Advertisement

The Patient - Patient-Centered Outcomes Research

, Volume 9, Issue 6, pp 499–510 | Cite as

What Do Users of Generic Medicines Think of Them? A Systematic Review of Consumers’ and Patients’ Perceptions of, and Experiences with, Generic Medicines

  • Suzanne S. DunneEmail author
Systematic Review

Abstract

Background and Objective

Considerable emphasis is placed on the use of generic medicines because of the potential economic benefits associated with their use. The objective of this systematic review is to compile and collate published research regarding patient/consumer perceptions and attitudes in relation to generic medicines, aiming to describe such views and detail patient experiences with generic medicines.

Methods

Literature published between 2005 and July 2015, indexed in PubMed, Scopus and EMBASE, on the topic of consumer or patient opinions of generic medicines were collated, using systematic searches, and appraised.

Results

A total of 59 papers were reviewed. Familiarity and trust in brand names appears to be a substantial barrier to the increased use of generics, with patients also appearing to hold the view that if a product is cheaper, then it must not be as good. Some publications report positive views of generics, with positively inclined consumers stating that they did not perceive any difference between a generic and the proprietary medicine. Acceptance of generics appears to be higher in consumers with higher levels of education while patients from lower socioeconomic demographic groups tend to have greater mistrust of generics.

Conclusions

The provision of information to consumers that dispels myths about generics may improve confidence in generic medicines. As patients demonstrate a high degree of trust in physicians, their opinions can impact on patient/consumer opinions. Therefore, enhancing the perceptions of generics held by physicians is likely to have a positive impact on patient/consumer opinions of, and trust in, generic medications.

Keywords

Generic Medication Generic Medicine Generic Drug MeSH Term Generic Substitution 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Notes

Compliance with Ethical Standards

The author declares that there is no conflict of interest. No funding was received to perform this study.

