Improving Perceptions of Generic Medications

AUGUST 21, 2016
Generic medications are bioequivalent to their brand-name counterparts and offer the same therapeutic effect at a reduced cost.
 
Inexpensive generics are crucial for lowering health care costs without sacrificing pharmacotherapeutic efficacy. Unfortunately, some perceive them as inferior to the often well-advertised brand-name counterparts.
 
A handful of recent studies considered how perception of brand-name and generic medications may impact reported and measured effects. In doing so, they uncovered evidence that perceptions can affect patients’ reported tolerance of the medication mentioned.

In one of the studies, undergraduate students who reported frequent headaches were given brand-named and generic ibuprofen, as well as placebos that were labeled either brand name or generic. Those taking brand-name placebos reported fewer side effects than those taking generic-labeled placebos. Therefore, the students perceived that branded medications conferred a treatment benefit.1  
 
In another study, students were given placebos—which they were told were beta-blockers—to treat pretest anxiety. All subjects were started on a brand-name placebo (“Betaprol”), followed by measurements of blood pressure and anxiety levels. Subsequently, they were randomly selected to continue with the brand-name placebo, be switched to a different brand-name placebo (“Novaprol”), or be switched to a generic-labeled placebo.2
 
The group that continued the brand-name placebo displayed modest yet statistically significant decreases in blood pressure and anxiety versus the group that switched to the alternate brand name or generic-labeled placebo. More perceived side effects were reported by the group switched to the alternate brand-name placebo or generic-labeled placebo, as well. The authors concluded that changing a medication has the potential to impact measured and perceived effectiveness of medication regimens.2

These findings indicate generic medication misconceptions can potentially impact the perceived effects of certain medications. Switching from brand name to generic may leave some skeptical patients feeling anxious and apprehensive, but pharmacists have the responsibility of informing patients about the benefits of generic medications.
 
Therapeutic equivalence and cost-savings are key points that can be highlighted in counseling. Hospitals generally use generic medications whenever possible, presenting an opportunity for health-system pharmacists to counsel and educate patients who may request brand-name medications.
 
Beyond patient education, it may be worthwhile to engage with prescribers on the importance of stressing the merits of generic medications when available, as they’re also in a powerful position to educate patients on their value.3,4  

Despite the image problem generics have had in the past, the literature shows public perceptions are indeed improving. In a recent survey, 83% of respondents thought physicians should prescribe generic medications when available. Further, 87% considered generics just as effective as brand-name medications.5
 
Although this is good news, the remaining percentage of individuals harboring misconceptions about generic medications still poses a challenge for health care cost savings. Pharmacists should not only stress the benefits of generics, but also provide reliable sources of information for patients and prescribers who wish to do their own research on the topic.
 
Improved understanding of generic medications can benefit both payers and patients. Pharmacists can play a positive role in correcting misconceptions and improving health care efficiency by encouraging their use.

References
1.  Faasse K, et al. Impact of brand or generic labeling on medication effectiveness and side effects. Health Psychol. 2016;2:187-190.
2.  Faasse K, et al. The effect of an apparent change to a branded or generic medication on drug effectiveness and side effects. Psychosom Med. 2013;1:90-96.
3.  Dunne SS, et al. What do people really think of generic medicines? A systematic review and critical appraisal of literature on stakeholder perceptions of generic drugs. BMC Med. 2015;1:173.
4.  Dunne SS. What do users of generic medicines think of them? A systematic review of consumers’ and patients’ perceptions of, and experiences with, generic medicines. The Patient. 2016;1-12.
5.  Kesselheim AS, et al. Variations in patients’ perceptions and use of generic drugs: results of a national survey. J Gen Intern Med. 2016;6:609-614.


Erik Hefti, PharmD, MS, PhD
Erik Hefti, PharmD, MS, PhD
Erik Hefti holds a PharmD as well as a Master's and PhD degrees in pharmaceutical science from the University at Buffalo. His research focus is pediatric pharmacogenomic factors impacting cardiovascular toxicity following cancer chemotherapy and genetic testing utilization to optimize healthcare outcomes. He is currently practicing as a clinical pharmacist at Sisters of Charity Hospital, St. Joseph Campus in Buffalo, NY.
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