Abstract
Aim
The aim of this study was to evaluate Japanese community pharmacists’ attitudes toward and their recommendation of generic substitution, and to identify the barriers towards performing generic substitution.
Subject and methods
A questionnaire survey was conducted from June 2007 to December 2008. A total of 1,590 community pharmacists working for 449 community pharmacies whose owners agreed to participate in the study were involved in the study.
Results
A total of 1,253 community pharmacists responded to the survey (response rate: 78.8%). The majority of respondents (72.1%) were in favor of dispensing generic medicine, but they agreed that they would carefully decide if it is appropriate. In spite of these favorable attitudes, more than half of the respondents (55.6%) seldom or never recommend generic substitution to patients. Respondents indicated four barriers preventing them from performing generic substitution: (1) the generic drug is not in stock or no generic drug equivalent is available yet in the market, (2) only a very small cost savings resulting in patients’ objections, (3) physicians’ objections and (4) presence of skepticism in the quality of generic medicines and inadequate drug information from generic manufacturers
Conclusion
It is not common for Japanese community pharmacists to recommend generic substitution to patients in spite of their positive attitudes towards generic substitution. Prospective policies on generic substitution are needed to overcome the barriers identified in this study, preventing community pharmacists from performing generic substitutions.
Similar content being viewed by others
References
Al-Gedadi NA, Hassali MA (2008) Pharmacists’ views on generic medicines: a review of the literature. J Generic Med 5(3):209–218
Allenet B, Barry H (2003) Opinion and behaviour of pharmacists towards the substitution of branded drugs by generic drugs: survey of 1,000 French community pharmacists. Pharm World Sci 25(5):197–202
Andersson K, Sonesson C, Petzold M, Carlsten A, Lönnroth K (2005) What are the obstacles to generic substitution? An assessment of the behaviour of prescribers, patients and pharmacies during the first year of generic substitution in Sweden. Pharmacoepidemiol Drug Saf 14(5):341–348
Beecroft G (2007) Generic drug policy in Australia: a community pharmacy perspective. Aust New Zealand Health Policy 1:4–7
Chong CP, Hassali MA, Bahari MB, Shafie AA (2010a) Evaluating community pharmacists’ perceptions of future generic substitution policy implementation: a national survey from Malaysia. Health Policy 94(1):68–75
Chong CP, Hassali MA, Bahari MB, Shafie AA (2010b) Generic medicine substitution practices among community pharmacists: a nationwide study from Malaysia. J Public Health. doi:10.1007/s10389-010-0349-3
European Generic Medicines Association (2007) Market Review 2007. EGMA, Brussels, Belgium
Ganther JM, Kreling DH (2000) Consumer perceptions of risk and required cost savings for generic prescription drugs. J Am Pharm Assoc Wash 40(3):378–383
Hassali MA, Kong DCM, Kay S (2005) Generic medicines: perceptions of consumers in Melbourne, Australia. Int J Pharm Practice 13(4):257–264
Hassali MA, Kong DC, Steward K (2006) Generic medicines: perceptions of community pharmacists in Melbourne, Australia. J Pharm Din Econom Policy 14(3):27–45
Hassali MA, Shafie AA, Awaisu A, Ibrahim MI, Chong CP, Jamshed S (2010) Physicians’ views on generic medicines: a narrative review. J Generic Med 7:30–39
Heikkilä R, Mäntyselkä P, Hartikainen-Herranen K, Ahonen R (2007) Customers’ and physicians’ opinions of and experiences with generic substitution during the first year in Finland. Health Policy 82(3):366–374
Himmel W, Simmenroth-Nayda A, Niebling W, Ledig T, Jansen RD, Kochen MM, Gleiter CH, Hummers-Pradier E (2005) What do primary care patients think about generic drugs? Int J Clin Pharmacol Ther 43(10):472–479
Iosifescu A, Halm EA, McGinn T, Siu AL, Federman AD (2008) Beliefs about generic drugs among elderly adults in hospital-based primary care practices. Patient Educ Couns 73(2):377–383
Kersnik J, Peklar J (2006) Attitudes of Slovene general practitioners towards generic drug prescribing and comparison with international studies. J Clin Pharm Ther 31(6):577–583
Kjoenniksen I, Lindbaek M, Granas AG (2006) Patients’ attitudes towards and experiences of generic drug substitution in Norway. Pharm World Sci 28:284–289
Kobayashi E, Karigome H, Sakurada T, Satoh N, Ueda S (2010) Patients’ attitudes towards generic drug substitution in Japan. Health Policy. doi:10.1016/j.healthpol.2010.07.006
Ministry of Finance (2007) Cost of pharmaceuticals. MOF web. http://www.mof.go.jp/singikai/zaiseseido/siryou/zaiseib190516/02-2c.pdf. Cited 31 August 2010
Ministry of Health, Labour and Welfare (2007) Notification no. 0401001 of pharmaceutical and food safety bureau date on 1st April 2007. MHLW, Tokyo
Ministry of Health, Labour and Welfare (2009a) Medical Insurance System in Japan. MHLW, Tokyo. http://www.mhlw.go.jp/bunya/iryouhoken/iryouhoken01/01.html. Cited 31 August 2010
Ministry of Health, Labour and Welfare (2009b) The survey on generic drug use. MHLW, Tokyo. http://www.mhlw.go.jp/bunya/iryou/kouhatu-iyaku/dl/35.pdf. Cited 31 August 2010
Ministry of Health, Labor and Welfare (2010) Drug Pricing System. MHLW, Tokyo. http://www.mhlw.go.jp/shingi/2010/06/dl/s0623-2b.pdf. Cited 31 August 2010
OECD (Organization for Economic Co-operation and Development) (2010) OECD Health Data 2010. OECD, Paris
Segal R, Wantz DL, Brusadin RA (1989) Pharmacists’ decision making in the selection of generic pharmaceuticals. J Pharm Mark Manage 4(1):75–91
Sheppard A (2010) Generic medicines: essential contributors to the long-term health of society. IMS Health, Norwalk, CT. http://www.imshealth.com/imshealth/Global/Content/Document/Market_Measurement_TL/Generic_Medicines_GA.pdf#search=IMS%20Health%20MIDAS%20Market%20Segmentation%20unprotected%20market. Cited 18 November 2010
Shrank WH, Cox ER, Fischer MA, Mehta J, Choudhry NK (2009) Patients’ perceptions of generic medications. Health Affairs 28(2):546–556
Simoens S, De Coster S (2006) Sustaining Generic Medicines Markets in Europe. PhD Thesis, Katholieke Univerisiteit Leuven, The Netherlands
Suh DC (1999) Trends of generic substitution in community pharmacies. Pharm World Sci 21(6):260–265
Williams AE, Chrystyn H (2007) Survey of pharmacists’ attitudes towards interchangeable use of dry powder inhalers. Pharm World Sci 29(3):221–227
Acknowledgements
The authors wish to thank all of the community pharmacists who participated in the survey. We also thank Ms. Yurika Yano and Mr. Yasutomo Morimoto (Graduate School of Pharmaceutical Sciences, Chiba University) for their contribution to the survey.
Conflict of interest
The authors declare that they have no conflict of interest.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Kobayashi, E., Satoh, N. & Ueda, S. Community pharmacists’ perspectives on generic substitution in Japan. J Public Health 19, 249–256 (2011). https://doi.org/10.1007/s10389-011-0393-7
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10389-011-0393-7