References

  1. 1.
    World Health Organisation. Generic drugs. Available from http://www.who.int/trade/glossary/story034/en/index.html. Accessed 26 Apr 2016.
  2. 2.
    European Medicines Agency. EMA Q&A on generic medicine. Available from: http://www.ema.europa.eu/docs/en_GB/document_library/Medicine_QA/2009/11/WC500012382.pdf. Accessed 26 Apr 2016.
  3. 3.
    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.CrossRefPubMedPubMedCentralGoogle Scholar
  4. 4.
    World Health Organisation. WHO drug information volume 28, No. 1, 2014. Available from: http://www.who.int/medicines/publications/druginformation/issues/DrugInformation2014_Vol28-1/en/. Accessed 21 June 2015.
  5. 5.
    OECD. What Future for Health Spending? In: OECD Economics Department policy notes, No. 19. . 2013. Available from: http://www.oecd.org/economy/health-spending.pdf. Accessed 21 June 2015.
  6. 6.
    Dunne SS, Dunne CP. What do people really think of generic medicines? A systematic review and critical appraisal of literature on stakeholder perceptions of generic drugs. BMC Med. 2015;13:173. doi: 10.1186/s12916-015-0415-3.CrossRefPubMedPubMedCentralGoogle Scholar
  7. 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. Eastern Med Health J. 2013;19(4):373–81.Google Scholar
  8. 8.
    Al Ameri MN, Whittaker C, Tucker A, Yaqoob M, Johnston A. A survey to determine the views of renal transplant patients on generic substitution in the UK. Transplant Int. 2011;24(8):770–9. doi: 10.1111/j.1432-2277.2011.01268.x.CrossRefGoogle Scholar
  9. 9.
    Al-Gedadi NA, Hassali MA, Shafie AA. A pilot survey on perceptions and knowledge of generic medicines among consumers in Penang, Malaysia. Pharm Pract (Granada). 2008;6(2):93–7.CrossRefGoogle Scholar
  10. 10.
    Babar ZU, Stewart J, Reddy S, Alzaher W, Vareed P, Yacoub N, et al. An evaluation of consumers’ knowledge, perceptions and attitudes regarding generic medicines in Auckland. Pharmacy World Sci. 2010;32(4):440–8. doi: 10.1007/s11096-010-9402-0.CrossRefGoogle Scholar
  11. 11.
    Berg MJ, Gross RA, Haskins LS, Zingaro WM, Tomaszewski KJ. Generic substitution in the treatment of epilepsy: patient and physician perceptions. Epilepsy Behav. 2008;13(4):693–9. doi: 10.1016/j.yebeh.2008.06.001.CrossRefPubMedGoogle Scholar
  12. 12.
    Bertoldi AD, Barros AJ, Hallal PC. Generic drugs in Brazil: known by many, used by few. Cad Saude Publica. 2005;21(6):1808–15.CrossRefPubMedGoogle Scholar
  13. 13.
    Bulsara C, McKenzie A, Sanfilippo F, Holman CD, Emery JE. ‘Not the full Monty’: a qualitative study of seniors’ perceptions of generic medicines in Western Australia. Aust J Primary Health. 2010;16(3):240–5. doi: 10.1071/py10006.CrossRefGoogle Scholar
  14. 14.
    Chong CP, March G, Clark A, Gilbert A, Hassali MA, Bahari MB. A nationwide study on generic medicines substitution practices of Australian community pharmacists and patient acceptance. Health Policy. 2011;99(2):139–48. doi: 10.1016/j.healthpol.2010.08.002.CrossRefPubMedGoogle Scholar
  15. 15.
    Choudhry NK, Cox E, Fischer MA, Mehta J, Shrank WH. Setting prices for generic medications: a survey of patients perceptions. Am J Pharm Benefits. 2010;2(1):33–8.Google Scholar
  16. 16.
    Costa-Font J, Rudisill C, Tan S. Brand loyalty, patients and limited generic medicines uptake. Health Policy. 2014;116(2–3):224–33. doi: 10.1016/j.healthpol.2014.01.015.CrossRefPubMedGoogle Scholar
  17. 17.
    Drozdowska A, Hermanowski T. Exploring the opinions and experiences of patients with generic substitution: a representative study of Polish society. Int J Clin Pharm. 2015;37(1):68–75. doi: 10.1007/s11096-014-0041-8.CrossRefPubMedGoogle Scholar
  18. 18.
    Dunne S, Shannon B, Dunne C, Cullen W. Patient perceptions of generic medicines: a mixed-methods study. Patient. 2014;7(2):177–85. doi: 10.1007/s40271-013-0042-z.CrossRefPubMedGoogle Scholar
  19. 19.
    El-Dahiyat F, Kayyali R. Evaluating patients’ perceptions regarding generic medicines in Jordan. J Pharm Policy Pract. 2013;6:3. doi: 10.1186/2052-3211-6-3.CrossRefPubMedPubMedCentralGoogle Scholar
