Evaluation of generic medicines substitution practices among community pharmacists in Malaysia and Australia
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Date
2010
Authors
Chee Ping, Chong
Journal Title
Journal ISSN
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Abstract
Many countries including Australia have developed a generic substitution policy designed 10
reduce medicines expenditure. In Malaysia, the government is facing a similar challenge of
managing increasing medicines expenditure. However, unlike Australia, the Malaysian
government has not yet implemented the generic substitution strategy. This thesis will provide
some baseline data and guideline for the development of a generic substitution policy in
Malaysia through direct comparison of issues around generic substitution among community
pharmacists in both countries. The study aims to evaluate and compare the perceptions,
knowledge and practices of generic substitution among the Malaysian and Australian
community pharmacists. The patients' acceptance toward substitution and the resulting costsaving
were also evaluated and compared between the two countries.
This was a nationwide cross-sectional descriptive study. Part I of the study involved a
questionnaire to assess the pharmacists' perceptions and knowledge of generic substitution. In
the Part II study, data were progressively collected across the multi-sources brand name
medicines requests encountered by the pharmacists. The entire populations of 1419 Malaysian
community pharmacies were invited in both Part I and II studies via mail. In Australian scene,
the recruitment of participants in Part I study was via self-selection using an anonymous web
based survey. A national representative sample of 500 Australian community pharmacies were
randomly selected and invited via mail in the Part II study.
Responses were received from 219 and 15 7 Malaysian and Australian pharmacist respective! y
in the Part I study. A higher proportion of Australian pharmacists (93.7%) than the Malaysian
group (66. 7%) indicated that they were willing to offer generic substitution. The Australian
pharmacists significantly held more positive attitudes and better understandings of generic
medicines than the Malaysian group, including issues around efficacy, safety, quality and
regulatory standard of generic medicines. The response rate in Part II study was 11.1% (n =
157) and 16.4% (n = 82) respectively for both the Malaysian and Australian arm study. The
Australian pharmacists significantly demonstrated higher generic substitution recommendation
rate (96.4%) than the Malaysian group (84.7%). Nevertheless, Malaysian consumers'
acceptance toward generic substitution (88.9%) was significantly greater than the Australian
citizens (78.5%). Through acceptance of substitution, the Malaysian consumers' medicines
expenditures reduced by 57.4%, as compared to around 21.0% among the Australian
consumers.
In conclusion, the Malaysian pharmacists' perceptions, knowledge and practices of generic
substitution need to be improved, if they are to play a future role in supporting the
implementation of a generic medicines policy.