Generics were legally consolidated in Brazil in February 1999. While ensuring safety and quality, the generics policy aimed to provide drugs at lower prices. Nevertheless, generics still have a small market share (27.2% of all drugs sold by unit in December 2013 in Brazil) and there are doubts as to their acceptance by the population.

Alternatives for reducing out-of-pocket spending by Brazilian families are especially important, since medicines represent the major item in their total healthcare spending. Furthermore, cost and reliance on drugs have been suggested in previous studies as key factors influencing adherence to medication.

In order to evaluate what factors might influence Brazilian patients, Nardi and co-authors from the São Paulo Center for Health Economics evaluated the perception of the value and potential limitations with generic medication among the Brazilian population [1]. This was undertaken by carrying out a face-to-face national household survey between April and May 2013, which included 5,000 individuals aged <15 years from sixteen regional capitals in Brazil. The sample was comprised of representative quotas of the Brazilian population, proportional to the population densities of the capitals in each region of the country, based on the census conducted in 2010.

To evaluate the perceptions on generics compared to brand-name drugs, six multiple choice questions were presented to the participants, concerning effectiveness, use, individual preference, physicians’ preferences, side effects and time for effect.

The results showed that most of the participants had a positive perception regarding generics, since 58.8% of participants disagreed that generics were less effective than brand-name drugs. Although most of participants had a positive perception, it is not negligible that almost a third (30.4%) of participants believed that generics were less effective than brand-name drugs, 59% said that if there were no price difference, they would prefer brand-name drugs and 41% of participants agreed that generics were more suitable or appropriate than brand-name drugs for mild, banal or less serious diseases. These findings could justify a potential underuse of generics.

Contrary to what one might expect, lower family income was associated with a more negative perception regarding generics − 32.4% of the lowest income group and 24.3% of the highest income group agreed with the statement that generics were less effective than brand-name drugs. As the lowest income group, more negative attitudes towards generics were observed with elderly population. These findings were in contrast to greater need for affordable products that elderly and low income populations have, which may lead to lower adherence to drug therapy among them.

When asked about their perceptions regarding the preference of physicians, less than half of the participants (45.8%) agreed with the statement that these professionals prefer to prescribe generics. Given the importance of physicians’ views as opinion leaders, it is necessary to explore the underlying reasons why participants had this perception.

In conclusion, although the majority of participants had a positive attitude towards generics, there was a considerable percentage who expressed concerns about these drugs. Consequently, it is necessary to explore if the negative perception that part of the population had regarding generics was caused by lack of knowledge between the two types of drugs.

Moreover, it is necessary to investigate whether the regulation and health surveillance concerning generics in Brazil are appropriate to ensure effectiveness and interchangeable products with assured quality.

Finally, a better understanding of individual perceptions regarding generics can stimulate actions that will improve the effective use of generics by the Brazilian population and guide the formulation of appropriate health policies aimed at increasing access to effective, safe and affordable drugs.

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

Abstracted by Elene Paltrinieri Nardi, São Paulo Center for Health Economics (GRIDES), Universidade Federal de São Paulo, Brasil.

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

Perceptions of physicians from private medical centres in Malaysia about generic medicine usage: a qualitative study

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Reference
1.   Nardi EP, Ferraz MB, Pinheiro GRC, Kowalski SC, Sato EI. Perceptions of the population regarding generic drugs in Brazil: a nationwide survey. BMC Public Health. 2015;15:117.

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