Results of a GP survey
Misunderstandings were identified about the safety, efficacy and quality of generic medicines [1]. More than half of the respondents agreed that locally manufactured medicines are as effective as brand-name medicines (n = 114; 55.4%). However, in terms of safety, the majority of respondents (n = 85; 41.26%) incorrectly understood that the generic medicines are less safe than brand-name medicines. So there is confusion between the message that generics are equivalent to brand-name medicines, and the perception that medicines sourced locally are not as effective or safe as internationally sourced medicines.

Discussion
One of the convincing findings in this study is that doctors expect to be educated more about the prices of medicines. Medical training should provide basic information on health policy, pharmaceutical policy, essential drug list, innovator and generic medicines, and their availability and affordability.

Gaps were identified in respondents’ knowledge, although good perception and attitude were noted among the respondents. Previous studies suggest that GPs consider commercial sources of drug information more powerful than non-commercial information sources [2]. The survey did not indicate whether the medical representatives who visit the GPs mainly come on behalf of multinational or local companies. The study authors propose a system whereby non-commercial sources of information should be promoted for doctors.

While the younger doctors at least were open to believing information brought to them by the government, the main requirement is always not what is said, but what is done. A system is needed to ensure the quality of generics. The questionnaire’s authors state that the government of Pakistan should be prompted to develop trust in local manufacturers.

Lack of quality in generic medicines and distrust of local manufacturers were found to be the main barriers to prescribing generics. The authors suggest introducing the concept of ‘Quality by Design’ in local manufacturing units.

Conclusion
The Pakistan Pharmaceutical Manufacturers Association quotes total market share of domestic industry of 70–85% by volume and 55% by value [3]. These figures are shifting more in favour of domestic production. As prescribers gain confidence with locally manufactured medicines and patent protection is lost, the generics industry will gain ground. Even though less than 50% of the population is able to access health care, Pakistan’s estimated population of over 170 million makes it the world’s sixth most populous country. The generics-based pharmaceutical industry will therefore continue to become established there.

Related articles

Attitude of general practitioners towards generics in Pakistan

Generics in Pakistan

Compliance with generic drug use among Pakistani immigrants

Perception of generic drugs as fake among Pakistani immigrants

Pakistani immigrants may confuse generics with counterfeit drugs

References

1.  Jamshed SQ, Ibrahim MIM, Hassali MA, Masood I, Low BY, Shafie AA, et al. Perception and attitude of general practitioners regarding generic medicines in Karachi, Pakistan: a questionnaire based study. Southern Med Review. 2012;5(1):22-30.

2.  Andersson SJ, et al. What shapes GPs’ work with depressed patients? A qualitative interview study. Family Practice. 2002;19(6):623-31.

3.  Pakistan Pharmaceutical Manufacturers’ Association (PPMA) [homepage on the Internet]. Pakistan Pharmaceutical Industry c2008 PPMA [cited 2012 Sep 7]. Available from: www.ppma.org.pk/