According to the statistics provided by the State Food and Drug Administration, more than 95% of the approved drug numbers in China are generic drugs. Whether generic drugs can achieve the same efficacy and long-term safety as the original drugs is still a common concern for doctors and patients. The non-compliance promotion of a domestic generic statin has once again aroused the attention of the industry. Patients with chronic diseases such as atherosclerotic cardiovascular disease (ASCVD) require long-term drug therapy, and rational drug selection is particularly important. Statins, as the basic medication for ASCVD, also need to be used for a long time, and their quality is a factor that cannot be ignored. From the perspective of industry development and long-term use of patients, how should we look at original drugs and generic drugs? A. Original drugs and generic drugs: which is more helpful to Chinese doctors? As we all know, in addition to the advantages of product quality, the original pharmaceutical companies are also able to provide quality academic services. So from the perspective of long-term promotion of the industry, which is more helpful to Chinese doctors, original drugs or generic drugs? What is the gap between generic drugs and originator drugs in terms of academic and regulatory promotion? The original drug has undergone a lot of preliminary research and development work and also invested a huge amount of money, so there should be a patent protection period, which is the embodiment of protecting intellectual property rights and encouraging innovation, and is also in line with the principle of fairness and the laws of market economy. Of course, the original drug may not be able to meet the needs of all people, and the price is higher, so the emergence of generic drugs also plays a role in making better treatment available to more people. It should be noted that the formulations of some original drug formulations are not publicly available, and some formulations are very characteristic, such as drugs that do not aggravate the excretory burden on the kidneys, and drugs with particularly good absorption and bioavailability, and these technologies are impossible to imitate, and some are long-held patented technologies, so there is still a slight gap between original drugs and generic drugs. The original drug has gone through a long research and development process, including basic research, animal experiments and clinical trials, and has accumulated a large amount of evidence-based medical evidence, and there are clear guidelines to recommend, including European and American and Chinese guidelines. Generic drugs, on the other hand, are relatively simple, relying only on the original drug to prove the equivalence of the generic drug and the original drug. But a simple equivalence study does not show that the effectiveness and safety of generic drugs and original drugs are the same. In short, the original drug has more advantages and plays an irreplaceable role. The original investigational drugs are marketed earlier, have sufficient evidence of evidence-based medicine, and have conducted some clinical observational studies in China; the marketing of the products of the original investigational drug companies is also becoming more and more standardized, and through the dissemination of scientific information on drugs and academic activities and even some clinical observational studies in China, there is a longer time to promote these innovative drugs to China, so that patients can get the effect first. Domestic pharmaceutical companies can only wait for the original drug to pass the patent protection period before they can make a generic version. The advantage of generic drugs is that they can fully draw on the experience of existing research at home and abroad and have a clearer understanding of the adverse effects of such drugs, so they can take fewer detours; this is a stage that benefits all people. Generic drugs can bring benefits to patients in many less developed countries, so the long-term role of generic drugs should not be underestimated; however, generic drugs should also have standards and regulations and procedures for quality control management to ensure their safety and effectiveness. Second, ASCVD prevention and treatment: choose original drugs or generic drugs? ASCVD has surpassed cancer as the disease with the highest mortality rate in China. Prevention of ASCVD is beneficial to curb the continuous increase of cardiovascular and cerebrovascular disease mortality in China. Drug therapy such as statin and lifestyle improvement are the cornerstones of ASCVD prevention and treatment, which need to be maintained for a long time. Given the advantages and disadvantages of original and generic drugs and the current situation in China, Prof. Xiaowei Guo prefers to use drugs with more evidence, a long time in the market, and relatively few adverse effects; and to choose the less expensive ones within several such drugs as much as possible. Professor Guo Xiaohui emphasized that the original drug has conducted a large number of clinical trials, and academic promotion and publicity are also compliant, which is admirable; while there are some drugs, such as some generics, which are cheaper but if there is improper commercial competition, these drugs will not be chosen clinically. Purely from the perspective of treating the disease, it is more desirable to use the original drug, first of all to ensure efficacy; but taking into account the economic situation of patients, but also specific problems specific treatment. He said, “First look at the patient needs to use, and then according to the patient’s individual situation to choose the original or generic, but if I must say which is better original and generic, I definitely advocate the original is good, it is undoubtedly, for sure.” The choice of which drug to treat must take into account the patient’s financial income situation and health insurance status. Generic drugs can allow more patients whose current health insurance is not very good and who have a more difficult life to take medication, and more importantly, to be able to adhere to the medication for a long time. However, many generic drugs are not cheaper than the original drugs, and over-prescribing increases the financial burden of patients. Professor Hu Dayi stressed that in the process of treating patients, it is most crucial to adhere to the moral bottom line and conscience. In short, the exact evidence-based medical evidence and unique process of the original drug is a strong guarantee of its efficacy and safety. The first thing to consider when choosing a drug in clinical practice is the quality and efficacy of the drug.