Potential savings from generic prescribing and generic substitution in South Africa

The magnitude of prescribing medicines by brand names at Muhimbili National Hospital, Tanzania

Background:

Tanzania National Treatment Guidelines and National Therapeutic Committee circular of 2012 requires prescribers to prescribe medicines using their generic names as recommended by the World Health Organization. The implementation of the aforementioned recommendations by prescribers is not well documented in our settings. Therefore, this study aimed to explore the compliance on the use of generic names by prescribers at Muhimbili National Hospital.

Methods:

A descriptive cross-sectional study was conducted at Muhimbili National Hospital from January to May 2019 in both inpatient and outpatient pharmacy units. Data were analyzed using SPSS, version 23. Chi-square test was used to analyze proportions between the different variables of the study. A p-value for significance was <0.05.

Results:

Of 1001 prescriptions analyzed, 71.6% contained medicines prescribed using brand names. The mean (±standard deviation (SD)) number of medicines per prescription was 2.98 (±1.5). The most frequently prescribed medicines by brand names were a combination of vitamin and mineral supplements (34.4%) followed by antibiotics (26.7%). Medical doctors (25.6%) and medical specialists (21.6%) prescribed ⩾2 medicines using brand names per prescription compared to interns (15.0%) and residents (6.9%) ( p < 0.001).

Conclusion:

Prescribing medicines using brand names was highly observed in this study. Supplements and antibiotics were among the products that were highly prescribed using their brand names. Qualitative studies to explore reasons for brand name prescribing practices are recommended.

Investigation of Biowaivers for Immediate Release Formulations Containing BCS III Drugs, Acyclovir, Atenolol, and Ciprofloxacin Hydrochloride, Using Dissolution Testing

The dissolution of several products containing Biopharmaceutical Classification System (BCS) class III drugs, acyclovir, atenolol, and ciprofloxacin hydrochloride, listed in the WHO essential drug list (EDL), was tested and compared with their respective comparator pharmaceutical products (CPPs) marketed in South Africa and India. US Pharmacopeia (USP) buffers of pH 1.2, 4.5, and 6.8 were used as dissolution media and tested using USP apparatus 2 at 75 rpm and 900 ml. Nine acyclovir products were tested, and only three dissolved very rapidly in all media; i.e., they showed a release of >85% in 15 min. Eight atenolol products tested were all very rapidly dissolving in all three pH media. Ten ciprofloxacin hydrochloride products were tested, and the results showed that only five products met the WHO biowaiver criteria. This study indicates that not all marketed products containing the same BCS III active pharmaceutical ingredient (API) in similar strength and dosage form are necessarily in vitro equivalent as per the WHO biowaiver criteria. Furthermore, selection and availability of an innovator product as CPP are important considerations that can affect the outcomes of such studies.

Potential Savings from Increased Substitution of Generic for Originator Medicines in Europe

This study aims to estimate annual savings from increased generic substitution in the retail market of 11 European countries in 2004. Savings from generic substitution were calculated for the top ten active substances by public expenditure on originator medicines in each country. For each active substance, average price levels weighted by volume of sales of medicines belonging to the group of originator medicines and to the group of generic medicines were calculated. The price difference between originator and generic medicines was multiplied by the volume of originator medicines to be substituted. The analysis considered that, following generic substitution, 5 per cent of market volume for each active substance would be made up by originator medicines and 95 per cent by generic medicines. Increased generic substitution for the top ten active substances generated total potential savings of around €3 bn, with country savings ranging from €1 lm in Poland to €1 bn in Germany. Increased generic substitution would be expected to reduce public expenditure on originator medicines containing these active substances by at least 20 per cent in each country. Countries that pursue the development of their domestic generic medicines market, therefore, can expect to gain substantial savings from increased generic substitution.

