Article Text

Perceptions of generic medication in the general population, doctors and pharmacists: a systematic review
  1. Sarah Colgan1,
  2. Kate Faasse1,
  3. Leslie R Martin2,
  4. Melika H Stephens1,
  5. Andrew Grey3,
  6. Keith J Petrie1
  1. 1Department of Psychological Medicine, University of Auckland, Auckland, New Zealand
  2. 2Department of Psychology, La Sierra University, Riverside, California, USA
  3. 3Department of Medicine, University of Auckland, Auckland, New Zealand
  1. Correspondence to Professor Keith J Petrie; kj.petrie{at}auckland.ac.nz

Abstract

Objective To investigate negative perceptions about generic medicines and evaluate the proportions of lay people, doctors and pharmacists who hold these perceptions.

Design A systematic review of observational studies.

Data sources MEDLINE, EMBASE, PsycInfo and Scopus.

Eligibility criteria Quantitative data from cross-sectional and prospective studies published in English after 1980, using self-report measures to evaluate perceptions about generic medicines, presented as percentages of the total sample assessed.

Results After screening 2737 articles, 52 articles were included in the final analysis. A high proportion of doctors, pharmacists and lay people had negative perceptions of generics. Lay people were significantly more likely to view generics as less effective than branded medication (35.6%, 95% CI 34.8% to 36.4%) compared to doctors (28.7%, 27.5% to 29.9%) and pharmacists (23.6%, 21.2% to 26.2%), p<0.0001. Pharmacists (33.4%, 31.0% to 35.9%) were significantly more likely to believe generics were of inferior quality compared to branded medication than were doctors (28.0%, 26.3% to 29.9%), p=0.0006, and lay people (25.1%, 24.2% to 26.0%), p<0.0001. Doctors believed generics caused more side effects than branded medication (24.4%, 22.2% to 26.9%), compared to pharmacists (17.6%, 15.3% to 20.1%) and lay people (18.8%, 17.8% to 19.8%), p<0.0001. Doctors (28.5%, 26.9% to 30.2%) and pharmacists (25.4%, 21.4% to 29.9%) had significantly more safety concerns about generics than did lay people (18.0%, 17.0% to 19.0%), p≤0.0002. A greater proportion of lay people felt negatively about generic substitution (34.0%, 33.2% to 34.9%), compared to doctors (24.1%, 22.0% to 26.4%) and pharmacists (11.0%, 9.6% to 12.7%), p<0.0001. Rates of negative perceptions of generics do not appear to have changed substantially over time in the general population or among physician groups, p≥0.431, but such negative beliefs show a decreasing trend in pharmacists over the study period, p=0.034.

Conclusions A significant proportion of doctors, pharmacists and lay people hold negative perceptions of generic medicines. It is likely these attitudes present barriers to the wider use of generics.

  • PUBLIC HEALTH
  • GENERAL MEDICINE (see Internal Medicine)
  • HEALTH ECONOMICS

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