Perceptions and attitudes of community pharmacists towards generic medicines

BACKGROUND: Following the enactment of legislation in June 2013, generic substitution and reference pricing of medicines has been introduced, for the first time, in Ireland. This novel study is the first assessment of the perceptions of community pharmacists in Ireland towards generic medicines completed in the period immediately prior to the introduction of generic substitution and reference pricing. OBJECTIVE: To determine the perceptions towards generic medicines among community pharmacists. METHODS: One-to-one semistructured interviews were performed with a convenience sample of 44 community pharmacists (from approximately 4,500 pharmacists in Ireland) recruited from Ireland's Midwest, South, and Southwest regions. Interviews were transcribed and analysed using NVivo (version 9). RESULTS: 98[%] of pharmacists believed that generics were of a similar quality to the originator, and 96[%] stated that they were as effective as the originator. However, a small number demonstrated some reticence regarding generics: 9[%] believed that generics were not manufactured to the same quality as the originator; 7[%] stated they would prefer to take an originator medicine themselves; and 7[%] reported having experienced quality issues with generic medicines. 89[%] of pharmacists reported receiving patient complaints regarding use of generic medicine, although 64[%] suggested that this was due to a nocebo effect (i.e., a result of patients' preconceived notions that generics were inferior). Only a minority (21[%]) reported that they had attempted to educate patients as to the equivalency of generics. Although 80[%] were in favor of Ireland's new legislation promoting the use generic medicines, 46[%] expressed concerns regarding its practical implementation. CONCLUSIONS: This key stakeholder group had positive attitudes towards generics and the legislation that promotes their use. Concerns regarding patient perception and experience, clinical effectiveness, and manufacturing quality were identified. We propose that interventions supporting implementation of the new legislation should address these concerns.