Generic Medicines: Perceptions of General Practitioners in Melbourne, Australia

The aims of this study were to investigate factors affecting generic medicine prescribing among general practitioners (GPs) in Melbourne, Australia. A qualitative approach was used. A convenience sample of GPs practising in Melbourne was interviewed using a semi-structured interview guide. Thematic content analysis of the interviews identified seven major themes: medicine prescribing patterns, knowledge and confidence with generic medicines, patient acceptance of generic medicines, issues related to ‘pseudo-generics’ and medicine labelling, drug advertising and marketing, brand substitution by community pharmacists and, finally, strategies to increase generics prescribing. Informants suggested some methods that could be used to increase the current rate of generics prescribing, including financial reward for GPs, patient education on generic medicines, convincing GPs of the safety and efficacy of generic medicines and educating senior medical students on issues involving generic medicines and generics prescribing. This study suggested that GPs in Melbourne have mixed attitudes to generics prescribing. The findings also show that misconceptions about safety and efficacy of generic medicines still persist among some GPs. Unless they are sufficiently educated by interested parties, such as the government and the generic medicines industry, this will have a negative impact on utilisation of generic medicines in future.

Translation and validation of the Arabic version of generic medicines scale

BACKGROUND

Generic drugs are considered the best alternative for the originator brand drugs because they have the same quality, safety, and efficacy yet offered at considerbaly lower cost. Prior research has developed instrumentation to assess patients' perceptions of generic drugs; however, little has been done to translate these measures in other languages.

OBJECTIVES

This study's aim was to translate and validate an Arabic version of the generic drug scale (GMS) in a Jordanian sample. This was a cross-sectional study.

METHODS

The English version of the GMS was translated to an Arabic version using the standard "forward-backward" procedure of translation. The questionnaire was distributed to 225 patients. The translated version was then validated in a sample of patients. Face validity of the translated GMS was confirmed with pilot testing. Content validity of the translated GMS was evaluated by a number of pharmacists and academicians. Confirmatory factor analysis (CFA) was used to test a pre-specified relationship of observed measures.

RESULTS

The GMS consisted of two subscales: efficacy, and similarity of generic drugs to originator brand drugs. The efficacy subscale consisted of ten items while the similarity subscale consisted of six. The responses to the items were framed on five-point, Likert-type scales. The instrument demonstrated good internal consistency (Cronbach's alpha = 0.83). The range model fit was good for some fit indices. The RMSEA value was 0.08, which indicates good fit. Also, CMIN/DF indicated a good fit model with a value of 2.7, as well as GFI and CFI values of 0.95 and 0.91, respectively. NFI and CFI values were 0.92 and 0.93, respectively. Factor loadings were over 0.30 for all items, which means the scale has CFA validity indictors.

CONCLUSIONS

The Arabic version of GMS was proved to be a reliable and valid measure to investigate patients' belief regarding generic drugs as it showed acceptable, internal consistency reliability, face and content validity.

Does educational intervention improve doctors' knowledge and perceptions of generic medicines and their generic prescribing rate? A study from Malaysia

Objectives:

To investigate the impact of an educational intervention on doctors’ knowledge and perceptions towards generic medicines and their generic (international non-proprietary name) prescribing practice.

Methods:

This is a single-cohort pre-/post-intervention pilot study. The study was conducted in a tertiary care hospital in Perak, Malaysia. All doctors from the internal medicine department were invited to participate in the educational intervention. The intervention consisted of an interactive lecture, an educational booklet and a drug list. Doctors’ knowledge and perceptions were assessed by using a validated questionnaire, while the international non-proprietary name prescribing practice was assessed by screening the prescription before and after the intervention.

Results:

The intervention was effective in improving doctors’ knowledge towards bioequivalence, similarity of generic medicines and safety standards required for generic medicine registration (p = 0.034, p = 0.034 and p = 0.022, respectively). In terms of perceptions towards generic medicines, no significant changes were noted (p > 0.05). Similarly, no impact on international non-proprietary name prescribing practice was observed after the intervention (p > 0.05).

Conclusion:

Doctors had inadequate knowledge and misconceptions about generic medicines before the intervention. Moreover, international non-proprietary name prescribing was not a common practice. However, the educational intervention was only effective in improving doctors’ knowledge of generic medicines.

Patients' beliefs about generic medicines in Malaysia

BACKGROUND

Acceptance of generic medicines by patients is an essential factor given that they are the end users of these medicines. In fact, adequate knowledge and positive perceptions are prerequisite to patients' acceptance and use of generic medicines.

OBJECTIVE

To assess the current belief and views of patients about generic medicines in Malaysia.

