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Background and objective Medical specialists have an essential role in promotion of generic medicines. However, misconceptions and negative perceptions about generic medicines among them could be a barrier to utilization of generic medicines. Therefore, the aim of this study was to explore their knowledge, perceptions and views about generic medicines. Methods A qualitative methodology was adopted in this study. A qualitative descriptive study with phenomenology overtones was the research strategy. Face-to-face semi-structured interviews were conducted with a purposive sample of medical specialists until saturation of data was achieved. The interviews were audio taped and transcribed verbatim. Then, the subsequent transcripts were analysed using thematic analysis. The themes were generated using both deductive (theoretical) and inductive coding. To ensure reliability of data analysis, peer review and independent analysis of the data were done. Results Five major themes were identified: (1) factors affecting specialists' prescribing practice with regard to generic medicines and original brand medicines, (2) specialists' perceptions of efficacy, safety and quality of generic medicines, (3) specialists' knowledge and confidence with Malaysian generic regulatory approval system, (4) drug information sources used by the specialists and (5) international non-proprietary name prescribing. Conclusion The study findings showed that several factors influenced prescribing decision with regard to the brands of the medicines including familiarity and experience with generic medicines, clinical condition of the patient, availability of the medicine brand in the hospital and department financial allocations. Moreover, misconceptions about quality, safety, efficacy and bioequivalence of generic medicines were prevalent among some participants. Furthermore, many participants were not familiar with the Malaysian generic medicines approval system. Therefore, medical specialists' concerns need to be addressed. Some recommendations and suggestions were made to improve generic medicines utilization in the country.

Objective The objectives were to document the published literature related to healthcare stakeholders’ knowledge, attitudes, views and perceptions towards generic medicines or generic substitution in Malaysia and to suggest recommendations to improve generic medicines utilization in Malaysia according to different healthcare stakeholders’ need. Methods A systematic search of articles published in peer-reviewed journals from January 2001 to November 2013 was performed. The search used 11 electronic databases. The search strategy involved using Boolean operators for combinations of the following keywords: generic AND Malaysia, Malaysia AND pharmaceutical, Malaysia AND Medicine Policy, Malaysia AND Economic Transformation. Key findings Twelve articles were included in this review. Two studies were conducted with generic manufacturers, one study with medical practitioners, six studies with community pharmacists and three studies with medicine consumers. Generic manufacturers expressed concerns about the generic medicines policy and drug approval system in Malaysia. In addition, medical practitioners, pharmacists and medicine consumers still have misconceptions about safety, quality, efficacy and bioequivalence of generic medicines. Furthermore, despite the availability of some pro-generic policies, there is a lack of implementation of these policies in the country. Conclusion Different healthcare stakeholders have different concerns and views towards generic medicines as well as different levels of knowledge about them. The existing generic medicines policy and Economic Transformation Program should be implemented as planned. Educational and promotional campaigns should be carried out to improve utilization of generic medicines among all healthcare stakeholders in Malaysia.

Objectives This review was conducted to document published literature related to physicians’ knowledge, attitudes, and perceptions of generic medicines in low- and middle-income countries (LMICs) and to compare the findings with high-income countries. Methods A systematic search of articles published in peer-reviewed journals from January 2001 to February 2013 was performed. The search comprised nine electronic databases. The search strategy involved using Boolean operators for combinations of the following terms: generic medicines, generic medications, generic drugs, generic, generic substitution, generic prescribing, international non-proprietary, prescribers, doctors, general practitioners, physicians, and specialists. Results Sixteen articles were included in this review. The majority (n = 11) were from high income countries and five from LMICs. The main difference between high income countries and LMICs is that physicians from high income countries generally have positive views whereas those from LMICs tend to have mixed views regarding generic medicines. Few similarities were identified among different country income groups namely low level of physicians’ knowledge of the basis of bioequivalence testing, cost of generic medicines as an encouraging factor for generic medicine prescribing, physicians’ concerns towards safety and quality of generic medicines and effect of pharmaceutical sales representative on generic medicine prescribing. Conclusion The present literature review revealed that physicians from LMICs tend to have mixed views regarding generic medicines. This may be due to differences in the health care system and pharmaceutical funding system, medicine policies, the level of educational interventions, and drug information sources in countries of different income levels.

