Étude prospective des facteurs associés à l’acceptation de la substitution des génériques par les patients et leurs médecins libéraux

Abstract

BackgroundMany prescribers and patients remain reluctant to substitution to generics. MethodsWe conducted a prospective observational study, using semi-structured interviews adapted to identify factors independently associated with the acceptance of alternative to a generic drug by doctors and patients. ResultsBetween December 2014 and August 2015, 108 patients and 73 private doctors from Île-de-France and Nord-Pas-de-Calais were enrolled. Only 48 % of patients thought that the effectiveness and safety of generic were identical to the brand-name, 50 % had a favorable opinion and 36 % said they routinely accept substitution, especially when substitution was proposed by the general practitioner (68 % of patients). Age, gender, occupational status and the presence of a chronic condition were not associated to acceptance of substitution (P>0, 1), unlike the opinion (P<0.001), perception of efficacy (P<0.001) and side effects (P=0.0005). Two thirds of physicians substituted more than 50 % of their brand name prescription to generics. This low figure was due to patient request not to substitute (63.9 %). ConclusionThe acceptance of substitution was independently associated to patient’ opinion about generic drugs, further emphasizing the need for information campaigns dedicated to patients.