Skip to main content
Log in

Patient Perceptions of Generic Medicines: A Mixed-Methods Study

  • Original Research Article
  • Published:
The Patient - Patient-Centered Outcomes Research Aims and scope Submit manuscript



In an attempt to benefit from the cost-savings associated with use of generic medicines, in June 2013 Ireland introduced generic substitution and reference pricing for the first time. However, perceptions of Irish patients towards generic medicines have not been published previously. Therefore, the objective of this study was to assess how generic medicines were perceived amongst patients in the time leading up to the enactment of the new legislation.


A total of 42 patients were recruited from general practices affiliated with the Graduate Entry Medical School at the University of Limerick and from community pharmacies. Interviews were semi-structured and included quantitative assessments of opinions using 15 structured questions and a five-point Likert scale response system. Interview transcripts were coded and thematically analysed using NVivo (version 9), for qualitative data. Quantitative data were analysed using SPSS (version 20).


Nearly one-third (31 %) of patients had no knowledge of generic medicines and 39 % of those exhibited confusion between the words ‘generic’ and ‘genetic’. Almost one-quarter (24 %) held the view that generics were of poorer quality than originators, while 18 % expressed the opinion that generics do not work as well as originator products. Approximately one-third (30 %) of patients believed that generics were manufactured to a poorer quality, with 29 % holding the view that generics are less expensive due to being of inferior quality. Nearly 90 % of patients stated they would take a generic medicine if it were prescribed by their GP; however, 24 % of patients stated a preference, if offered a choice, for the originator medication. Additionally, a majority of patients (86 %) were in favour of reference pricing and generic substitution. Of the patients interviewed, 50 % stated that a leaflet, or similar, with appropriate, understandable, and accessible information regarding generic medicines would be of use to them.


This is the first study of patients’ attitudes towards generic medicines in Ireland. Conducted in the time period leading up to the implementation of legislation promoting the use of generic medicines, it highlights variable knowledge about generic medicines among this key stakeholder group. Although patients are supportive of their more widespread use, concerns regarding safety, clinical effectiveness, and manufacturing quality of generic medicines were identified.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others


  1. Generic substitution is the substitution of an equivalent, non-branded, medicine for a prescribed branded (usually, proprietary) medication, which generally happens at pharmacy level.

  2. A reference price is the price that will be reimbursed by the State for a medicine (in a group of designated interchangeable medicines). Where a patient chooses not to receive a reference priced medicine, the patient must pay any difference between the reference price and the price of the chosen medication. This additional payment is known as a co-payment.


  1. Health (Pricing and Supply of Medical Goods) Act 2013.

  2. Dunne S, Shannon B, Dunne C, Cullen W. A review of the differences and similarities between generic drugs and their originator counterparts, including economic benefits associated with usage of generic medicines, using Ireland as a case study. BMC Pharmacol Toxicol. 2013;14(1):1.

    Article  PubMed Central  PubMed  Google Scholar 

  3. Wettermark B, Godman B, Andersson K, Gustafsson LL, Haycox A, Bertele V. Recent national and regional drug reforms in Sweden: implications for pharmaceutical companies in Europe. Pharmacoeconomics. 2008;26(7):537–50.

    Article  PubMed  Google Scholar 

  4. Timonen J, Bengtstrom M, Karttunen P, Ahonen R. The impact of generic substitution on the activities of pharmaceutical companies - a survey from the companies’ perspective one year and five years after the introduction of generic substitution in Finland. BMC Clin Pharmacol. 2010;10:15.

    Article  PubMed Central  PubMed  Google Scholar 

  5. Posner J, Griffin JP. Generic substitution. Br J Clin Pharmacol. 2011;72(5):731–2.

    Article  PubMed Central  PubMed  Google Scholar 

  6. Ireland: Pharmaceutical Prices, Prescribing Practices and Usage of Generics in a Comparative Context.

  7. Al Ameri MN, Mohamed W, Makramalla E, Shalhoub B, Tucker A, Johnston A. Renal patients’ views on generic prescribing and substitution: example from the United Arab Emirates. East Mediterr Health J. 2013;19(4):373–81.

    CAS  PubMed  Google Scholar 

  8. Allenet B, Golay A. What are patients’ attitudes towards generic drugs? The example of metformin. Rev Med Suisse. 2013;9(385):1005–9.

    PubMed  Google Scholar 

  9. Babar ZU, Stewart J, Reddy S, Alzaher W, Vareed P, Yacoub N, Dhroptee B, Rew A. An evaluation of consumers’ knowledge, perceptions and attitudes regarding generic medicines in Auckland. Pharm World Sci. 2010;32(4):440–8.

