As a chemist, a molecule is a molecule is a molecule. Now a few things can come into play. The purity of that molecule has to be considered and also any added fillers which might do something to interfere with the total and proper functioning of the active ingredient molecule.
But generics for as long as I can remember had the leeway of using other additives as long as the active ingredient was the same to within some given tolerances.
A classic thing that happens too is when a manufacturer changes and say the pill goes to a different color or shape - heck in supplements even if the label on the bottle changes - customers will often immediately think something is different and it doesn't work as good. Some of that is obviously the placebo effect and what the customer/patient wants to believe.
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