An investigation into the use of generic medicines by family practioners.
Background. Good health care is becoming increasingly unaffordable. A wider use of generic medicines offers significant cost savings. As the family practitioner is the gatekeeper in prescribing medicines, his attitude towards generic medicines is crucial. The factors that influence family practitioners' prescription of pharmaceuticals require investigation. Objectives. The primary objective of this study is to assess attitudes and perceptions that family practitioners have towards generic medicines and evaluate factors that influence its prescription. The secondary aim is to assess the individual characteristics and personality traits of family practitioners that may impact on generic prescription. Methods. This study is a convenient sample of 198 family practitioners that are surveyed by means of a questionnaire. Responses were based largely on a Likert scale and evaluated by factor analysis. Results. Using factor analysis, five factors identified in the order of importance are as follows: 1) Patient factors: It is primarily the patients' disease profile and their financial capacity that determines the use of generic versus ethical drugs. 2) Clinical autonomy of the family practitioners: Family practitioners resent their clinical decisions being challenged by managed care organisations. 3) Strategies promoting generics: Improved marketing by the generic pharmaceutical industry and the provisions of acceptable financial incentives are likely to promote wider use of generics. 4) Cost of medicines: Most family practitioners are price-sensitive. A further reduction in the price of generic medicines is therefore likely to increase the use. 5) Specialists' opinion: Specialists use fewer generics and their choice of medication is respected by family practitioners. A wider use of generic medicines by specialists will positively impact on generic prescription by family practitioners. Personality traits and individual characteristics of the family practitioners do not affect their prescription of generic medicines. It is noted that most family practitioners have encountered specific instances of reduced efficacy, an increased side-effect profile, substandard packaging, erratic availability and poor patient confidence with the use of generic drugs. Conclusion. In order to bring about a reduction in the healthcare costs by promoting wider use of generics, different stakeholders in the industry need to act synergistically. All stakeholders need to increase the awareness of generic medicines by continuing health education. Specific recommendations for the generic pharmaceutical industry include increased marketing, further reduction in the price of generics and implementation of research and surveillance studies to ensure satisfactory clinical efficacy of their drugs. Medicines Control Council need to closely monitor the number and quality of available generic medicines. Managed care organisations need to respect the clinical autonomy of family practitioners and work closely with them. Finally, acceptable and ethical incentives need to be considered for family practitioners, the gatekeepers, to achieve the objective of wider use of generic medicines.