METHOD

This was a self-administered questionnaire-based study. The study was conducted with patients visiting outpatient pharmacy department at a tertiary care hospital in Malaysia. The Malaysian version of Generic Medicines Scale (GMS) was used. The GMS consists of two subscales: efficacy and similarity of generic medicines to original brand medicines. The efficacy subscale consists of 10 items while the similarity subscale consists of 6 items. The responses to the items were framed as a five-point Likert scale (1=strongly disagree to 5=strongly agree).

RESULTS

A total of 202 out of 300 patients participated in the study, giving a response rate of 67.3%. In this study, only 49% of them (n=99) knew the term 'generic medicine'. Moreover, only 53.5% of the respondents (n=108) believed that the efficacy of generic medicines was the same as original brand medicines. In terms of quality, only 44% of the respondents (n=89) disagreed that generic medicines were of a lower quality. About one third (n=65, 32.2%) believed that generic medicines were cheaper because they were less efficacious. In terms of side effects, 44.5% of the respondents (n=90) believed that generic medicines had the same side effect profile as original brand medicines.

CONCLUSIONS

The study finding showed that almost half of the respondents had negative belief in generic medicines. Similarly, many patients were not aware of the similarities and differences between generic and original brand medicines. Therefore, there is a need to provide patients with adequate information about generic medicines.

Perspectives of physicians practicing in low and middle income countries towards generic medicines: a narrative review

OBJECTIVES

This review was conducted to document published literature related to physicians' knowledge, attitudes, and perceptions of generic medicines in low- and middle-income countries (LMICs) and to compare the findings with high-income countries.

METHODS

A systematic search of articles published in peer-reviewed journals from January 2001 to February 2013 was performed. The search comprised nine electronic databases. The search strategy involved using Boolean operators for combinations of the following terms: generic medicines, generic medications, generic drugs, generic, generic substitution, generic prescribing, international non-proprietary, prescribers, doctors, general practitioners, physicians, and specialists.

RESULTS

Sixteen articles were included in this review. The majority (n=11) were from high income countries and five from LMICs. The main difference between high income countries and LMICs is that physicians from high income countries generally have positive views whereas those from LMICs tend to have mixed views regarding generic medicines. Few similarities were identified among different country income groups namely low level of physicians' knowledge of the basis of bioequivalence testing, cost of generic medicines as an encouraging factor for generic medicine prescribing, physicians' concerns towards safety and quality of generic medicines and effect of pharmaceutical sales representative on generic medicine prescribing.

CONCLUSION

The present literature review revealed that physicians from LMICs tend to have mixed views regarding generic medicines. This may be due to differences in the health care system and pharmaceutical funding system, medicine policies, the level of educational interventions, and drug information sources in countries of different income levels.

Physicians' perception of generic and electronic prescribing: A descriptive study from Jordan

Objectives

The aim of this study was to investigate Jordanian physicians’ perception and attitudes toward generic medicines and generic substitution. It also aimed to examine factors that affect physicians’ pattern of prescribing, and to evaluate their opinion regarding future introduction of Electronic Prescribing (EP) in Jordan.

Methods

A cross-sectional descriptive study involving Jordanian physicians working in both public and private sectors was undertaken, using a self-administrated anonymous questionnaire. Frequency tables, cross-tabulation and chi square tests were used for data analysis. The response rate was 75.2% (n = 376/500).

Results

Cost was claimed to be an important factor in the prescribing decision for 69.1% of the Jordanian physicians. The majority of physicians (77.4%) claimed that they often prescribe generic medicines. Jordanian physicians predominantly welcomed the implementation of an EP and International Nonproprietary Name (INN) prescribing systems with 92%, and 80.1% respectively. More than two thirds of the physicians (69.4%) accepted generic substitution by pharmacists, with a significant association with their employment sector; physicians who work in the private sector tended to oppose generic substitution compared with physicians who work in the public sector. Physicians mostly (72.1%) opposed that generic substitution should only be allowed upon patient request.

Conclusions

Jordanian physicians have a positive attitude towards generic medications and high willingness and acceptance of strategies that encourage generic utilisation such as EP, INN prescribing and generic substitution. All these strategies would help reduce the high expenditure on medicines in Jordan. These findings would provide baseline data to policy makers to develop a robust generic policy to achieve greater clinical effectiveness and economic efficiency from medicines prescribing.

