Skip to main content
Log in

Generic medicine substitution practices among community pharmacists: a nationwide study from Malaysia

  • Original Article
  • Published:
Journal of Public Health Aims and scope Submit manuscript

Abstract

Aims

This study aims to assess generic medicine substitution practices among Malaysian community pharmacists.

Method

A cross-sectional nationwide descriptive study using a specific mailing data collection form was conducted from May 2007 through December 2007. A sample of 1,419 community pharmacies was involved in this study. Data were collected across the brand name medicine requests encountered on 14 working days and for which an equivalent generic product was available. Pharmacists’ generic substitution rate, physicians’ and patients’ acceptance of substitution and cost saving achieved from substitution were assessed.

Results

Responses were received from 157 pharmacies (response rate 11.1%). The pharmacists recommended generic substitution for 84.7% (1,538/1,815) of the brand name medicine requests. While suggesting substitution, the pharmacists voluntarily consulted the physicians for 13.1% (91/695) of the recommendations which involved prescription orders. The majority of the physicians (87.9%) when consulted by the pharmacists accepted the recommendation for substitution. Meanwhile, 88.9% (1,368/1,538) of the pharmacists’ substitution suggestions were accepted by the patients. The overall patients’ expenditure on medicines was reduced by a total of 57.4% (Malaysian ringgit 27,266.30 or US $7,369.30; US $1.00 = Malaysian ringgit 3.70) through acceptance of substitution.

Conclusion

The Malaysian community pharmacists actively recommended generic substitution for brand name medicine requests which they encountered. Both the physicians and patients highly accepted the substitution recommendation and this contributed to significant reduction in patients’ medicines expenditure.

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

References

  • 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 25:197–202

    Article  PubMed  Google Scholar 

  • Andersen ML, Laursen K, Schaumann M et al (2000) How do patients evaluate the newly introduced system of substituting prescriptions? Ugeskr Laeger 162(45):6066–6069

    CAS  PubMed  Google Scholar 

  • Andersson K, Sonesson C, Petzold M et al (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 14:341–348

    Article  PubMed  Google Scholar 

  • Andersson K, Bergström G, Petzold MG et al (2007) Impact of a generic substitution reform on patients’ and society’s expenditure for pharmaceuticals. Health Policy 81:376–384

    Article  PubMed  Google Scholar 

  • Anonymous (1990) Consumer confidence in generic drug products down in wake of industry scandal, but satisfaction with products remains high, survey shows. Am J Hosp Pharm 47:468–476

    Google Scholar 

  • Babar ZUD, Awaisu A (2008) Evaluating community pharmacists’ perceptions and practices on generic medicines: a pilot study from Peninsular Malaysia. J Generic Med 5:315–330

    Article  Google Scholar 

  • Banahan B, Kolassa E (1994) Generic substitution and narrow therapeutic index drugs: a national survey of retail and hospital pharmacies. The University of Mississippi, Mississippi

    Google Scholar 

  • Barrett LL (2005) Physicians’ attitudes and practices regarding generic drugs. AARP, Washington

    Google Scholar 

  • Ess SM, Schneeweiss S, Szucs TD (2003) European healthcare policies for controlling drug expenditure. Pharmacoeconomics 21:89–103

    Article  PubMed  Google Scholar 

  • Fischer MA, Avorn J (2004) Potential savings from increased use of generic drugs in the elderly: what the experience of Medicaid and other insurance programs means for a Medicare drug benefit. Pharmacoepidemiol Drug Saf 13:207–214

    Article  PubMed  Google Scholar 

  • Gossell-Williams M (2007) Generic substitutions: a 2005 survey of the acceptance and perceptions of physicians in Jamaica. West Indian Med J 56:458–463

    CAS  PubMed  Google Scholar 

  • Hassali MA, Kong DCM, Stewart K (2005) Generic medicines: perceptions of community pharmacists in Melbourne, Australia. J Pharm Finance Econ Policy 14:27–45

    Article  Google Scholar 

  • Heikkilä R, Mäntyselkä P, Hartikainen-Herranen K et al (2007) Customers’ and physicians’ opinions of and experiences with generic substitution during the first year in Finland. Health Policy 82:366–374

    Article  PubMed  Google Scholar 

  • Himmel W, Simmenroth-Nayda A, Niebling W et al (2005) What do primary care patients think about generic drugs? Int J Clin Pharmacol Ther 43:472–479

    CAS  PubMed  Google Scholar 

  • Homedes N, Ugalde A (2005) Multisource drug policies in Latin America: survey of 10 countries. Bull World Health Organ 83:64–70