    Article  PubMed  Google Scholar 

  10. Gonzalez Hernando S, Gonzalez Mieres C, Diaz Martin AM. Intention of purchasing generic prescription drugs on the part of consumers in Asturias. Spain. Rev Esp Salud Publica. 2003;77(6):691–9.

    Google Scholar 

  11. Hakonsen H, Eilertsen M, Borge H, Toverud EL. Generic substitution: additional challenge for adherence in hypertensive patients? Curr Med Res Opin. 2009;25(10):2515–21.

    Article  PubMed  Google Scholar 

  12. Hakonsen H, Toverud EL. Special challenges for drug adherence following generic substitution in Pakistani immigrants living in Norway. Eur J Clin Pharmacol. 2011;67(2):193–201.

    Article  PubMed Central  PubMed  Google Scholar 

  13. Halme M, Linden K, Kaaria K. Patients’ preferences for generic and branded over-the-counter medicines: an adaptive conjoint analysis approach. Patient. 2009;2(4):243–55.

    Article  PubMed  Google Scholar 

  14. Himmel W, Simmenroth-Nayda A, Niebling W, Ledig T, Jansen RD, Kochen MM, Gleiter CH, Hummers-Pradier E. What do primary care patients think about generic drugs? Int J Clin Pharmacol Ther. 2005;43(10):472–9.

    Article  CAS  PubMed  Google Scholar 

  15. Keenum AJ, Devoe JE, Chisolm DJ, Wallace LS. Generic medications for you, but brand-name medications for me. Res Social Adm Pharm. 2012;8(6):574–8.

    Article  PubMed  Google Scholar 

  16. Kobayashi E, Karigome H, Sakurada T, Satoh N, Ueda S. Patients’ attitudes towards generic drug substitution in Japan. Health Policy. 2011;99(1):60–5.

    Article  PubMed  Google Scholar 

  17. Lagarce L, Lusson-Brisset C, Bruhat C, Diquet B, Laine-Cessac P. How practitioners view generic drugs: an opinion study from general practitioners in Maine-et-Loire (France). Therapie. 2005;60(1):67–74.

    Article  PubMed  Google Scholar 

  18. Papsdorf TB, Ablah E, Ram S, Sadler T, Liow K. Patient perception of generic antiepileptic drugs in the Midwestern United States. Epilepsy Behav. 2009;14(1):150–3.

    Article  PubMed  Google Scholar 

  19. Patel A, Gauld R, Norris P, Rades T. “This body does not want free medicines”: South African consumer perceptions of drug quality. Health Policy Plan. 2010;25(1):61–9.

    Article  PubMed  Google Scholar 

  20. Quintal C, Mendes P. Underuse of generic medicines in Portugal: an empirical study on the perceptions and attitudes of patients and pharmacists. Health Policy. 2012;104(1):61–8.

    Article  PubMed  Google Scholar 

  21. Ringuier R, Rouquette A, Dagorne C, Garnier F, Fanello S. Fifty years old and more patients’ attitudes towards and experiences of generic substitution of prescription medicines. Therapie. 2008;63(1):11–7.

    Article  PubMed  Google Scholar 

  22. Roman B. Patients’ attitudes towards generic substitution of oral atypical antipsychotics: a questionnaire-based survey in a hypothetical pharmacy setting. CNS Drugs. 2009;23(8):693–701.

    Article  PubMed  Google Scholar 

  23. Sarradon-Eck A, Blanc MA, Faure M. Users sceptical about generic drugs: an anthropological approach. Rev Epidemiol Sante Publique. 2007;55(3):179–85.

    Article  CAS  PubMed  Google Scholar 

  24. Sharrad AK, Hassali MA. Consumer perception on generic medicines in Basrah, Iraq: preliminary findings from a qualitative study. Res Social Adm Pharm. 2011;7(1):108–12.

    Article  PubMed  Google Scholar 

  25. Murphy MB: Review of indicative drug target savings scheme. In: Review of indicative drug target savings scheme. Lenus website: Health Service Executive; 1997.

  26. Delivery of Pharmaceuticals in Ireland—Getting a Bigger Bang for the Buck.

  27. Power C, O’Connor R, Dunne S, Finucane P, Cullen W, Dunne C. An evidence-based assessment of primary care needs in an economically deprived urban community. Ir J Med Sci. 2013;182(3):457–61.

