Abstract
Objective
The aim of the study was to assess patients’ attitudes towards and experiences of generic substitution 3 years after generic substitution of prescription medicines was permitted in Norway.
Methods
Prescriptions from 2,128 consecutive patients in a Norwegian pharmacy were retrospectively reviewed to identify all patients (n = 274) receiving eight or more different prescription drugs on the fifth level in the Anatomical Therapeutic Chemical (ATC) classification system during the last 6 months. An age-adjusted control group (n = 269) of patients receiving three to seven different prescription drugs was randomly selected. Of the 543 patients, 386 were eligible for inclusion. Both groups received a mailed questionnaire addressing their experiences with and attitudes towards generic substitution.
Results
The overall response rate was 73% (281/386) and the average age of the respondents was 66 years old. The study found that patients who reported to have received information from their physician or the pharmacy about generic substitution were more likely to have switched (P < 0.001). About half (138/281) of the patients had experienced a generic switch, and a higher proportion of the polypharmacy patients had their medication substituted compared to the control patients (P < 0.001). Altogether 50 (36%) of the patients who had experienced a switch, reported one or more negative experiences connected to the substitution, and 29 of these (21%) reported an overall negative experience after the change. The experiences of the patients were not related to age, gender, or number of medications or information about generics from either the pharmacy or the physician. About 41% of the patients would not switch if they had no personal economic incentives.
Conclusions
About 1/3 of the patients who had their medication substituted reported negative experiences. Generic drug substitution for a number of patients is not considered an equal alternative to branded drugs, and these patients may need additional information and support. The lack of correlation between patient experiences and age, gender, and medical regimen complexity is interesting and should be investigated further.
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References
Aarseth HP. Why generic substitution? (In Norwegian). Tidskr Nor Laegefor 2001; 121(28):3339.
Husom N. Generic substitution - not at any price (In Norwegian). Tidskr Nor Laegefor 2004; 124(16):2165.
Meredith P. Bioequivalence and other unresolved issues in generic drug substitution. Clin Ther 2003; 25(11):2875–90.
Tilyard MW, Dovey SM, Rosenstreich D. General practitioners’ views on generic medication and substitution. N Z Med J 1990; 103(893):318–20.
Colaizzi JL, Lowenthal DT. Critical therapeutic categories: a contraindication to generic substitution? Clin Ther 1986; 8(4):370–9.
Reiffel JA. Issues in the use of generic antiarrhythmic drugs. Curr Opin Cardiol 2001; 16(1):23–29.
Welty TE, Pickering PR, Hale BC, Arazi R. Loss of seizure control associated with generic substitution of carbamazepine. Ann Pharmacother 1992; 26(6):775–7.
Williamson IJ, Reid A, Monie RD, Fennerty AG, Rimmer EM. Generic inhaled salbutamol versus branded salbutamol. A randomised double-blind study. Postgrad Med J 1997; 73(857):156–8.
Murphy JE. Generic substitution and optimal patient care. Arch Intern Med 1999; 159(5):429–33.
Banahan BF, III, Kolassa EM. A physician survey on generic drugs and substitution of critical dose medications. Arch Intern Med 1997; 157(18):2080–88.
Nordling S, Lindberg G, Sandberg S, Anell A, Melander A, Rydberg T. Hur gikk det med försöket med generisk substitusjon i Skåne? En rapport från IHE, NEPI og Apoteken i Skåne. (In Swedish) 2000. Kristianstad, Apotekarsocieteten. ISBN 91-8627-489-9.
Madsen S, Huse J, Roksvaag PO. [Pharmacy customers’ attitude to generics] In Norwegian. Tidsskr Nor Laegeforen 2003; 123(6):792–3.
Ganther JM, Kreling DH. Consumer perceptions of risk and required cost savings for generic prescription drugs. J Am Pharm Assoc 2000; 40(3):378–83.
Mott DA, Cline RR. Exploring generic drug use behaviour: the role of prescribers and pharmacists in the opportunity for generic drug use and generic substitution. Med Care 2002; 40(8):662–74.
Suh DC. Trends of generic substitution in community pharmacies. Pharm World Sci 1999; 21(6):260–5.
Haas JS, Phillips KA, Gerstenberger EP, Seger AC. Potential savings from substituting generic drugs for brand-name drugs: medical expenditure panel survey, 1997–2000. Ann Intern Med 2005; 142(11):891–7.
Lund-Jacobsen B. [Generic substitution – patients’ incentives are too low]. Ugeskr Laeger 1992; 154(46):3215–6.
Andersson K, Sonesson C, Petzold M, Carlsten A, Lonnroth K. 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 2005; 14(5):341–8.
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Kjoenniksen, I., Lindbaek, M. & Granas, A.G. Patients’ attitudes towards and experiences of generic drug substitution in Norway. Pharm World Sci 28, 284–289 (2006). https://doi.org/10.1007/s11096-006-9043-5
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DOI: https://doi.org/10.1007/s11096-006-9043-5