    PubMed  Google Scholar 

  • Kennedy J, Coyne J, Sclar D (2004) Drug affordability and prescription noncompliance in the United States: 1997–2002. Clin Ther 26:607–614

    Article  PubMed  Google Scholar 

  • King DR, Kanavos P (2002) Encouraging the use of generic medicines: implications for transition economies. Croat Med J 43:462–469

    PubMed  Google Scholar 

  • Kirking DM, Gaither CA, Ascione FJ et al (2001) Pharmacists’ individual and organizational views on generic medications. J Am Pharm Assoc 41:723–728

    Google Scholar 

  • Kjoenniksen I, Lindbaek M, Granas AG (2006) Patients’ attitudes towards and experiences of generic drug substitution in Norway. Pharm World Sci 28:284–289

    Article  PubMed  Google Scholar 

  • Legal Research Board of Malaysia (2006) Malaysian laws on poison and sales of drugs. International Law Books Services, Kuala Lumpur

    Google Scholar 

  • McGavock H (1997) Strategies to improve the cost effectiveness of general practitioner prescribing. An international perspective. Pharmacoeconomics 12:307–311

    Article  CAS  PubMed  Google Scholar 

  • McGavock H (2001) Generic substitution—issues relating to the Australian experience. Pharmacoepidemiol Drug Saf 10:555–556

    Article  CAS  PubMed  Google Scholar 

  • McManus P, Birkett DJ, Dudley J et al (2001) Impact of the Minimum Pricing Policy and introduction of brand (generic) substitution into the Pharmaceutical Benefits Scheme in Australia. Pharmacoepidemiol Drug Saf 10:295–300

    Article  CAS  PubMed  Google Scholar 

  • Ministry of Health Malaysia (MOH) (2007) National medicines policy of Malaysia. MOH, Putrajaya

    Google Scholar 

  • Mott DA, Cline RR (2002) Exploring generic drug use behavior: the role of prescribers and pharmacists in the opportunity for generic drug use and generic substitution. Med Care 40:662–674

    Article  PubMed  Google Scholar 

  • National Association of Pharmaceutical Manufacturers (NAPM) (2009) The generic pharmaceutical market in South Africa: at the crossroads? J Generic Med 6:137–144

    Article  Google Scholar 

  • Ping CC, Bahari MB, Hassali MA (2008) A pilot study on generic medicine substitution practices among community pharmacists in the State of Penang, Malaysia. Pharmacoepidemiol Drug Saf 17:82–89

    Article  PubMed  Google Scholar 

  • Royal Pharmaceutical Society of Great Britain (2006) British national formulary, BNF 51. BMJ Publishing Group Ltd and RPS Publishing, London

    Google Scholar 

  • Scuderi M (2002) Generic substitution in a Brisbane community pharmacy. Aust Pharm 21:116–121

    Google Scholar 

  • Shafie AA, Hassali MA (2008) Price comparison between innovator and generic medicines sold by community pharmacies in the state of Penang, Malaysia. J Generic Med 6:35–42

    Article  Google Scholar 

  • Simoens S (2009) Developing the Japanese generic medicines market: what can we learn from Europe? J Generic Med 6:129–135

    Article  Google Scholar 

  • Simoens S, De Coster S (2006) Sustaining generic medicines markets in Europe. Research Centre for Pharmaceutical Care and Pharmaco-economics, Katholieke Universiteit Leuven, Belgium

    Google Scholar 

  • Simoens S, De Bruyn K, Bogaert M et al (2005) Pharmaceutical policy regarding generic drugs in Belgium. Pharmacoeconomics 23:755–766

    Article  PubMed  Google Scholar 

  • Smeaton J (2000) The generics market. Aust J Pharm 81:540–542

    Google Scholar 

  • Suh DC (1999) Trends of generic substitution in community pharmacies. Pharm World Sci 21:260–265

    Article  CAS  PubMed  Google Scholar 

  • The Social Insurance Institution of Finland (2009) Generic substitution generated nearly €40 million of savings in Finland in six months. www.kela.fi/in/internet/english.nsf/NET/181103105045MP?OpenDocument. Accessed 15 Jul 2009

  • Williams AE, Chrystyn H (2007) Survey of pharmacists’ attitudes towards interchangeable use of dry powder inhalers. Pharm World Sci 29:221–227

    Article  PubMed  Google Scholar 

Download references

Conflict of interest

The authors declare that they have no conflict of interest.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Chee Ping Chong.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Chong, C.P., Hassali, M.A., Bahari, M.B. et al. Generic medicine substitution practices among community pharmacists: a nationwide study from Malaysia. J Public Health 19, 81–90 (2011). https://doi.org/10.1007/s10389-010-0349-3

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10389-010-0349-3

Keywords

Navigation