A survey of patients in the Philippines showed that less than half were offered a generic drug alternative and even fewer asked for a generic drug alternative. The survey also revealed that patients preferred brand-name medicines over generics [1].
The survey was carried out via a questionnaire of consumers coming out of pharmacies. Of the 1,160 patients that participated in the survey, only 7% knew the correct definition of a generic drug. While 55% were aware of a law that required physicians to write the generic names of the drugs in their prescription, 47% were aware that the law requires pharmacies to offer generic drug alternatives to their customers and 84% knew that they have the right to choose to buy a generic or brand-name version of their medicine.
Cost
When asked about the price of generic drugs, almost all (91.71%) respondents said that generics are cheaper compared to brand-name medicines, with only 2.68% believing that generics are more expensive.
Efficacy
In terms of efficacy, almost half (48%) of respondents said that generics are less effective compared to brand-name medicines, with 33% believing that generics have similar effectiveness and 4.8% believing that generics are more effective.
Preference
Patients were asked if they would prefer a generic or a brand-name drug if the price and the effectiveness were equal. Only 15% said that they would prefer the generic drug, while 70% said that they would prefer the brand-name medicine and 14.5% had no preference. However, when the generic drug was cheaper, 41.23% would prefer the generic to the brand-name drug if they were equally effective, while 40% would prefer the brand-name medicine, with the remainder having no preference.
Influences
Persons likely to influence patients in their choice of generic or brand-name medicines included physicians (96%); pharmacists (46%); government agencies, e.g. Department of Health (45%); drug companies (20%); commercials (16%); friends, relatives, neighbours (9.3%) and others (1.6%).
Generics substitution
As part of the Generics Act of 1988 pharmacies are required to use generic drug substitution/dispensing, price menu cards. Of the 43 pharmacies surveyed, 36 (84%) had price menu cards. However, when questioned, only 44% of patients noticed a generics menu card and only 41% were offered generic drug alternatives. Of those that were not offered a generic drug alternative, 75% also did not request one. Of those that did request a generic drug alternative, the main reason (78%) was because generics are cheaper. While for those who did not ask for the generic drug alternative, 77% said it was because they were following what was written in their prescription.
The authors concluded that the patients more likely to purchase generic medicines consulted a public facility, knew the requirement to write generic drug names and were influenced by friends and relatives. They recommended that because there is already high compliance from drug prescribers, government efforts should now focus on pharmacies and patients. Pharmacy compliance should be regularly monitored, and consumers empowered on their right to know alternatives.
Related article
Physicians’ views on generics in the Philippines
Reference
1. Wong JQ, et al. The Prevalence of Philippine Prescribing, Dispensing, and Use Behavior in Relation to Generic Drugs and their Risk Factors. Philippine Institute for Development Studies. Discussion Paper Series No. 2014-17.
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