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I'm guessing it's because of concerns about quality control.
For example, I used to use generic eye drops. Then there were a bunch of recalls on eye drops made in India because they weren't kept sterile and people were getting eye infections. So now I make sure to only buy eye drops that are manufactured in countries with actual controls on health codes. It turns out that imposing that restriction elliminated all the generic options. I'm certainly not happy to be paying double for brand name pataday, but I don't care to mess with the chance of eye infections.