Kumar and co-authors from the Universiti Sains Malaysia carried out a cross-sectional nationwide survey targeting physicians from private medical centres in Malaysia. The study included 95 hospitals registered with the Association of Private Hospitals of Malaysia (APHM) and was carried out during the period of May to June 2013.

Of the 263 participants that completed questionnaires only 2.3% of physicians were aware of the regulatory limits of bioequivalence standard in Malaysia. Of the respondents, 23.6% agreed that they ‘always’ write their prescriptions using the originator product name whereas 49.4% do it ‘usually’, with only 9.9% indicating that they ‘sometimes’ write a brand name on their prescriptions.

A staggering 51.7% of physicians stated that generics are less effective compared to their reference product, with 27.4% remaining neutral and 20.9% disagreeing with this statement. This was supported by the fact that 74.2% of the physicians believe that brand-name products are required to meet higher standards than generics, with only 13.7% of respondents rejecting this statement. This is perhaps not surprising when considering the fact that the majority of the physicians who participated in this survey indicated a very low generics prescription rate. They also preferred to use originator drugs and write their prescriptions using brand names.

The majority of physicians (n = 213, 81%) also believed that there were too many generics available and 63.1% of the respondents confirmed that patients preferred the originator products and that they got confused about generics.

Most of the physicians (92.4%) said that they needed more information on issues pertaining to the safety and efficacy of generics. And most (93.1%) agreed that there should be a standard guideline for both prescribers and pharmacists on substitution of brand-name drugs for generics.

Prescribing generics has become common practice in public hospitals in Malaysia. However, the trend in private medical centres seems to be different [2]. The negative perceptions of physicians, the authors believed, could be the reason for the limited use of generics in private hospitals in Malaysia.

This is not the first time that generics have had a rough deal in Malaysia. A study of pharmacists in the country showed that they had a lack of confidence in generics produced by local pharmaceutical companies [3].

The authors recommend the distribution of educational material, as well as academic detailing and monitoring of prescribing behaviour coupled with feedback, as well as prescribing by International Nonproprietary Name (INN). Another suggestion is the development of a list of non-interchangeable medications to address the concern of bioequivalence and therapeutic equivalence.

Conflict of interest
The authors of the research paper [1] did not provide the conflict of interest statement.

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Related articles
Generics have their feet under the table in Malaysia

Malaysian guidelines for generics

References
1.   Kumar R, Hassali MA, Saleem F, et al. Knowledge and perceptions of physicians from private medical centres towards generic medicines: a nationwide survey from Malaysia. J Pharm Policy Pract. 2015;8:11.
2.   Kumar R, Hassali MA, Kaur N, Kader MA. Perceptions of physicians from private medical centres in Malaysia about generic medicine usage: a qualitative study. Generics and Biosimilars Initiative Journal (GaBI Journal). 2014;3(2):63-70. doi:10.5639/gabij.2014.0302.019
3.   GaBI Online - Generics and Biosimilars Initiative. Attitudes towards prescribing generics in Malaysia [www.gabionline.net]. Mol, Belgium: Pro Pharma Communications International; [cited 2015 Jun 12]. Available from: www.gabionline.net/Generics/Research/Attitudes-towards-prescribing-generics-in-Malaysia

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