Prescribing generics for chronic musculoskeletal pain

Genéricos/Investigación | Posted 06/11/2015 post-comment0 Post your comment

The use of generics has become an issue of concern, both in public health and economical terms. Nevertheless, parallel to an ever-stronger advocacy for their use, various sources of information have reported patients’ concerns regarding substitution. Using a qualitative interview study, researchers from Geneva University Hospitals and the University of Geneva investigated the personal definitions and understanding of generics in patients suffering from non-specific chronic musculoskeletal pain, to elucidate the reasons that might explain why patients are confident or reluctant to take generics [1].

MD002152

The most important findings of this study showed that patients’ representation of generics is ambivalent; when one perception predominates, it is clearly a negative one. Patients emphasized their doubts regarding the similarity (from ‘partial copy’ to ‘forgery’) and their concern to receive a ‘second choice’ or ‘discount’ medication. According to Horne’s model [2], when the perceived potential for the generic drug to cause problems is exceeding the perceived need to take the medication, then the prescription of the generic drug becomes a source of embarrassment for the patient.

The issue of cost was frequently mentioned by respondents, with a clear emphasis on the benefits of generics from a societal rather than an individual point of view. A number of patients explained that the substitution was not the best option in their particular situation. Thus, economic arguments per se are not sufficient to justify substitution, and may even raise issues calling upon cognitive dissonance. In an attempt to reduce the inner tension, some patients underlined the positive features of the chosen alternative (to take nevertheless an originator medication with a perceived value) and the negative features of the rejected one (cheaper price as a synonym for lower quality) [3]. This is illustrated by a respondent indicating: ‘The xx,which is called the Rolls-Royce in this field, is much more effective than the generic I had before … (…) If a medication has been invented and it’s satisfactory, I don’t believe an imitation can be as good as the real one, the original’.

The economic and public health arguments often put forward in information campaigns emphasizing liable citizenship are not sufficient motivation. The results of this study emphasize the importance of individualized negotiation regarding the prescription of generics. Tailored information and trust between patients and health professionals may convince patients that the prescribed generic drug is just as well adapted to their health problem as the originator medication.

Conflict of interest
The authors of the research paper [1] declared that there were no conflicts of interest.

Abstracted by Valérie Piguet, Division of Clinical Pharmacology and Toxicology, Multidisciplinary Pain Center, Geneva University Hospitals and University of Geneva, Switzerland.

Editor's comment
Readers interested to learn more about patients’ perceptions about generics are invited to visit www.gabi-journal.net to view the following manuscript published in GaBI Journal

A review of patient perspectives on generics substitution: what are the challenges for optimal drug use

If you are interested in contributing a research article in a similar area to the GaBI Journal, please send us your submission here.

Related articles
Patients’ and physicians’ perceptions of HIV generics

Physician perceptions of generics substitution

References
1.   Piguet V, D’Incau S, Besson M, Desmeules J, Cedraschi C. Prescribing generic medication in chronic musculoskeletal pain patients: an issue of representations, trust, and experience in a Swiss cohort. PLoS One. 2015 Aug 3;10(8):e0134661.
2.   Horne RE. Treatment perception and self-regulation. In: Cameron LD, Leventhal H, editors. The self-regulation of health and illness behavior. 2003. London: Routledge. p. 138-53.
3.   Stone J, Fernandez NC. How behavior shapes attitudes: cognitive dissonance processes. In: Crano WD, Prislin D, editors. Attitudes and Attitude Change. 2008. New York, London: Psychology Press. p. 313-36. 

Permission granted to reproduce for personal and non-commercial use only. All other reproduction, copy or reprinting of all or part of any ‘Content’ found on this website is strictly prohibited without the prior consent of the publisher. Contact the publisher to obtain permission before redistributing.

Copyright – Unless otherwise stated all contents of this website are © 2015 Pro Pharma Communications International. All Rights Reserved.

comment icon Comments (0)
Post your comment
Most viewed articles
Sobre GaBI
INICIO/Sobre GaBI Posted 06/08/2009
EU guidelines for biosimilars
EMA logo 1 V13C15
INICIO/Directrices Posted 08/10/2010