  20. 20.
    Figueiras MJ, Alves NC, Marcelino D, Cortes MA, Weinman J, Horne R. Assessing lay beliefs about generic medicines: development of the generic medicines scale. Psychol Health Med. 2009;14(3):311–21. doi: 10.1080/13548500802613043.CrossRefPubMedGoogle Scholar
  21. 21.
    Figueiras MJ, Marcelino D, Cortes MA. People’s views on the level of agreement of generic medicines for different illnesses. Pharm World Sci. 2008;30(5):590–4. doi: 10.1007/s11096-008-9247-y.CrossRefPubMedGoogle Scholar
  22. 22.
    Fraeyman J, Peeters L, Van Hal G, Beutels P, De Meyer GR, De Loof H. Consumer choice between common generic and brand medicines in a country with a small generic market. J Manag Care Spec Pharm. 2015;21(4):288–96.CrossRefPubMedGoogle Scholar
  23. 23.
    Frisk P, Rydberg T, Carlsten A, Ekedahl A. Patients’ experiences with generic substitution: a Swedish pharmacy survey. J Pharm Health Serv Res. 2011;2(1):9–15. doi: 10.1111/j.1759-8893.2011.00036.x.CrossRefGoogle Scholar
  24. 24.
    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. doi: 10.1185/03007990903192223.CrossRefPubMedGoogle Scholar
  25. 25.
    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. doi: 10.1007/s00228-010-0960-9.CrossRefPubMedGoogle Scholar
  26. 26.
    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. doi: 10.2165/11314130-000000000-00000.CrossRefPubMedGoogle Scholar
  27. 27.
    Hassali MA, Kong DCM, Stewart K. Generic medicines: perceptions of consumers in Melbourne, Australia. Int J Pharm Pract. 2005;13(4):257–64. doi: 10.1211/ijpp.13.4.0004.CrossRefGoogle Scholar
  28. 28.
    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. doi: 10.1002/pds.2084.CrossRefPubMedGoogle Scholar
  29. 29.
    Heikkilä R, Mäntyselkä P, Ahonen R. Why people refuse generic substitution: a population survey of public opinion on generic substitution in Finland. Drugs Ther Perspect. 2012;28(8):24–6.Google Scholar
  30. 30.
    Heikkilä R, Mäntyselkä P, Hartikainen-Herranen K, Ahonen R. Customers’ and physicians’ opinions of and experiences with generic substitution during the first year in Finland. Health Policy. 2007;82(3):366–74. doi: 10.1016/j.healthpol.2006.10.006.CrossRefPubMedGoogle Scholar
  31. 31.
    Hensler K, Uhlmann C, Porschen T, Benecke R, Rösche J. Generic substitution of antiepileptic drugs: a survey of patients’ perspectives in Germany and other German-speaking countries. Epilepsy Behav. 2013;27(1):135–9. doi: 10.1016/j.yebeh.2012.12.029.CrossRefPubMedGoogle Scholar
  32. 32.
    Himmel W, Simmenroth-Nayda A, Niebling W, Ledig T, Jansen RD, Kochen MM, et al. What do primary care patients think about generic drugs? Int J Clin Pharmacol Ther. 2005;43(10):472–9.CrossRefPubMedGoogle Scholar
  33. 33.
    Hulbert AL, Pilch NA, Taber DJ, Chavin KD, Baliga PK. Generic immunosuppression: deciphering the message our patients are receiving. Ann Pharmacother. 2012;46(5):671–7. doi: 10.1345/aph.1R028.CrossRefPubMedGoogle Scholar
  34. 34.
    Ibrahim R, McKinnon RA, Ngo SNT. Knowledge and perceptions of community patients about generic medicines. J Pharm Pract Res. 2012;42(4):283–6. doi: 10.1002/j.2055-2335.2012.tb00189.x.CrossRefGoogle Scholar
  35. 35.
    Iosifescu A, Halm EA, McGinn T, Siu AL, Federman AD. Beliefs about generic drugs among elderly adults in hospital-based primary care practices. Patient Educ Couns. 2008;73(2):377–83. doi: 10.1016/j.pec.2008.07.012.CrossRefPubMedPubMedCentralGoogle Scholar
  36. 36.
    Jacomet C, Allavena C, Peyrol F, Pereira B, Joubert LM, Bagheri H, et al. Perception of antiretroviral generic medicines: one-day survey of HIV-infected patients and their physicians in France. PloS One. 2015;10(2):e0117214. doi: 10.1371/journal.pone.0117214.CrossRefPubMedPubMedCentralGoogle Scholar
  37. 37.
    Keenum AJ, Devoe JE, Chisolm DJ, Wallace LS. Generic medications for you, but brand-name medications for me. Res Social Admin Pharm. 2012;8(6):574–8. doi: 10.1016/j.sapharm.2011.12.004.CrossRefGoogle Scholar
