FACTORS AFFECTING PHYSICIAN’S ADHERENCE TO GENERIC DRUG PRESCRIBING PRACTICE IN PRIVATE HEALTH FACILITIES, MEKELLE CITY, NORTHEASTERN ETHIOPIA
Abstract
Introduction: Generic medicines are produced by multiple manufacturers hence, are usually cheaper than innovator brands and therefore save costs on medicines. Many physicians oppose brand substitution, believing generic medicines to be inferior to their originator counterparts. Physicians’ belief about generic medicines and factors affecting generic prescribing in Ethiopia are poorly investigated.
Objective: To assess the physicians’ belief about generic medicines and to identify factors affecting generic medicines prescribing in private health facilities, Mekelle, Northern Ethiopia.
Materials and Methods: An institution based cross-sectional study was conducted enrolling all physicians working in private health facilities. The data were collected from January 2016 to March 2016. Data were collected using self-administered structured questionnaires measuring generic medicines belief of physicians using a Likert scale of 1–5. Data were then entered into SPSS version 20 for analysis.
Results: Of the fifty-six physicians approached in this study, 50 (89.2% response rate) questionnaires were included in the analysis. Nearly three-fourth (72%) of the physicians claimed that they always prescribe generic medicines. More than half (55.3) of the respondents beliefs generic medicines have different active ingredients than a brand innovator. Almost equal percentage (52% and 54%) of the Physicians disagreed with brand medicines were safer than generic medicines and prescribing generic due to the complicated health problem of the patient respectively. Around two third (67.5%) of physicians reported that quality profile of medicine was a major reason for prescribing generic medicines. Moreover, availability of medicines in pharmacies and low cost of medicines were the main reasons for prescribing generic medicines with 58.1% and 52.4% respectively.
Conclusion: The majority of physicians do not have a positive perception of generic medicines and a significant portion of the physician’s belief brand medicines safer and effective than generic counterparts. The availability of medicines in pharmacies, low cost of medicines and purchasing power of the patients are major factors affecting generic medicines prescribing.
Keywords: Generic medicines, belief, private health facilities, physicians
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Keywords:
Keywords, Generic medicines, Belief, Private health facilities, PhysiciansDOI
https://doi.org/10.22270/jddt.v7i2.1394References
Manzoli L. Flacco ME. Boccia S. et al. Generic versus brand-name drugs used in cardiovascular diseases. Eur J Epidemiol. 2016; 31:351-368.
World Health Organization: Trade, foreign policy, diplomacy and health: generic drugs. http://www.who.int/trade/glossary/story034/en/ (accessed January 8, 2013).
Auta A, Bala ET, Shalkur D. Generic medicine substitution: a cross-sectional survey of the perception of pharmacists in north-central, Nigeria. Medical Principles and Practice. 2013; 23(1):53-8.
World Health Organization. Globalization (2004), Trade and Health, Available from: http://www.who.int/trade/glossary/story 034/en/index.html.
Homedes N, Ugalde A. Multisource drug policies in Latin America: survey of 10 countries. Bulletin of the World Health Organization. 2005; 83(1): 64–70.
Chong CP, Hassali MA, Bahari MB, etal.Evaluating community pharmacists’ perceptions of future generic substitution policy implementation: a national survey from Malaysia. Health Policy. 2010; 94: 68–75.
Cameron A, Mantel-Teeuwisse AK, Leufkens HGM, etal.Switching from originator brand medicines to generic equivalents in selected developing countries: how much could be saved? Value Health. 2012; 15: 664–673.
Colgan S, Faasse K, Martin LR, Stephens MH, Grey A, Petrie KJ. Perceptions of generic medication in the general population, doctors and pharmacists: a systematic review. BMJ open. 2015; 5(12):e008915.
Shrank WH, Liberman JN, Fischer MA, Girdish C, Brennan TA, Choudhry NK. Physician perceptions about generic drugs. Annals of Pharmacotherapy. 2011; 45(1):31-8.
Ferner R, Lenney W, Marriott J, et al. Controversy over generic substitution. BMJ.2010; 340:c1341–3.
Johnston A, Asmar R, Dahlöf B, et al. Generic and therapeutic substitution: a viewpoint on achieving best practice in Europe. British journal of clinical pharmacology. 2011; 72(5):727-30.
Jacobzone S. Pharmaceutical Policies in OECD Countries: Reconciling Social and Industrial Goals. Paris: OECD; 2000.
Garattini L, Tediosi F. A comparative analysis of generics markets in five European countries. Health Policy. 2000; 51(3):149–162.
DanzonPM, Chao LW. Cross-national price differences for pharmaceuticals: how large, and why? J Health Econ. 2000; 19(2):159–195.
Danzon PM, Chao LW. Does regulation drive out competition in pharmaceutical markets? J Law Econ. 2000; 43:311–357.
King DR, Kanavos P: Encouraging the use of generic medicines.implications for transition economies. Croatian Medical. 2002; 43(4): 462–9.
Haas JS, Phillips KA, Gerstenberger EP, SegerAC.Potential savings from substituting generic drugs for brand-name drugs: medical expenditure panel survey, 1997–2000. Annals of Internal Medicine.2005; 142(11):891–7.