The study aims to translate and validate the generic medicine scale (GMS) among the Malaysian population. A standard “forward–backward” procedure of translation was used and the translated version was then validated on a convenience sample of 202 patients. Face validity of translated GMS was confirmed with pilot testing. Content validity of the translated GMS was evaluated by eight postgraduate students who are experts in the field. For reliability, the instrument demonstrated good internal consistency (Cronbach’s α = 0.734) with correlation coefficient ranging from 0.198 to 0.500. Alpha value for efficacy dimension of the scale was 0.623 and for similarity dimension was 0.716. The test–retest reliability of the GMS indicates good reliability and stability of the instrument with Spearman’s rank correlation coefficient of 0.532 (rs = 0.532, n = 202, p = 0.005). In conclusion, the Malaysian version of the GMS is a reliable and valid measure of patients’ belief about generic medicines.

Objective: To describe the health-related quality of life (HRQOL) among nonprescription medicine customers in Malaysia and the factors that affect it. Methods: A nationwide cross-sectional survey was conducted among pharmacy customers in 59 randomly selected community pharmacies in Malaysia. The self-administered questionnaire included the EuroQoL five-dimensional (EQ-5D) questionnaire, the EuroQol visual analogue scale (EQ-VAS), nonprescription medicines purchase, and demographic questions. Data were analyzed by using the multivariate analysis of variance and multiple logistic regressions. Results: A total of 2729 customers enrolled in this study, with a mean EQ-5D questionnaire score of 0.92 0.15 and a mean EQVAS score of 69.92 24.80. Compared with the Malaysian adult population, nonprescription medicine customers have a lower mean EQ-5D questionnaire score (t ¼� 4.49, P o 0.01) and EQ-VAS score (t ¼� 25.87, P o 0.01). We found that pain/discomfort (25.6%) and anxiety/depression (13.7%) were the major HRQOL problems. Locality, age, ethnicity, household income per month, type of occupation, and type of nonprescription medicine purchased were associated with health status of nonprescription medicine customers (F22,5286 ¼ 2.555; Wilks’ lambda ¼ 0.979; P o 0.01). Conclusions: The HRQOL of nonprescription medicine customers is lower than that of the general Malaysian population. Lower health status was independently associated with older age, living in rural areas, having low income and education level, and purchasing blood and blood-forming medicines

Background: Acceptance of generic medicines by patients is an essential factor given that they are the end users of these medicines. In fact, adequate knowledge and positive perceptions are prerequisite to patients’ acceptance and use of generic medicines. Objective: To assess the current belief and views of patients about generic medicines in Malaysia. Method: This was a self-administered questionnaire-based study. The study was conducted with patients visiting outpatient pharmacy department at a tertiary care hospital in Malaysia. The Malaysian version of Generic Medicines Scale (GMS) was used. The GMS consists of two subscales: efficacy and similarity of generic medicines to original brand medicines. The efficacy subscale consists of 10 items while the similarity subscale consists of 6 items. The responses to the items were framed as a five-point Likert scale (1=strongly disagree to 5=strongly agree). Results: A total of 202 out of 300 patients participated in the study, giving a response rate of 67.3%. In this study, only 49% of them (n=99) knew the term ‘generic medicine’. Moreover, only 53.5% of the respondents (n=108) believed that the efficacy of generic medicines was the same as original brand medicines. In terms of quality, only 44% of the respondents (n=89) disagreed that generic medicines were of a lower quality. About one third (n=65, 32.2%) believed that generic medicines were cheaper because they were less efficacious. In terms of side effects, 44.5% of the respondents (n=90) believed that generic medicines had the same side effect profile as original brand medicines. Conclusions: The study finding showed that almost half of the respondents had negative belief in generic medicines. Similarly, many patients were not aware of the similarities and differences between generic and original brand medicines. Therefore, there is a need to provide patients with adequate information about generic medicines.