Knowledge, attitudes, and practices of community pharmacists on generic medicines in Qatar

BACKGROUND

The practice of generic medicines prescribing, dispensing and substitution in developing countries has been controversial among healthcare professionals, particularly due to issues on quality, safety and efficacy. These controversies are as a result of inter-country differences in policies and laws as well as individualized knowledge and attitudes of pharmacists pertaining to generic medicines.

OBJECTIVE

This study primarily aims to assess the knowledge, attitudes, and practices of community pharmacists in Qatar towards generic medicines.

SETTING

Community pharmacy settings throughout the State of Qatar.

METHOD

A cross-sectional study using a pretested paper-based survey was conducted among a random sample of community pharmacists in Qatar. The data were analyzed using IBM-SPSS(®) version 20. Both descriptive and inferential statistical analyses were applied.

MAIN OUTCOME MEASURE

Knowledge, attitudes, and practices of generic medicines pertaining to regulatory standards, safety, efficacy, quality, and future policies. Results A total of 160 surveys were distributed to community pharmacists of which 118 were returned (response rate, 74 %). The mean total score of generic medicines knowledge among the pharmacists was 6.8 ± 1.6 (maximum possible score was 10). Years of practice as well as place of obtaining academic degree did not influence knowledge score. Approximately 72 % of the pharmacists supported generic substitution for brand name drugs in all cases where a generic medicine is available and the majority (93 %) agreed that pharmacists should be given generic substitution right. Nearly 61 % of the pharmacists considered lack of proven bioequivalence to original brands as an important barrier for selecting generic medicines and 55 % rated "lack of policy for directing the practice of generic medicine" as an important barrier.

CONCLUSION

In order to enhance the quality use of and to promote the practice of generic medicines in Qatar, an educational program should be implemented. A national generic medicine policy and guidelines are warranted in the State of Qatar.

Examining characteristics, knowledge and regulatory practices of specialized drug shops in Sub-Saharan Africa: a systematic review of the literature

BACKGROUND

Specialized drug shops such as pharmacies and drug shops are increasingly becoming important sources of treatment. However, knowledge on their regulatory performance is scarce. We set out to systematically review literature on the characteristics, knowledge and practices of specialized drug shops in Sub-Saharan Africa.

METHODS

We searched PubMed, EMBASE, WEB of Science, CAB Abstracts, PsycINFO and websites for organizations that support medicine policies and usage. We also conducted open searches using Google Scholar, and searched manually through references of retrieved articles. Our search included studies of all designs that described characteristics, knowledge and practices of specialized drug shops. Information was abstracted on authors, publication year, country and location, study design, sample size, outcomes investigated, and primary findings using a uniform checklist. Finally, we conducted a structured narrative synthesis of the main findings.

RESULTS

We obtained 61 studies, mostly from Eastern Africa, majority of which were conducted between 2006 and 2011. Outcome measures were heterogeneous and included knowledge, characteristics, and dispensing and regulatory practices. Shop location and client demand were found to strongly influence dispensing practices. Whereas shops located in urban and affluent areas were more likely to provide correct treatments, those in rural areas provided credit facilities more readily. However, the latter also charged higher prices for medicines. A vast majority of shops simply sold whatever medicines clients requested, with little history taking and counseling. Most shops also stocked popular medicines at the expense of policy recommended treatments. Treatment policies were poorly communicated overall, which partly explained why staff had poor knowledge on key aspects of treatment such as medicine dosage and side effects. Overall, very little is known on the link between regulatory enforcement and practices of specialized drug shops.

CONCLUSIONS

Evidence suggests that characteristics and practices of specialized drug shops differ across rural and urban locations, and that these providers are highly responsive to client demand. However, there is a dearth in knowledge on how regulatory enforcement influences their characteristics and practices, and what strategies can be employed to strengthen the governance of the retail pharmaceutical sector.

