Search

Generic drug substitution is a common practice in healthcare systems worldwide to promote cost-saving treatments while maintaining therapeutic effectiveness. Several factors influence this substitution, including regulatory policies, safety and efficacy considerations, patient and physician preferences, and market dynamics. This review comprehensively analyzes how these factors interact and influence generic drug substitution in healthcare settings and across various therapeutic classes and highlight the importance of balancing cost-saving measures with maintaining patient safety and therapeutic efficacy. Policies and guidelines established by health authorities in each country influence the approval, interchangeability, and substitution of generic drugs. Bioequivalence and therapeutic equivalence are critical factors, particularly in drugs with narrow therapeutic indexes. Moreover, physicians' acceptance and willingness to prescribe generic drugs, as well as patient acceptance and compliance with generic drug use, play a vital role in promoting generic substitution. [ABSTRACT FROM AUTHOR]

Background: Pharmacists are crucial in lowering pharmaceutical expenditures by substituting brand-name drugs for generic drugs. They are expected to understand the principles and practices of generic drug substitution for high-quality patient care. Some key areas of knowledge include bioequivalence and therapeutic equivalence, regulatory requirements, drug interchangeability, and adequate patient counseling. Objectives: This study aims to assess the knowledge, perception, and practice of generic drug substitution among pharmacists in Lebanon following the crises and the factors affecting the prescription and selection of generic drugs. Methods: A pilot descriptive cross-sectional study targeting 80 Lebanese pharmacists was conducted over 2 months (September-October 2022), in which data were collected using a uniform survey. Results: Overall, pharmacists had a good knowledge of generic drugs in terms of active ingredients (97.5%), pharmaceutical form (85.0%), lower cost (88.7%), bioequivalence to the brand before (95.0%), and therapeutic equivalence. Nevertheless, 22.5% reported that generic drugs are less safe than brands, and 22.5% said they cause side effects or did not know. Among the possible factors that influence the prescription of generic drugs, 35.0% of pharmacists reported that the financial situation of the patient is among the least important factors, while the lack of possible alternatives (45.0%) and the difference in prices (40.0%) were the most important ones. The price of different generics on the market was among the most important factors (36.3%) affecting the selection of generic drugs, followed by the patient's. preference (26.3%). Only 11.2% considered the information given by pharmaceutical firms could affect their choice, and 10.0% considered the presence or not of excipients with known effects in the formulation. Conclusion: Most pharmacists in Lebanon were familiar with generic drugs and supported generic drug substitution. Factors affecting generic drug use and prescription should be further explored to clarify misconceptions and reduce possible adverse events. [ABSTRACT FROM AUTHOR]

The use of generic medicines facilitate access to treatment and reduce the overall health cost. Policies promoting generic substitution take into account many components such as quality and efficacy considering health stakeholders including physicians and pharmacists and identifying factors impacting generics prescription. The current study aimed to assess the association between the perception of physicians towards generics with their sex and age and their willingness to switch to generics after initial treatment. Furthermore, it aimed to evaluate the predictors for switching brands to generics after initial treatment and perceiving the exclusivity to perform this substitution. Prescription of generics to lower medical cost was more common among younger physicians compared to those 50 years and older. Interestingly, physicians aged 40 and above were more prone to prescribe generics to patients without medical coverage, while compared to physicians younger than 30 years of age. Age was significantly associated with switching initial treatment to generics, which was 2.46 times higher for physicians older than 50 years compared to those younger than 30 years. In addition, physicians practicing more than 20 years were about 1,5 times more accepting the substitution by pharmacists after initial treatment by brand while compared to physicians practicing for less than 10 years. Strategies to increase generic substitution and promoting its acceptance among physicians should take into consideration the different significant predictors. However, Further research is required to explore more factors, predicting prescription of generics in Lebanon, such as visits by medical representatives, regulations of the hospital that the physician is practicing, which are also proven to have high influence on the prescription practice of generics. [ABSTRACT FROM AUTHOR]

INTRODUCTION: The unified medical prescription was implemented as a policy to decrease the overall health expenditures and increase the use of generic drugs. The main objective of this study was to evaluate the perception of Lebanese physicians towards the unified medical Prescription and its impact on the overall generic prescription. Additionally, an overview was assessed concerning the type of drugs that physicians tend more to accept to be substituted to generic alternatives. METHODS: A cross-sectional descriptive study was conducted in Lebanon over a period of three months targeting physicians in their private clinics or in various hospitals using a survey as an instrument. RESULTS: Our findings demonstrated that more than the half of respondents (56.6%) believed that the unified medical prescription preserves the exclusivity for physicians to choose the medication while only 39.5% of physicians think that the unified medical prescription encouraged generic prescription and almost 42% admitted that the unified medical prescription lowers the medical cost for the patient. DISCUSSION: Despite that this new medical form of prescription is a high achievement for the Lebanese Ministry Of Public Health, this last should make essential actions: coordinating the generic drug substitution policy and monitoring its implementation over time and achievement of goals; establishing appropriate pricing system and medicines prices and controlling the interactions between physicians, pharmacists, and pharmaceutical industries; ensure their full commitment; and update the national list of substitutable generic drugs. CONCLUSION: The main objective of the unified medical prescription is to decrease the pharmaceutical expenditure and to provide access to medications for patients with lower socio-economic status. Lebanese physicians reported that this tool did not achieve its goal yet but have an impact on lowering the medical cost for patients and promoting generic prescription. [ABSTRACT FROM AUTHOR]

Generic substitutions practice is increasingly encouraged by health authorities. The use of cheaper generic drugs is often promoted as a measure to reduce the health care expenditure on pharmaceutical products, and save money to patients as well as governments. The current study aimed to explore the knowledge, perception, and attitude of physicians toward generic medicines in Lebanon and potential barriers to generic use and finally their confidence in the Lebanese pharmacist in the whole healthcare sector. A random sample of 385 physicians was recruited from different regions across Lebanon either by visiting their private clinics or in different hospitals. Among the respondents, 115 (29.9%) reported that they prefer to prescribe generic medicines over the innovator product and 258 (68.3%) reported that a generic medicine has the same therapeutic effect as the brand medicine. However, 181 (47.9%) respondents reported that a generic medicine should have the same active ingredient as the branded medicine and 357 (94.4%) reported that they do not have same excipients. When asked about their trust in the pharmacist in the health care system, almost 229 (59.5%) of respondents reported distrust. The majority of the physicians who participated in this survey indicated a low generic medicine prescription rate. They preferred to use and prescribe brand medicines. This phenomenon was observed in all of the age groups and was independent of their year, their place of graduation and experience but directly depends on the type of certificate. [ABSTRACT FROM AUTHOR]