The rising cost of medicines has led many people to patronize cheap non-branded substitutes of the branded medicines they're using. Because they're sold at "bargain" prices, non-branded or multi-source drugs appear to be the ideal alternative to the pricey branded medicines doctors often prescribe.

But experts warn that not all generic substitutes match their branded counterparts in terms of safety and efficacy. Associating price with quality is not always a good idea, especially in the case of non-branded drugs. This is because non-branded drugs may not be bioequivalent to the branded drugs they're copying.

"A building engineer once came to my clinic and started arguing with my fellows about bioequivalence because he said generic drugs are the same as branded drugs. I told him 'If you make a plan for a building with a measurement of 2.5 millimeters (mm) and somebody changed that to 2.0 mm, what would happen?' He laughed and said 'That building would collapse!' That means a teeny-weeny difference could mean disaster," according to Dr. Ricardo Fernando, a diabetologist and president of the Institute for Studies in Diabetes Foundation.

Bioequivalence is a comparison of two or more products with respect to their bioavailability - the amount of the drug in the bloodstream and how long it takes to get there. When a generic drug is certified as bioequivalent to a brand name drug, it means that its active ingredient works in the same way and in the same amount of time as the innovator drug.

To determine its bioequivalence, a non-branded drug is tested for its bioavailability or the rate and extent of the drug that reaches the general circulation from an administered dosage form. Ideally, non-branded drugs should be bioequivalent and therapeutically equivalent to the branded products before they can be substituted for the latter.

In a market riddled with fake or substandard drugs, however, that may be a problem. The issue of bioequivalence becomes even more important for the patient whose very life depends on the drug he or she is taking. If the non-branded drug a person uses doesn't match the branded product, his or her condition won't improve. Worse, that individual may suffer from serious side effects.

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