Exploring factors underlying the attitude of community pharmacists to generic substitution: a nationwide study from Poland

International Journal of Clinical Pharmacy, Dec 2015

Background Generic uptake will increasingly be promoted by governments in the face of increasing healthcare costs and global economic uncertainties. Objective The purpose of this study was to investigate attitudes towards generic substitution among community pharmacists, with a focus on the perception of the efficacy, knowledge of the generics characteristics, as well as the willingness to recommend generic substitution. Setting Community pharmacies in Poland. Method The survey was conducted in 2013 by telephone interviews with 802 holders of an MSc degree in pharmacy working as community pharmacists. Stratified sampling was implemented to make the study representative in geographic terms. Main outcome measure Pharmacists’ attitudes towards generics drugs. Results The study showed that only 40 % of pharmacists always inform patients about their right to choose a generic substitute. It was also shown that the less time a pharmacist has been practising, the less likely they are to invite consumers to choose between generic and innovator products. The likelihood of informing was not affected by pharmacist’s sex or age, or by pharmacy location or status (chain vs. independent pharmacy) (p > 0.05). Pharmacists varied in their approach to their statutory obligation to inform about a generic; a more or less equal share of respondents were either in favour or against it. Approximately 60 % pharmacists were shown to be familiar with the definition of a generic medicine. Pharmacists with shorter time of practice proved to know more about generics. However, more than 30 % respondents failed to choose the correct statement on generic versus reference medicine dosage. The majority of respondents (67 %) believed there are no differences in efficacy between generics and innovator drugs, whereas 31 % claimed that original brands could be more effective. A significant correlation was demonstrated between the views of pharmacists on the therapeutic efficacy and their willingness to substitute for generics whenever permitted by a physician. Conclusion It is important to address all concerns pharmacists may have over generics, for example by implementing comprehensive awareness-raising campaigns. Also, pharmacotherapy monitoring systems (i.e. provided in a framework of pharmaceutical care) could be considered to identify any safety or quality concerns that may arise.

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Exploring factors underlying the attitude of community pharmacists to generic substitution: a nationwide study from Poland

Int J Clin Pharm Exploring factors underlying the attitude of community pharmacists to generic substitution: a nationwide study from Poland Aleksandra Drozdowska 0 Tomasz Hermanowski 0 Aleksandra Drozdowska 0 0 Department of Pharmacoeconomics, InterQuality Project Leader (7FP), The President of the Polish Society of Health Economic, Medical University of Warsaw , ul. Z_ wirki i Wigury 81, 02-091 Warsaw , Poland Background Generic uptake will increasingly be promoted by governments in the face of increasing healthcare costs and global economic uncertainties. Objective The purpose of this study was to investigate attitudes towards generic substitution among community pharmacists, with a focus on the perception of the efficacy, knowledge of the generics characteristics, as well as the willingness to recommend generic substitution. Setting Community pharmacies in Poland. Method The survey was conducted in 2013 by telephone interviews with 802 holders of an MSc degree in pharmacy working as community pharmacists. Stratified sampling was implemented to make the study representative in geographic terms. Main outcome measure Pharmacists' attitudes towards generics drugs. Results The study showed that only 40 % of pharmacists always inform patients about their right to choose a generic substitute. It was also shown that the less time a pharmacist has been practising, the less likely they are to invite consumers to choose between generic and innovator products. The likelihood of informing was not affected by pharmacist's sex or age, or by pharmacy location or status Educational campaigns; Generic substitution; Pharmacists' knowledge; Pharmacists' opinions; Poland; Quality; Safety; Therapeutic efficacy - Department of Pharmacoeconomics, Medical University of Warsaw, ul. Z_ wirki i Wigury 81, 02-091 Warsaw, Poland (chain vs. independent pharmacy) (p [ 0.05). Pharmacists varied in their approach to their statutory obligation to inform about a generic; a more or less equal share of respondents were either in favour or against it. Approximately 60 % pharmacists were shown to be familiar with the definition of a generic medicine. Pharmacists with shorter time of practice proved to know more about generics. However, more than 30 % respondents failed to choose the correct statement on generic versus reference medicine dosage. The majority of respondents (67 %) believed there are no differences in efficacy between generics and innovator drugs, whereas 31 % claimed that original brands could be more effective. A significant correlation was demonstrated between the views of pharmacists on the therapeutic efficacy and their willingness to substitute for generics whenever permitted by a physician. Conclusion It is important to address all concerns pharmacists may have over generics, for example by implementing comprehensive awareness-raising campaigns. Also, pharmacotherapy monitoring systems (i.e. provided in a framework of pharmaceutical care) could be considered to identify any safety or quality concerns that may arise. Impacts on practice Pharmacists who are against the legal obligation to inform consumers about optional substitution also have a more skeptical opinion on the therapeutic efficacy of generics. • An education campaign for pharmacists should be planned to refresh the knowledge on generic medicines of especially the older pharmacists. Introduction During the 1980s and 1990s, most new legal regulations were intended to curtail the increasing costs of general medical care, with medicine being the major cost in healthcare globally [ 1 ]. Generally speaking, increasing drug expenditure over the past 10 years can be attributed to supply (the introduction of new expensive technologies) and demand (an ageing society and an increased prevalence of some health conditions). Due to the underlying assumption that market competition would not guarantee affordable prices alone, a wide range of regulatory interventions were implemented [ 2 ]. Generic drugs represent a major share in the drug market in Poland [ 1 ]. Drug expenditure in Poland is one of the lowest in Europe—$306 per capita in 2011 [ 3 ]. However, patient co-payment for drugs in Poland is the highest among all of the OECD countries, 60.8 % in 2009 with an increase of 3.4 % between 2000 and 2009 [ 4 ] (approximately 35 % of Poles reported that they could not afford to buy prescribed drugs and almost 8 % admitted to having resigned from or discontinued treatment for financial reasons [ 5 ]). According to the Polish Drug Reimbursement Act of May 2011, public spending on drug reimbursement cannot exceed 17 % of overall public spending on healthcare services guaranteed under the financial plan of the National Health Fund (NFZ). Since EU accession, Polish legislative and regulatory framework has been harmonized with EU directives governing production, market placement, advertising and the marketing of medicinal products, in addition to relevant s (...truncated)


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Aleksandra Drozdowska, Tomasz Hermanowski. Exploring factors underlying the attitude of community pharmacists to generic substitution: a nationwide study from Poland, International Journal of Clinical Pharmacy, 2016, pp. 162-170, Volume 38, Issue 1, DOI: 10.1007/s11096-015-0227-8