    Article  CAS  PubMed  Google Scholar 

  28. Proposed Model for Reference Pricing and Generic Substitution. Archived at:

  29. Likert R: A technique for the measurement of attitudes. Arch Psychol. 1932;140:5–55.

    Google Scholar 

  30. Kjoenniksen I, Lindbaek M, Granas AG. Patients’ attitudes towards and experiences of generic drug substitution in Norway. Pharm World Sci. 2006;28(5):284–9.

    Article  PubMed  Google Scholar 

  31. Patel A, Gauld R, Norris P, Rades T. Quality of generic medicines in South Africa: perceptions versus reality—a qualitative study. BMC Health Serv Res. 2012;12:297.

    Article  PubMed Central  PubMed  Google Scholar 

  32. McAuley JW, Chen AY, Elliott JO, Shneker BF. An assessment of patient and pharmacist knowledge of and attitudes toward reporting adverse drug events due to formulation switching in patients with epilepsy. Epilepsy Behav. 2009;14(1):113–7.

    Article  PubMed  Google Scholar 

  33. Omojasola A, Gor B, Jones L. Perceptions of generic drug discount programs among low-income women: a qualitative study. Womens Health Issues. 2013;23(1):e55–60.

    Article  PubMed  Google Scholar 

  34. Sewell K, Andreae S, Luke E, Safford MM. Perceptions of and barriers to use of generic medications in a rural African American population, Alabama, 2011. Prev Chronic Dis. 2012;9:E142.

    Article  PubMed Central  PubMed  Google Scholar 

  35. Cené CDDA. Left behind: ensuring clarity and completeness of our educational materials and messages. JAMA Intern Med. 2013;173(7):583–4.

    Article  PubMed  Google Scholar 

  36. Dunne S, Cummins N, Hannigan A, Shannon B, Dunne C, Cullen W. A method for the design and development of medical or health care information websites to optimize search engine results page rankings on Google. J Med Internet Res. 2013;15(8):e183.

    Google Scholar 

  37. Heikkila R, Mantyselka P, Ahonen R. Do people regard cheaper medicines effective? Population survey on public opinion of generic substitution in Finland. Pharmacoepidemiol Drug Saf. 2011;20(2):185–91.

    Article  PubMed  Google Scholar 

  38. Shrank WH, Cadarette SM, Cox E, Fischer MA, Mehta J, Brookhart AM, Avorn J, Choudhry NK. Is there a relationship between patient beliefs or communication about generic drugs and medication utilization? Med Care. 2009;47(3):319–25.

    Article  PubMed Central  PubMed  Google Scholar 

  39. Mumoli N, Cei M, Luschi R, Carmignani G, Camaiti A. Allergic reaction to Croscarmellose sodium used as excipient of a generic drug. QJM. 2011;104(8):709–10.

    Article  CAS  PubMed  Google Scholar 

  40. Coloe J, Zirwas MJ. Allergens in corticosteroid vehicles. Dermatitis. 2008;19(1):38–42.

    PubMed  Google Scholar 

  41. Elwood SA, Martin DG. “Placing” interviews: location and scales of power in qualitative research. Prof Geogr. 2000;52(4):649–57.

    Article  Google Scholar 

  42. Schönfelder W. CAQDAS and qualitative syllogism logic—NVivo 8 and MAXQDA 10 compared. Forum: Qualitative Soc. Res. 2011;12(1): Article 21.

    Google Scholar 

  43. Timonen J, Heikkilä R, Ahonen R. Generic substitution in Finland: lessons learned during 2003–2008. J Pharm Health Serv Res. 2013;4(3):165–72.

    Article  Google Scholar 

Download references


This work was supported in part by a scholarship from the Faculty of Education and Health Sciences, University of Limerick, Ireland.

The authors wish to express their sincere thanks to all of the patients who took part in the interviews and also to the individual GPs and pharmacists who permitted patients to be recruited from their practices or pharmacies.

The authors each declare that they do not have any conflicts of interest.

SD designed the study and carried out the interviews and data analysis. SD was the primary author of the manuscript.

BS approved the design of the study and provided critical review of the manuscript.

CD approved the design of the study and provided critical review of the manuscript and is the overall guarantor.

WC approved the design of the study and provided critical review of the manuscript.

Author information

Authors and Affiliations


Corresponding author

Correspondence to Suzanne Dunne.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Dunne, S., Shannon, B., Dunne, C. et al. Patient Perceptions of Generic Medicines: A Mixed-Methods Study. Patient 7, 177–185 (2014).

Download citation

  • Published:

  • Issue Date:

  • DOI: