Generics were first approved in Brazil in 1999. Substitution of generics and reference drugs can occur at the time of purchase and upon patients’ request, and, in the public healthcare system, physicians must prescribe drugs by their Brazilian Common Denomination (Denominação Comum Brasileira – DCB). However, despite legislation that supports their prescription, generics still have a small market share, representing only 27.3% of all drug units sold in Brazil in January 2014. A potential reason for the low penetration of generics into the Brazilian market is a negative perception of the value of generics.
In order to better understand what factors might influence Brazilian patients and healthcare professionals, Nardi and Ferraz from the Division of Health Economics and Healthcare Management (Federal University of São Paulo) evaluated the perception of the value of opinion leaders, patients and their accompanying family members regarding generics .
The authors carried out a face-to-face survey between March and August 2013 with three groups of participants: (i) 50 customers while they were visiting commercial pharmacies located in São Paulo, Brazil; (ii) 25 patients and 25 companions while they were waiting at the university outpatient clinic; and (iii) 50 healthcare opinion leaders from government, hospitals, health plans, academia and pharmaceutical companies. The survey explored the respondents’ perceived value regarding generics compared to that of brand-name drugs.
The results showed that, in general, a positive perception was identified towards generics, as 66% of participants believe that generics are as effective as brand-name drugs, 65% believe they have the same quality, and 54% believe they are equally safe. Nevertheless, there is a considerable proportion of respondents who perceive generics as being less effective than brand-name drugs (31%), less safe (40%) and of a lower quality (26%).
Comparing with the two other groups, more opinion leaders believe generic and brand-name drugs to be equally effective (73%) and that generics cause as many side effects as brand-name drugs (90%). However, a higher proportion of opinion leaders (29%) were concerned with quality deviations of generics (compared with 26% of pharmacy respondents and 22% of hospital respondents). This result raises the concern that opinion leaders do not trust in the current regulation and inspection processes involving generics in the country.
Moreover, 46% of respondents in the study admitted to getting confused when offered more drugs with the same name or active ingredient. However, despite the confusion, more than half of respondents did not appear to seek advice from the pharmacists or salespersons.
In conclusion, the study contributed to a better understanding of how Brazilian patients, their companions and healthcare opinion leaders value generics, what may be useful in guiding new public policies and actions to ensure access to good therapeutics in the country.
Conflict of Interest
The authors of the research paper  did not provide any conflict of interest statement.
Abstracted by Elene Paltrinieri Nardi from the Universidade Federal de São Paulo, São Paulo, Brasil.
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Generics perceptions in patients, pharmacists and doctors
1. Nardi EP, Ferraz MB. Perception of the value of generic drugs in São Paulo, Brazil. Cad. Saúde Pública, Rio de Janeiro, 32(2):e00038715, fev, 2016.
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