Generic medicines: knowledge, perceptions and practice of community pharmacists, physicians and medicine consumers in Riyadh, Saudi Arabia
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Date
2014-09
Authors
Alrasheedy, Alian Aaly F
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Abstract
Generic medicines are essentially the same as their counterpart brand medicines. They
provide the same therapeutic outcomes, but at a much cheaper price. Therefore, they are
promoted in many countries to confront the problem of escalating pharmaceutical
expenditures. In Saudi Arabia, the use of generic medicines is currently low. Therefore,
to promote generic medicines, the roles of physicians, community pharmacists and
medicine consumers are essential. Hence, this research project aimed to study their
knowledge, perceptions and practice regarding the use of generic medicines. In the first
part of the thesis, three qualitative studies were conducted, using face-to-face individual
semi-structured interviews. The first qualitative study was conducted with 20
community pharmacists. The study findings showed that proactive generic substitution
is currently not a common practice in community pharmacies. Moreover, different
factors related to community pharmacists, physicians and patients hindered the generic
substitution practice. The second qualitative study was conducted with 18 physicians.
The study findings showed that generic (international nonproprietary name) prescribing
is currently not a common practice but rather product-specific prescribing is the practice
model. Moreover, different factors influenced the physicians’ choice of the brands of
medicines, including factors related to the physician, factors related to the drug product
and its manufacturer/drug company, factors related to the patient, and factors related to
pharmaceutical marketing. The third qualitative study was conducted with 15 medicine
consumers. The study findings showed that medicine consumers generally preferred the
use of brand medicines over generic medicines. Moreover, many consumers have
negative perceptions and misconceptions about generic medicine. More importantly,
recommendations (i.e. prescribing and dispensing) by physicians and pharmacists were
the main factors influencing the use and acceptance of generic medicines by patients. In
the second part of the thesis, two quantitative cross-sectional questionnaire-based
studies were conducted. One study was conducted with 251 physicians practising in
polyclinics (response rate = 59.3%). In this study, 128 (51%) stated that they prescribe
both generic medicines and original brand medicines at approximately the same ratio,
76 (30.3%) stated that they prescribe more original brand medicines and 46 (18.3%)
stated that they prescribe more generic medicines. Similarly, another study was
conducted with 381 community pharmacists (response rate = 90.1%). In this study,
almost all participants (379; 99.5%) stated that they dispense brand medicine in the
prescription as written by prescribers without offering generic substitution in most
situations. Regarding the main dispensing practice for OTC medicines, 153 (40.2%)
stated that they offer generic medicines to consumers, 124 (32.5%) participants offer
brand medicines, 101 (26.5%) participants offer both – sometimes they offer generic
medicines and sometimes brand medicines – and only three participants (0.8%) stated
that they offer both original brand and generic medicines and left the choice to the
consumer. The quantitative studies showed that a considerable proportion of physicians
and community pharmacists have misconceptions and negative perceptions of generic
medicines. In conclusion, to increase utilization of generic medicines, it needs to be
promoted in a holistic approach by considering the perspectives of all stakeholders,
including physicians, community pharmacists and medicine consumers.
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Keywords
Generic Medicines , Pharmacists , Physicians , Medicine Consumers