When Dr. Louis Kraus, a chief of child psychiatry at a hospital in Chicago, writes prescriptions for patients who have attention-deficit hyperactivity disorder, he often chooses Concerta, an extended-release form of the drug Ritalin that gives patients relief from their symptoms for as long as 12 hours.

He was unconcerned when, a few years ago, pharmacies began substituting lower-cost generic alternatives for brand-name Concerta — after all, generic drugs are widely seen as effective and account for the overwhelming majority of prescriptions filled nationwide.

His feelings changed last November, however, when the Food and Drug Administration announced that two of the three available Concerta generics, one made by Mallinckrodt Pharmaceuticals and the other by UCB, could no longer be considered the equivalent of the brand and, in most states, could not be automatically substituted by pharmacies for the brand name.


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