[Comment] The paradox of generics: broader access, less freedom

The Italian National Health Service is founded on universal coverage and equal access to care.1 In this context, sustainability is not optional, but structural; innovative treatments must coexist with responsible use of constrained financial resources. In oncology, where novel therapies have improved outcomes but also driven up costs, generic drugs represent a crucial tool.2 When patent protection expires, bioequivalent formulations can be marketed at lower prices, enabling systems to reduce expenditure on established therapies and reallocate resources to innovation.