Iosifescu A, Halm EA, McGinn T, Siu AL, Federman AD. Beliefs about generic drugs among elderly adults in hospital-based primary care practices. Patient education and counseling. 2008; 73(2):377-83.
Awaisu A, Kheir N, Ibrahim MI, El-Hajj M, Hazi H, Khudair N, Barazi R. Knowledge, attitudes, and practices of community pharmacists on generic medicines in Qatar. International journal of clinical pharmacy. 2014; 36(2):394-404.
Cameron A, Mantel-Teeuwisse AK, Leufkens HG, Laing RO. Switching from originator brand medicines to generic equivalents in selected developing countries: how much could be saved? Value in Health. 2012 Aug 31; 15(5):664-73.
Food, Medicine and Healthcare Administration and Control Authority of Ethiopia: Standard Treatment Guidelines for General Hospital; Addis Ababa Ethiopia.3rded. Addis Ababa; 2014, Available at:
http://apps.who.int/medicinedocs/documents/s21694en/s21694en.pdf
World Health Organization. Pakistan - Medicine prices, availability, affordability and pricecomponents.Availablefrom:http://www.haiweb.org/medicineprices/ surveys /200407PK/sdocs/Pakistan-summary-report-web.pdf. Accessed June 20, 2016.
Jamshed SQ, Ibrahim MI, Hassali MA, et al. Perception and attitude of general practitioners regarding generic medicines in Karachi, Pakistan: A questionnaire based study. Southern med review. 2012; 5(1):22-30.
PROFILE C. PHARMACEUTICAL COUNTRY PROFILE. 201. Available from:
http://www.who.int/medicines/areas/coordination/pakistan.pdf. Accessed June 24, 2016.
Zaidi S, Bigdeli M, Aleem N, Rashidian A. Access to essential medicines in Pakistan: policy and health systems research concerns. PloS one. 2013 May 22; 8(5):e63515.
Abratt R, Lanteigne J. Factors influencing general practitioners in the prescription of homeopathic medicines. South African Journal of Business Management. 2000; 31(3).
Bakthavathsalam G. Generic drugs: cost effective alternate to branded drugs. Health Admin. 2006;19(1):16-9.
Moss G, Schuiling I. A brand logic for pharma?: A possible strategy based on FMCG experience. Journal of Medical Marketing: Device, Diagnostic and Pharmaceutical Marketing. 2004; 4(1):55-62.
Seiter A. A practical approach to pharmaceutical policy. World Bank Publications; 2010.
El-Dahiyat F, Kayyali R, Bidgood P. Physicians’ perception of generic and electronic prescribing: A descriptive study from Jordan. Journal of pharmaceutical policy and practice. 2014; 7(1):1.
Workneh BD, Gebrehiwot MG, Bayo TA, et al. Influence of Medical Representatives on Prescribing Practices in Mekelle, Northern Ethiopia. PloS one. 2016; 11(6):e0156795.
Roberts MJ. Pharmaceutical reform: a guide to improving performance and equity. World Bank Publications; 2011.
Scherer FM. Pricing, profits and technological progress in the pharmaceutical industry. J Econ Perspect.1993; 7(3): 97–115.
Wang H, Li N, Zhu H, Xu S, Lu H, Feng Z. Prescription pattern and its influencing factors in Chinese county hospitals: a retrospective cross-sectional study. PLoS One. 2013; 8(5):e63225.
El-Dahiyat F, Kayyali R, Bidgood P. Physicians’ perception of generic and electronic prescribing: A descriptive study from Jordan. Journal of pharmaceutical policy and practice. 2014; 7(1):1.
Ahiabu MA, Tersbøl BP, Biritwum R, Bygbjerg IC, Magnussen P. A retrospective audit of antibiotic prescriptions in primary health-care facilities in Eastern Region, Ghana. Health policy and planning. 2015 Jun 4:czv048
Auta A, Bala ET, Shalkur D. Generic medicine substitution: a cross-sectional survey of the perception of pharmacists in north-central, Nigeria. Medical Principles and Practice. 2013; 23(1):53-8.
Riaz H, Godman B, Hussain S, Malik F, Mahmood S, Shami A, Bashir S. Prescribing of bisphosphonates and antibiotics in Pakistan: challenges and opportunities for the future. Journal of Pharmaceutical Health Services Research. 2015; 6(2):111-21.
Akter SF, Rani MF, Rahman JA, Nordin MS, Satwi S, Awang MB. Antimicrobial use and factors influencing prescribing in medical wards of a tertiary care hospital in Malaysia. Int J Sci Environ Technol. 2012; 1(4):274-84.
Caudill TS, Johnson MS, Rich EC, McKinney WP. Physicians, pharmaceutical sales representatives, and the cost of prescribing. Archives of Family Medicine.1996; 5(4):201-6.
Tsiantou V, Zavras D, Kousoulakou H, Geitona M, Kyriopoulos J. Generic medicines: Greek physicians’ perceptions and prescribing practices. Journal of clinical pharmacy and therapeutics. 2009; 34(5):547-54.
Hellerstein JK. The importance of the physician in the generic versus trade-name prescription decision. The Rand journal of economics. 1998:108-36.
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