I used the words 'Sub optimal' as I was trying to avoid simply saying it doesn't work, Intas pharmaceuticals who manufacture the Accord Brand is a large company who distribute products worldwide, no doubt there are people who use their finasteride products and feel they achieve satisfactory results, From my personal experience when I am on an Finasteride that I consider to be working optimally, my hair is what I call stable, I have no excessive shedding, if I run a comb through my hair, there is no stray hairs in the comb, washing my hair vigorously results only a few extra lost hairs, and although my hairline has receded, along the front of my hair there is still a row of fine /vellus hair that softens my hairline. When I take some brands of finasteride Accord being one of them the opposite happens, my hair sheds continually without touching it, the middle/top section of my head diffuse thins and the row of fine vellus hairs disappears, so this is what I mean by suboptimal. the Accord finasteride is doing 'something' but its not able to replicate the results that I have been able to achieve on other brands of finasteride. The problem with alot of the generic finasteride, is that you are actually buying a product that was formulated, costed and manufactured to be affordable to people in India on extremely low incomes, that is the original purpose of the Indian Generics Industry, the drugs were only meant to be originally available in India, where a philosophy of ''close enough, is good enough'' rules supreme. The industry has been so successful that India now exports generic medicines all over the world which is great for them, but it doesn't change the fact that when you buy accord you are actually buying rebranded Finalo or one of their other ultra low budget local products, that's been repacked and price hiked for the International market. I don't know if Accord is the only brand you have tried ? but at some point it might be worth asking yourself how many more years are you prepared to give them the benefit of the doubt? before you think its worth trying a different brand just in case it does make a difference?