It's sad but true. The rising cost of medicines and health care has made most people suckers for "bargain" medicines without realizing they're gambling with their health. In the case of buying generics drugs, it's like playing Russian roulette since not all products deliver and some may even be dangerous to your health.

Generics per se aren't bad. If they're as effective and safe as their brand name counterparts, these drugs help patients save money. The problem lies in the fact that there are many fake and substandard products in the market today.

"People don't die from carrying a fake handbag or wearing a fake t-shirt. They can die from taking a counterfeit medicine," says Howard Zucker, assistant director general for health technology and pharmaceuticals at the World Health Organization.

The problem with generic drugs is that they may not be bioequivalent to brand name drugs. In bioequivalence, two or more products are compared with respect to their bioavailability - the amount of the drug in the bloodstream and how long it takes to get there. A lot of fake or substandard generic drugs fall short of this important test, posing a threat to patients who use them.

"Generic equivalence does not guarantee bioequivalence because bioequivalence is a measure of the drug's effectivity. If you can prove bioequivalence, you still have to go further and show therapeutic equivalence. The two are different. Bioequivalence is what you measure in the blood but therapeutic equivalence is the actual response of the patient to the drug - whether positively or negatively. And if positively, to what extent?" according to Dr. Ricardo Fernando, a diabetologist and president of the Institute for Studies in Diabetes Foundation.

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