Perceptions and patterns of use of generic drugs among Italian family pediatricians: first round results of a web survey

Prescription of generic medicines represents an efficacious healthcare cost containment strategy. In some European countries and in the US, generic medicines are largely prescribed. In Italy, generic drugs prescription rate is lower. General Practitioners and Family Pediatricians may be less confident in prescribing generic equivalents instead of "branded" medicines. There are currently no data about Italian Family Pediatricians' perceptions and patterns of use of generic drugs. This is a first nationwide web survey conducted with the aim to evaluate generic medicines knowledge and prescribing habits of Italian Family Pediatricians. 303 Family Pediatricians completed the online questionnaire. 37.2% and 32.6% of them declared to have a sufficient or fairly good knowledge of generic medicines, respectively, and the majority of them believed that efficacy of generic medicines was sufficient (33.6%) or good (45.2%). Nevertheless, Italian Family Pediatricians are still prone to prescribe trade medicines more frequently, since only 13.5% of them declared that more than a half of their patients were treated with generic medicines. Major issues related with generic medicines prescriptions by Italian Family Pediatricians seem to be represented by diffuse scepticism about reliability of bioequivalence tests and safety of switchability from branded to generic equivalents. More information about generic drugs and more research in the field of pediatric pharmacology are needed for increasing generic medicines prescription rate among Italian Family Pediatricians.

Generic medicines: perceptions of consumers in Melbourne, Australia

Objective

The objective of this study was to explore consumers' perceptions and opinions of generic medicines and to identify barriers to their use of generic medicines.

Method

A qualitative approach was used. A purposive sample of consumers, aged 22–80 years, living in the Melbourne, Australia, metropolitan area were interviewed using a semi-structured interview guide.

Key findings

Sixteen consumers were interviewed. Thematic content analysis of the interviews identified four major themes: knowledge about generic medicines, acceptance of generics, non-acceptance of generics, and education needs pertaining to generic medicine use. In terms of knowledge, some consumers were not familiar with the term ‘generic medicines’, but were more familiar with the term ‘cheaper brand of medicine’. The major reason for acceptance of generic medicines among the consumers interviewed was cost. Positive encouragement from the healthcare providers was seen to influence generic medicine uptake by consumers. The major barriers to acceptance included influence from medical practitioners, side-effects from generic brands, and confusion that may arise from using different brands. To encourage future uptake of generics by consumers, some of the respondents recommended that education strategies be implemented by healthcare practitioners and governmental agencies to educate people on the safety and efficacy of generic medicines.

Conclusions

This study indicated that consumers interviewed generally had positive attitudes towards the use of generic medicines. The findings also suggest that direct patient education by the healthcare providers on issues relating to safety and efficacy of generic medicines could further enhance their uptake.

Influence of a new reference-based pricing system in South Africa on the prevalence and cost of antidiabetic medicine: a pilot study

Objective

To determine the influence of the implementation of the new reference-based pricing system (single exit price or SEP) in South Africa on the prescribing prevalence and cost of antidiabetic medicine.

Setting

Private healthcare sector of South Africa (national medicine claims processing company).

Method

A retrospective drug utilisation study and basic cost analysis were conducted on antidiabetic medicine usage data. Data were extracted from a national medicine claims processing company's database for the period January 1, to December 31, 2004, and analysed according to three study periods: January 1 to April 31, 2004 (pre-SEP period), May 1 to August 31, 2004 (interim period) and September 1 to December 31, 2004 (post-SEP period).

Key findings

The study population consisted of the total number of prescriptions claimed (n = 2 595 254) during the 1-year period. The total number of medicine items prescribed were 5 305 882, at a total cost of R661 223 146.00 ($102 375 382.80). Antidiabetics represented 2.7% (n = 143 447) of these, at a cost of R29 734 655.19 ($4 603 735.86) (4.5%). The average cost of insulin on the database for the year 2004 decreased by approximately R188.26 ($29.15) from the pre-SEP period to the post-SEP period, and that of oral antidiabetic products by approximately R47 ($7.28). The average cost of antidiabetic medicine products in general showed a decrease from the pre-SEP period to the post-SEP period — with a reduction in average cost of approximately R73 ($11.30) or 29.6%. Conclusion The reduction in average cost of antidiabetic medicine products observed in this study could possibly be attributed to the implementation of new pricing regulations in South Africa in 2004. It is recommended that further investigations on the impact of the implementation of the new reference-based pricing structure in South Africa be done.

