It's always bothered me that there was an insistence on difference without explanation. Certainly years ago there could've been a huge difference because of differences in the GH itself, but the technical obstacles to producing recombinant HGH have been overcome and production cost, like so many other high tech products, has come way down.
The only explanation for any ongoing difference was contaminants of various types, and the fact they can lead to your immune system clearing the drug, or blocking receptors.
I'm sure legit pharma is still superior in this regard, because they pay more attention to handling and excipients, but the gap has closed significantly, and someone determined to make a counterfeit could closely replicate what pharma is doing. I strongly suspect the rHGH itself is now being sold by the large pharma companies making it in China, but as a raw API, which is legal, leaving the UGLs to add excipients and package it (that's certainly what QSC means by "manufacturing", they're not inserting DNA into cells in a back room).
