Table 1.

Illustration of similarities and possible differences between a reference branded ARB and potential alternatives

Aspect of branded ARB	Generic ARB*	Any other ARB	Any ACEIs
Main mechanism of action	≡	≡	≠
Structure of drug	≡	≠	≠
Excipients and binders	≠	≠	≠
Appearance	≠	≠	≠
Pharmacokinetics
In healthy subjects	≡	NR	NR
In patients	?	NR	NR
In special populations	?	NR	NR
Evidence for similar efficacy
Primary outcome (surrogate marker)	?	?	?
Clinical cardiovascular outcomes	?	≠	≠
In same clinical indications	?	≠	≠
Pleiotropic effects	?	≠	≠
Safety
Adverse events	?	≠	≠
Drug–drug interactions	?	≠	≠
Contraindications and warnings	≡	≠	≠
Adherence and persistence	≠	≠	≠

^*No generic ARBs are currently available; based on evidence usually available for an approved generic version of a drug. ≡, equivalent, ≠, not equivalent, ?, equivalence may not be proved or evidence suggests differences may occur. ACEI, angiotensin-converting enzyme inhibitor, ARB, angiotensin receptor blocker, NR, not relevant.