Consumers' views on generic medicines: A review of the literature

Objectives

To review the literature on consumers' knowledge, attitudes and opinions of the use of generic medicines.

Method

A narrative review of studies conducted from 1970 to 2008 on consumers' perceptions and views towards generic medicines was performed. An extensive literature search was undertaken using indexing services available at the authors' institution library. The following keywords were used for the search: brand, generic, multisource, medications, medicines, drugs, pharmaceuticals and consumers, customers, and patients. Electronic databases searched were Medline, Inside Web, ISI Web of Knowledge, Science Direct, Springer Link, JSTOR, Proquest, Ebsco Host and Google Scholar. These electronic databases were searched for full text papers published in English from 1970 to October 2008.

Key findings

Twenty studies were identified. Eleven were from the USA, four were from Europe, two were from Canada and one each was from Australia, Brazil and Malaysia. In general, consumers showed mixed reactions towards the use of generic medicines. This was evident from the divergence of views observed by country development level, consumers' socioeconomic characteristics, drug product characteristics, pharmaceutical reimbursement system, policy environment, contact with health care professionals, past experience with medications, and knowledge of the seriousness of a medical condition.

Conclusions

Patient confidence and knowledge pertaining to generic medicines use have increased over the past four decades, especially in developed countries. Mass educational efforts, financial incentives, and greater communication among patients and health care professionals were seen as major drivers to the uptake of generic medicines among consumers.

A survey exploring knowledge and perceptions of general practitioners towards the use of generic medicines in the northern state of Malaysia

OBJECTIVES

The objective of this study was to evaluate the general practitioners' (GPs') knowledge and perceptions towards generic medicines in a northern state of Malaysia.

METHOD

A postal cross-sectional survey involving registered GPs in Penang, Malaysia was undertaken. A 23-item questionnaire was developed, validated and administered on the GPs. Eighty-seven GPs responded to the survey (response rate 26.8%).

RESULTS

The majority of the respondents (85.1%) claimed that they actively prescribed generic medicines in their practice. On the other hand, only 4.6% of the respondents correctly identified the Malaysia's National Pharmaceutical Control Bureau's bioequivalence standard for generic products. There were misconceptions among the respondents about the concepts of "bioequivalence", "efficacy", "safety", and "manufacturing standards" of generic medicines. GPs in this survey believed that a standard guideline on brand substitution process, collaboration with pharmacists, patient education and information on safety and efficacy of generic medicines were necessary to ensure quality use of generics. Furthermore, advertisements and product bonuses offered by pharmaceutical companies, patient's socio-economic factors as well as credibility of manufacturers were factors reported to influence their choice of medicine.

CONCLUSION

Although it appeared that GPs have largely accepted the use of generic medicines, they still have concerns regarding the reliability and quality of such products. GPs need to be educated and reassured about generic products approval system in Malaysia concerning bioequivalence, quality, and safety. The current findings have important implications in establishing generic medicines policy in Malaysia.

Evaluating community pharmacists' perceptions of future generic substitution policy implementation: a national survey from Malaysia

OBJECTIVES

This study aims to provide baseline data to support the implementation of generic substitution policy in Malaysia by evaluating the community pharmacists' perceptions and opinions on generic substitution and current substitution practices.

METHODS

A cross-sectional descriptive study involving the entire population of Malaysian community pharmacies (n=1419) was undertaken using a self-completed anonymous mail questionnaire.

RESULTS

A total of 219 responses were received for a response rate of 15.4%. Majority of the respondents (93.6%) agreed that pharmacists should have generic substitution rights. Almost all pharmacists (96.8%) viewed Poison Class C (pharmacist only medicine) as most suitable class of controlled medicines for substitution. About half (51.6%) of the pharmacists preferred a policy which allowed substitution on any prescription. The pharmacists prefer to consult the physician when substituting narrow therapeutic index medicines (88.1%) and prescription only medicines (51.3%). Less than 25.0% of the pharmacists routinely keep the medication records and follow-up the patients who received substitution. Monitoring the efficacy (79.2%) and patient's satisfaction with the generic medicines (74.9%) were the main reasons for following-up the patient if substitution occurs.

CONCLUSIONS

Malaysian community pharmacists are generally in favour of generic substitution policy implementation.

