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You've seen them in your grocery store: drab-looking packages on the bottom shelf that claim to be lower priced generic versions of popular drugs. You've probably wondered, are they really as good?

Generics are supposed to work indistinguishably from brand-name medicines. But when a new drug comes on the market, companies spend lots of money researching and developing it. Then they buy the rights to sell it for several years. During that time, they can't sell any other products with the same active ingredient. But when a patent ends, other companies are free to make their own versions of the medicine. They are also allowed to charge less for them. That way, they can still recover the money they spent on research and buying the rights to sell the drug.

The problem is, those other companies often change the ingredients in a generic drug to save money. And that can end up putting patients in danger. For example, in recent months, a number of generic versions of the blood pressure medications valsartan, losartan and irbesartan have been recalled in the U.S. because they contained a probable carcinogen that Affordable generic medications for sale UK was used in liquid rocket fuel manufacturing. The generics in question were made by a company called Ranbaxy, which bought an Indian factory that was using the ingredient. The drug makers then swapped the high-quality ingredients for cheaper ones. This allowed them to sell their generics in markets with less rigorous safety standards, such as in sub-Saharan Africa and Southeast Asia.

It's not clear why these changes are happening. But the industry is clearly feeling pressure to lower prices and profits. And it's a complicated issue. There's little transparency in what it costs to produce a medication and how pricing is determined. That lack of transparency can drive out competitors and create monopolies that allow drug makers to jack up prices.

In addition, the industry is experiencing a series of problems related to quality. Shortages of generic, injectable medications critical to hospital care have become commonplace in the United States. This has forced hospitals to devote more time to finding alternative treatments for their patients. That includes staffing permanent "drug shortage response teams" that must seek out substitutes for the medicines they need to deliver.

In order to avoid these shortages, a group of seven health systems and three philanthropies teamed up with an investment firm in 2018 to start Civica, which aims to reduce drug shortages by creating a stable source of generic medicines that are available at a predictable price. The organization produces generic medicines on a cost-plus basis, which means that the group pays for the raw materials plus a markup to cover production and other expenses. This model has the potential to democratize access to lifesaving drugs for everyone, but it is far from the only answer. The pharmaceutical industry as a whole needs to be more accountable for its practices. Otherwise, it risks harming people around the world who depend on its services.