  38. 38.
    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. doi: 10.1007/s11096-006-9043-5.CrossRefPubMedGoogle Scholar
  39. 39.
    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. doi: 10.1016/j.healthpol.2010.07.006.CrossRefPubMedGoogle Scholar
  40. 40.
    Kohli E, Buller A. Factors influencing consumer purchasing patterns of generic versus brand name over-the-counter drugs. Southern Med J. 2013;106(2):155–60. doi: 10.1097/SMJ.0b013e3182804c58.CrossRefPubMedGoogle Scholar
  41. 41.
    Lebanova H, Manolov D, Getov I. Patients’ attitude about generics: Bulgarian perspective. Marmara Pharm J. 2012;16:36–40. doi: 10.12991/201216418.CrossRefGoogle Scholar
  42. 42.
    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. doi: 10.1016/j.yebeh.2008.08.009.CrossRefPubMedGoogle Scholar
  43. 43.
    Ngo SN, Stupans I, McKinnon RA. Generic substitution in the treatment of epilepsy: patient attitudes and perceptions. Epilepsy Behav. 2013;26(1):64–6. doi: 10.1016/j.yebeh.2012.10.032.CrossRefPubMedGoogle Scholar
  44. 44.
    Omojasola A, Gor B, Jones L. Perceptions of generic drug discount programs among low-income women: a qualitative study. Women Health Issues. 2013;23(1):e55–60. doi: 10.1016/j.whi.2012.10.002.CrossRefGoogle Scholar
  45. 45.
    Omojasola A, Hernandez M, Sansgiry S, Jones L. Perception of generic prescription drugs and utilization of generic drug discount programs. Ethn Dis. 2012;22(4):479–85.PubMedPubMedCentralGoogle Scholar
  46. 46.
    Palagyi M, Lassanova M. Patients attitudes towards experience with use of generics in Slovakia, performance of generic substitution. Bratisl Lek Listy. 2008;109(7):324–8.PubMedGoogle Scholar
  47. 47.
    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. doi: 10.1016/j.yebeh.2008.09.009.CrossRefPubMedGoogle Scholar
  48. 48.
    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. doi: 10.1093/heapol/czp039.CrossRefPubMedGoogle Scholar
  49. 49.
    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. doi: 10.1186/1472-6963-12-297.CrossRefPubMedPubMedCentralGoogle Scholar
  50. 50.
    Pereira JA, Holbrook AM, Dolovich L, Goldsmith C, Thabane L, Douketis JD, et al. Are brand-name and generic warfarin interchangeable? A survey of Ontario patients and physicians. Can J Clin Pharmacol. 2005;12(3):e229–39.PubMedGoogle Scholar
  51. 51.
    Piette JD, Heisler M, Harand A, Juip M. Beliefs about prescription medications among patients with diabetes: variation across racial groups and influences on cost-related medication underuse. J Health Care Poor Underserved. 2010;21(1):349–61. doi: 10.1353/hpu.0.0247.CrossRefPubMedGoogle Scholar
  52. 52.
    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. doi: 10.1016/j.healthpol.2011.10.001.CrossRefPubMedGoogle Scholar
  53. 53.
    Rathe J, Andersen M, Jarbol DE, dePont Christensen R, Hallas J, Sondergaard J. Generic switching and non-persistence among medicine users: a combined population-based questionnaire and register study. PloS One. 2015;10(3):e0119688. doi: 10.1371/journal.pone.0119688.CrossRefPubMedPubMedCentralGoogle Scholar
  54. 54.
    Rathe J, Larsen P, Andersen M, Paulsen M, Jarbol D, Thomsen J, et al. Associations between generic substitution and patients’ attitudes, beliefs and experiences. Eur J Clin Pharmacol. 2013;69(10):1827–36. doi: 10.1007/s00228-013-1539-z.CrossRefPubMedGoogle Scholar
  55. 55.
    Rathe J, Sondergaard J, Jarbol DE, Hallas J, Andersen M. Patients’ concern about their medicine after a generic switch: a combined cross-sectional questionnaire and register study. Pharmacoepidemiol Drug Saf. 2014;23(9):965–73. doi: 10.1002/pds.3671.CrossRefPubMedGoogle Scholar
  56. 56.
    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. doi: 10.2165/00023210-200923080-00006.CrossRefPubMedGoogle Scholar
  57. 57.
    Sansgiry SS, Bhosle M, Pope N. Consumer perceptions regarding generic drug substitution: an exploratory study. J Pharm Mark Manag. 2005;17(1):77–91. doi: 10.3109/J058v17n01_06.CrossRefGoogle Scholar
