In hospital pharmacy conversations across India, two words get used interchangeably more often than they should: generic and biosimilar. Both refer to non-originator versions of existing medicines. Both are generally less expensive than the originator product. And both require regulatory approval before they can be sold. But beyond those surface similarities, the two are fundamentally different — in how they are made, what regulatory approval actually means for each, and what the clinical implications of substitution are. For hospital pharmacists and procurement teams, understanding this distinction is not an academic exercise. It has direct consequences for procurement decisions, for conversations with clinicians about substitution, and for the documentation trail that protects the hospital if a question about product equivalence ever arises.
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