A pilot survey on perceptions and knowledge of generic medicines among consumers in Penang, Malaysia

Objective

To explore the consumers’ perceptions and knowledge towards issues surrounding generic medicines utilization in Penang, Malaysia.

Methods

A cross sectional survey was conducted with consumers who attended the annual University open day. Using convenience sampling, survey forms were distributed to the respective consumers via the help of a group of trained 1st year pharmacy students. For a period of 5 days, 400 respondents had participated in the survey. Analysis of the response from the collected forms yielded in 396 usable forms.

Results

Only 28.3% (n=112) of the respondents were familiar with the term “generic medicines”. More than 70% of the respondents do not know that generic medicines can be marketed under different names. About 34% (n=38) of consumers stated that they had been given information regarding generics by their pharmacists. In terms of side effects, about 32% (n=127) of the respondents felt that generic medicines may cause more side effects than branded medicines. Majority of the consumers surveyed (64%) understand that generic cost less compared to their branded counterparts.

Conclusion

This survey showed that there is a gap in consumers’ knowledge and understanding about generic medicines. The findings also suggest that direct patient education by the healthcare providers on issues relating to safety and efficacy of generic medicines could further enhance their uptake.

A pilot study on generic medicine substitution practices among community pharmacists in the State of Penang, Malaysia

PURPOSE

The purpose of this study was to evaluate the generic substitution (GS) practices undertaken by community pharmacists in the State of Penang, Malaysia with a focus on the extent of communication between pharmacists and prescribers on issues related to GS, consumer's acceptance on the GS and estimation of cost saving achieved for patients opted for GS.

METHOD

A cross-sectional descriptive study for a period of 2 months using a specific questionnaire as a data collection tool was undertaken with a random sample of 40 community pharmacies located in the State of Penang.

RESULTS

By the end of the study period, 34 out of 40 pharmacies contacted participated in the study. Forty-seven per cent of pharmacists consulted prescribers while promoting GS to their consumers. Majority of the prescribers (84.4%) when contacted by the pharmacists accepted the suggestion for substitution. From consumers' perspective, 88% (n = 156) of the consumers involved in this study accepted pharmacist's recommendation to generically substitute their prescribed medications. Through acceptance of GS, it has been estimated that the overall consumers' expenses on drugs can be reduced to a total of RM6137 (US$1615; US$1 = RM3.80) and this corresponds to a cost saving of 61.1%.

CONCLUSIONS

The outcome of the present study showed that through GS recommendation by community pharmacist, consumers can save the expenditure of their prescribed medications.

A comparison between senior medical students' and pharmacy pre-registrants' knowledge and perceptions of generic medicines

OBJECTIVE

To ascertain any differences in knowledge and perceptions of generic medicines between senior (final year) medical students and pharmacy pre-registrants in Australia.

METHODS

National web-based surveys containing 16 common questions were administered to each group. Responses were compared using Mann-Whitney U-test.

RESULTS

Responses were received from 400 medical students (response rate 26.7%) and 289 pharmacy pre-registrants (response rate 30.5%). Both groups scored poorly on the allowable bioequivalence limits when comparing a brand-name medicine with a generic medicine, with pharmacy pre-registrants scoring better (P < 0.001). Pharmacy pre-registrants were more likely (P < 0.001) to report having been introduced to bioequivalence during their courses, and less likely (P < 0.001) to desire more information on bioequivalence testing. Both groups correctly agreed that generic medicines are bioequivalent to corresponding brand-name medicines but not necessarily to each other, and that generic medicines are cheaper. Pharmacy pre-registrants were more aware that generic medicines must be in the same dosage form (P < 0.001) and contain the same dose (P < 0.001) as the comparator brand-name medicine. Both groups incorrectly believed that generic medicines are required to meet higher safety standards, are inferior in quality, are less effective and produce more side-effects. Both groups agreed that it is easier to recognise a drug's therapeutic class from its generic name and that they needed more information about the safety and efficacy of generic medicines, with medical students feeling more strongly about this (P < 0.001).

CONCLUSIONS

Although there were some differences in responses, both groups had knowledge deficits about the quality, safety and effectiveness of generic medicines, which need to be addressed by educators in order to increase the future use of generic medicines in Australia.