Patient knowledge, perceptions, and acceptance of generic medicines: a comprehensive review of the current literature

Abstract

Patient knowledge, perceptions, and acceptance of generic medicines: a comprehensive review of the current literature Alian A Alrasheedy,1 Mohamed Azmi Hassali,1 Kay Stewart,2 David CM Kong,2 Hisham Aljadhey,3 Mohamed Izham Mohamed Ibrahim,4 Saleh Karamah Al-Tamimi1 1Discipline of Social and Administrative Pharmacy, School of Pharmaceutical Sciences, Universiti Sains Malaysia, Penang, Malaysia; 2Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, Melbourne, VIC, Australia; 3Medication Safety Research Chair, Clinical Pharmacy Department, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia; 4College of Pharmacy, Qatar University, Doha, Qatar Background: Generic medicines have the same quality, safety, and efficacy as their counterpart original brand medicines. Generic medicines provide the same therapeutic outcomes but at a much cheaper cost, so are promoted in many countries to contain pharmaceutical expenditure and sustain the health care system. Thus, the perspective of patients and medicine consumers as end users of these medicines is an important factor to enhance the use and utilization of generic medicines. The objective of this paper is to review patients’ and consumers’ knowledge, perceptions, acceptance, and views of generic medicines in the current literature. Methods: An extensive literature search was performed in several databases, namely Scopus, PubMed, ISI Web of Knowledge, Proquest, and the Wiley online library, to identify relevant studies published in the English literature for the period 1990–2013. Results: A total of 53 studies were included in the review, comprising 24 studies from Europe, ten from North America, six from Asia, five from Australia and New Zealand, five from the Middle East, one from Africa, one from Latin America, and one from the Caribbean region. A large body of literature has reported misconceptions and negative perceptions about generic medicines on the part of patients and medicine consumers. Moreover, although it is reported in almost all countries, the percentage of consumers who had such misconceptions varied from one country to another. However, in many countries, there was a meaningful percentage of patients who had negative perceptions and misconceptions about generic medicines. Moreover, such misconceptions and negative perceptions were reported as major obstacles to the use and acceptance of generic medicines among patients. Further, studies that focused on specific populations (eg, patients with epilepsy, psychosis, or renal disease) reported a more negative perception and more resistance to the use of generic medicines. The type of medical condition and its level of seriousness or severity, recommendations by health care professionals, price difference (ie, cost saving), previous experience of generic medicines, and knowledge/information about generic medicines were considered to be important factors that affect a patient’s decision to use a generic medicine or a brand medicine. Conclusion: The results from this literature search show that patients and medicine consumers tend to prefer original brand medicines over generic medicines. Further, in many countries, there is still a considerable proportion of patients and consumers who lack adequate knowledge or have insufficient information about generic medicines. Thus, there is a need for educational interventions and activities to educate patients about generic medicines. It is also evident in the literature that health care professionals (physicians and pharmacists) play a key role in the promotion of generic medicines and in patients’ acceptance of generic medicines and generic substitution. Hence, health care professionals need to play a more active role by educating patients and recommending generic medicines to their patients. Keywords: patients, generic substitution, perceptions, policy