  58. 58.
    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. Prevent Chronic Dis. 2012;9:E142. doi: 10.5888/pcd9.120010.Google Scholar
  59. 59.
    Sharrad AK, Hassali MA. Consumer perception on generic medicines in Basrah, Iraq: preliminary findings from a qualitative study. Res Social Admin Pharm. 2011;7(1):108–12. doi: 10.1016/j.sapharm.2009.12.003.CrossRefGoogle Scholar
  60. 60.
    Shrank WH, Cadarette SM, Cox E, Fischer MA, Mehta J, Brookhart AM, et al. Is there a relationship between patient beliefs or communication about generic drugs and medication utilization? Med Care. 2009;47(3):319–25. doi: 10.1097/MLR.0b013e31818af850.CrossRefPubMedPubMedCentralGoogle Scholar
  61. 61.
    Shrank WH, Cox ER, Fischer MA, Mehta J, Choudhry NK. Patients’ perceptions of generic medications. Health Affairs. 2009;28(2):546–56. doi: 10.1377/hlthaff.28.2.546.CrossRefPubMedPubMedCentralGoogle Scholar
  62. 62.
    Sicras-Mainar A, Navarro-Artieda R. Physicians’ and patients’ opinions on the use of generic drugs. J Pharmacol Pharmacother. 2012;3(3):268–70. doi: 10.4103/0976-500x.99438.CrossRefPubMedPubMedCentralGoogle Scholar
  63. 63.
    Toklu HZ, Dulger GA, Hidiroglu S, Akici A, Yetim A, Gannemoglu HM, et al. Knowledge and attitudes of the pharmacists, prescribers and patients towards generic drug use in Istanbul, Turkey. Pharm Pract (Granada). 2012;10(4):199–206.CrossRefGoogle Scholar
  64. 64.
    Toverud EL, Hartmann K, Hakonsen H. A systematic review of physicians’ and pharmacists’ perspectives on generic drug use: what are the global challenges? Appl Health Econ Health Policy. 2015;13(1):35–45.CrossRefPubMedCentralGoogle Scholar
  65. 65.
    Toverud EL, Roise AK, Hogstad G, Wabo I. Norwegian patients on generic antihypertensive drugs: a qualitative study of their own experiences. Eur J Clin Pharmacol. 2011;67(1):33–8. doi: 10.1007/s00228-010-0935-x.CrossRefPubMedGoogle Scholar
  66. 66.
    Wong ZY, Hassali MA, Alrasheedy AA, Saleem F, Yahaya AH, Aljadhey H. Patients’ beliefs about generic medicines in Malaysia. Pharm Pract. 2014;12(4):474.Google Scholar
  67. 67.
    International Committee of Medical Journal Editors. Recommendations for the conduct, reporting, editing, and publication of scholarly work in medical journals. 2015. Available from: http://www.icmje.org/icmje-recommendations.pdf. Accessed 15 Jan 2016.
  68. 68.
    Kesselheim AS, Misono AS, Lee JL, Stedman MR, Brookhart MA, Choudhry NK, et al. Clinical equivalence of generic and brand-name drugs used in cardiovascular disease: a systematic review and meta-analysis. JAMA. 2008;300(21):2514–26. doi: 10.1001/jama.2008.758.CrossRefPubMedPubMedCentralGoogle Scholar
  69. 69.
    US FDA. Review of therapeutic equivalence generic Bupropion XL 300 mg and Wellbutrin XL 300 mg. FDA, FDA website. 2013. Available from: http://www.fda.gov/AboutFDA/CentersOffices/OfficeofMedicalProductsandTobacco/CDER/ucm153270.htm. Accessed 22 Nov 2014.
  70. 70.
    US FDA. Methylphenidate hydrochloride extended release tablets (generic Concerta) made by Mallinckrodt and Kudco. FDA, FDA website. 2015. Available from: http://www.fda.gov/Drugs/DrugSafety/ucm422568.htm. Accessed 22 Nov 2014.
  71. 71.
    Kesselheim AS, Bykov K, Avorn J, Tong A, Doherty M, Choudhry NK. Burden of changes in pill appearance for patients receiving generic cardiovascular medications after myocardial infarction: cohort and nested case-control studies. Ann Intern Med. 2014;161(2):96–103.CrossRefPubMedGoogle Scholar
  72. 72.
    US FDA. Size, shape, and other physical attributes of generic tablets and capsules: guidance for Industry. US FDA. 2015. Available from: http://www.fda.gov/downloads/drugs/guidancecomplianceregulatoryinformation/guidances/ucm377938.pdf. Accessed 15 Jan 2016.

Copyright information

© Springer International Publishing Switzerland 2016

Authors and Affiliations

  1. 1.Centre for Interventions in Infection, Inflammation and Immunity (4i) and Graduate Entry Medical SchoolUniversity of LimerickLimerickIreland

Personalised recommendations