Patients’ perspectives on generic substitution among statin users in Japan
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The study was undertaken to reveal the differences in statin users’ characteristics, the views on generic drugs between brand-name statin users and generic statin users, and the factors associated with being generic statin users.
Subjects and methods
A questionnaire survey was conducted on patients visiting community pharmacies in order to have their prescriptions including statins dispensed. Respondents answered their views on the questionnaire items using a 5-point Likert-type scale, then answers were dichotomized. Odds ratios were calculated to analyze respondent’s views and respondents’ characteristics associated with being generic users.
In total, 122 patients agreed to participate in the survey; with regard to respondent’s views associated with being generic statin users, those agreeing “I have a concern in switching any currently taken drugs to generic drugs” were less likely to be generic statin users [OR (95% CI): 0.13, (0.05–0.35)]. Respondents agreeing “generic drugs are less expensive than brand-name drugs” were more likely to be generic users [4.55, (1.77–11.67)]. No respondent’s characteristics were associated with being generic statin users. The majority of respondents agreed “I don’t mind taking the generic drugs that my physician prescribe”. With regard to how much cost savings would encourage them to substitute, 1000–1999 Japanese Yen per pharmacy visit was most often indicated by the respondents.
A certain level of cost saving is necessary for patients to substitute. Physician-initiated substitution reduce patients’ concerns in switching. The introduction of a kind of policy to widen the price difference between brand-name drugs and generic drugs should be considered as one of the policy options.
KeywordsGeneric substitution Pharmaceutical policy Patient medication knowledge Questionnaire survey
The authors thank all of the patients who participated in the survey. The authors also thank the two pharmacies collaborating with our research.
This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.
Compliance with ethical standards
Conflict of interest
Eriko Kobayashi has no conflict of interest. Chiemi Abe has no conflict of interest. Nobunori Satoh has no conflict of interest.
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.
Patients’ consent to participate was indicated by returning the completed questionnaire.
- Alrasheedy AA, Hassali MA, Stewart K, Kong DCM, Aljadhey H, Ibrahim MIM, Al-Tamimi SK (2014) Patient knowledge, perceptions, and acceptance of generic medicines: a comprehensive review of the current literature. Patient Intelligence 6:1–29Google Scholar
- Degli Esposti L, Sangiorgi D, Buda S, Degli Esposti E, Scaglione F (2016) Therapy discontinuation or substitution in patients with cardiovascular disease, switching among different products of the same off-patent active substance: a ‘real-world’ retrospective cohort study. BMJ Open 6(11):e012003. https://doi.org/10.1136/bmjopen-2016-012003 CrossRefGoogle Scholar
- The Federal Reserve (2018) Foreign Exchange Rates - G.5A. January 11, 2018. https://www.federalreserve.gov/releases/g5a/current/ Accessed 29 Jul 2018
- Hoshi S, Kimura H (2008) Questionnaire on the awareness of generic drugs among outpatients and medical staff. Drug Discov Ther 2(3):194–199Google Scholar
- Inoue Y, Kmiya K, Odaka A, Noritake K, Kanamoto I, Higashi K, Moribe K, Yamamoto K (2008) Current status of diabetic and hypertensive patients prescribed by nonproprietary name in a small local hospital. Prog Med 28:2013–2019 [in Japanese]Google Scholar
- Li P, Schwartz JS, Doshi JA (2016) Impact of cost sharing on therapeutic substitution: the story of statins in 2006. J Am Heart Assoc 5(11)Google Scholar
- Mano Y, Fukushima S, Kuroda H, Ohshima H, Kato Y, Ohuchi K, Maezawa K, Momose Y, Ikeda S, Asahi M (2015) Adherence to changing from brand-name to generic atorvastatin in newly treated patients: a retrospective cohort study using health insurance claims. J Pharm Health Care Sci 1:12CrossRefGoogle Scholar
- Ministry of Health, Labour and Welfare. Japan (MHLW) (2011) The survey of cases of advanced initiatives for promoting the use of generic medicines. 2011. http://www.mhlw.go.jp/bunya/iryou/kouhatu-iyaku/dl/03_01.pdf Accessed 10 Jul 2017
- Ministry of Health, Labour and Welfare. Japan (MHLW) (2013) Roadmap for further promotion of the use of generic drugs. 2013 April. http://www.mhlw.go.jp/stf/houdou/2r9852000002z7fr.html Accessed 10 Jul 2017
- Ministry of Health, Labour and Welfare. Japan (MHLW) (2014a) Estimates of National Medical Care Expenditure, FY 2014. http://www.mhlw.go.jp/english/database/db-hss/dl/digest2014.pdf Accessed 10 Jul 2017
- Ministry of Health, Labour and Welfare. Japan (MHLW) (2014b) The result of Patient Survey 2014. http://www.mhlw.go.jp/toukei/saikin/hw/kanja/14/index.html Accessed 10 Jul 2017
- Ministry of Health, Labour and Welfare. Japan (MHLW) (2016) The Notice of Hohatsu 0210–01, on February 10th, 2016 of the director of Health Insurance Bureau, Ministry of Health, Labor and Welfare. “the reference of drug pricing”Google Scholar
- Ministry of Health, Labour and Welfare. Japan (MHLW) (2017a) Market share of generic medicines. 2017. http://www.mhlw.go.jp/file/06-Seisakujouhou-10800000-Iseikyoku/0000114903.pdf Accessed 10 Jul 2017
- Ministry of Health, Labour and Welfare. Japan (MHLW) (2017b) Promotion of the use of generic drugs. http://www.mhlw.go.jp/stf/seisakunitsuite/bunya/kenkou_iryou/iryou/kouhatu-iyaku/ Accessed 10 Jul 2017
- O’Brien EC, McCoy LA, Thomas L, Peterson ED, Wang TY (2015) Patient adherence to generic versus brand statin therapy after acute myocardial infarction: insights from the can rapid stratification of unstable angina patients suppress adverse outcomes with early implementation of the American College of Cardiology/American Heart Association guidelines registry. Am Heart J 170(1):55–61CrossRefGoogle Scholar
- Organisation for Economic Co-operation and Development (OECD) (2015) Share of generic market, in Health at a Glance 2015: OECD Indicators. OECD Publishing, Paris. https://doi.org/10.1787/health_glance-2015-69-enAccessed 10 Jul 2017
- Ramkumar S, Raghunath A, Raghunath S (2016) Statin therapy. Review of safety and potential side effects. Acta Cardiol Sin 32(6):631–639Google Scholar
- Rathe J, Andersen M, Jarbøl DE, dePont Christensen R, Hallas J, Søndergaard J (2015) Generic switching and non-persistence among medicine users: a combined population-based questionnaire and register study. PLoS One 10(3):e0119688. https://doi.org/10.1371/journal.pone.0119688. eCollection 2015CrossRefGoogle Scholar
- Salami JA, Warraich H, Valero-Elizondo J, Spatz ES, Desai NR, Rana JS, Virani SS, Blankstein R, Khera A, Blaha MJ, Blumenthal RS, Lloyd-Jones D, Nasir K (2017) National trends in statin use and expenditures in the US adult population from 2002 to 2013: insights from the medical expenditure panel survey. JAMA Cardiol 2(1):56–65CrossRefGoogle Scholar
- Sarpong EM, Zuvekas SH (2014) Trends in statin therapy among adults (age ≥ 18), United States, 2000 to 2011. Statistical brief #458. November 2014. Agency for Healthcare Research and Quality, Rockville MDGoogle Scholar
- Ude M, Schuessel K, Quinzler R, Leuner K, Müller WE, Schulz M (2011) Generic switch after ramipril patent expiry is not associated with decreased pharmacy refill compliance: a retrospective study using the DAPI database. J Hypertens 29(9):1837–1845. https://doi.org/10.1097/HJH.0b013e32834942be CrossRefGoogle Scholar