increasingly prescribing generic and biosimilar medicines in line with MOH’s directive to help manage healthcare expenses at the nation’s leading cardiac centre. 

However, IJN CEO Prof Datuk Seri Dr Mohamed Ezani Md Taib said the institute continues to use certain original branded drugs due to ongoing contracts and its commitment to maintaining its reputation as a top cardiovascular institution. 

While the use of generic medicines can reduce costs, the Ministry of Health (MOH) stated that prescribing decisions are left to healthcare providers, based on their clinical judgment and patients’ needs. The ministry has not imposed any blanket rule requiring private healthcare facilities to adopt a generic-first policy. 

“MOH wishes to clarify that it has not issued any blanket policy mandating the exclusive use of generic medicines in private healthcare facilities. 

“Formulary decisions and prescribing in private healthcare facilities remain at the discretion of healthcare providers, based on clinical judgment and patient needs.” 

MOH added that it has long promoted the safe, effective and rational use of medicines, in line with World Health Organisation (WHO) guidelines. 

It supports WHO’s call for the safe and rational use of medicines, including the promotion of the International Non-proprietary Names (INN) — standardised names for drug ingredients — to reduce confusion, enhance patient safety, allow flexibility in dispensing and improve access to treatment. 

“Both innovator and generic medicines may carry brand names, but by prescribing using INN, doctors clearly identifies the active substance (such as paracetamol instead of branded options like Panadol or Uphamol). 

“This approach ensures clarity and transparency, preserves clinical autonomy and empowers patients to make informed decisions about their health,” it added. 

However, analysts caution against adopting generic-only policy. 

In August 2025, third-party administrator (TPA) MiCare Sdn Bhd had reportedly instructed its panel healthcare providers to prescribe only generic medicines for Hong Leong Bank Bhd (HLBB) and Hong Leong Islamic Bank Bhd (HLIBB) employees with chronic conditions. 

The TPA said all panel clinics, hospitals and pharmacies must list only the active ingredients in prescriptions, with the policy applying specifically to long-term medications. 

In response, the Malaysian Medical Association (MMA) warned that a “generic-only” policy could undermine patient rights and medical ethics. 

In a September 2025 statement, MMA president Datuk Dr Thirunavukarasu Rajoo said while doctors support the use of quality-assured generics to improve affordability and access, clinical decisions should not be dictated by corporate policies. 

At the same time, the Association of Private Hospitals Malaysia (APHM) cautioned the insurance sector against introducing blanket policies that require private hospitals to prescribe only generic medicines. 

President Datuk Dr Kuljit Singh said while no insurance providers have formally implemented such a policy to date, one TPA had instructed healthcare providers to prescribe generics for long-term medications for a corporate client’s employees, beginning Sept 1 this year. 

The Need for Price Transparency

Despite strict regulations on bioequivalence testing, Amrahi said there is still a lack of transparency in drug pricing. 

In MOH facilities, medicine labels display the “cost price”, the amount the government pays for the drug, but this is not the ceiling or retail price. 

When patients compare these government-subsidised prices with those at community pharmacies, they often assume the latter are overcharging, leading to public misunderstanding. 

Outside government facilities, pharmacies are allowed to set their own prices. This variability can confuse patients and lead to perceptions of price gouging, while also creating unfair competition. 

High operating costs and inconsistent pricing practices, particularly in chain stores or remote regions, can put smaller pharmacies at a disadvantage. 

“Therefore, there is no transparency,” Amrahi added. 

A price comparison between two pharmacies showed slight variations in the cost of paracetamol. 

At AA Pharmacy in Bukit Jelutong, Shah Alam, Panadol (500mg 10 tablets) was priced at RM3.90, while Watson’s online store listed the same product at RM12.78. 

Users’ Experiences 

Universiti Malaysia Pahang Al-Sultan Abdullah (UMPSA) pharmaceutical engineering student Zul Idham Aiman is well aware of the differences between branded and generic medicines. 

“Generic and original brands mainly differ in patent status and excipients, but the active pharmaceutical ingredient (API) is the same and works in the same way,” he told TMR. 

Having been prescribed both types, Zul Idham said his experience showed no significant difference in outcome. 

He believes the effectiveness of generic medicines is on par with branded ones. 

“Both contain the same API and dosage. Only the excipients vary and those do not affect how the drug works. The mechanism of action remains unchanged,” he added. 

For freelancer Muhammad Arif Mohamad Amir, generic medicines are simply a practical choice. His experience with generics has been positive, reinforcing his confidence in their effectiveness. 

He said his trust lies more with doctors and pharmacists than with brand names or price tags. 

“I trust their professional judgement more than the brand or price,” he said. 

With rising healthcare costs in Malaysia, generic medicines offer a practical, effective and affordable alternative. 

With proper regulation, clear communication from healthcare providers, and grater price trans- parency, generics can become a trusted solution for Malaysians, helping to ease the growing burden of healthcare expenses. 

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• This article first appeared in The Malaysian Reserve weekly print edition

The post Generics can ease healthcare burden, but trust still lacking appeared first on The Malaysian Reserve.