As part of a multicentric cross-sectional survey, patients completed a questionnaire on their perception and willingness to accept generics in September 2013.

The results showed that of the 556 patients included in the study 76% (N = 409) accepted generics; 81% of them willingly and 19% of them because the National Health Insurance will directly charge the pharmacy for generics. Furthermore, 55% (N = 309) trusted generics overall. This increased to 58% if generics were recommended by the pharmacist and to 76% if recommended by the physician.

For antiretroviral generics, 44% of the patients accepted them but this dropped to 17% with increased pill burden. A total of 29% of the patients rejected antiretroviral generics. Reasons for patient rejection of antiretroviral generics included; reasons of confidence (65%), as a rule (36%), by fear of effectiveness (38%), adverse side effects (36%) or the fact they are disturbing (17%). In multivariate analysis, the only significant criterion associated with acceptance of antiretroviral generics was acceptance of generics in general (p < 0.001).

The authors concluded that switching brand-name antiretroviral medications to generics was mostly accepted if the patient accepted generics overall and if the pill burden was unchanged. The authors also found that patients are not well-informed about the costs of brand-name and generic antiretroviral medicines. This may be linked to the fact that 100% coverage by the healthcare system eclipses the concept of the costs involved for society in general.

The finding that one-third of patients are opposed to antiretroviral generics was perhaps not surprising. A study of perceptions to generics in general also found that about one-third of patients reported negative experiences, which it was thought could lead to poor adherence and medication errors [2].

Patients’ wishes remain a decisive factor in the acceptability of antiretroviral generics. The authors therefore concluded that ‘efficient information about antiretroviral generics … for patients and patients’ associations is an essential step towards improving the acceptability of generic antiretrovirals, which are prescribed and effective in the majority of HIV patients in the world.’

Conflict of interest
The authors of the research paper [1] declared that the paper presents independent research by CHU Clermont-Ferrand, the promoter of the survey to compile the paper. Mylan provided funding for data capture.

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

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

Readers interested in contributing a research or perspective paper to GaBI Journal – an independent, peer reviewed academic journal platform – please send us your submission here.

Related article
Patients’ and physicians’ perceptions of HIV generics

Physicians’ perceptions of HIV generics in France

References
1.   Jacomet C, Allavena C, Peyrol P, et al. Perception of Antiretroviral Generic Medicines: One-Day Survey of HIV-Infected Patients and Their Physicians in France. PLoS ONE. 2015;10(2): e0117214. doi:10.1371/journal. pone.0117214
2.  Håkonsen H, Toverud E-L. A review of patient perspectives on generics substitution: what are the challenges for optimal drug use. Generics and Biosimilars Initiative Journal (GaBI Journal). 2012;1(1):28-32. doi:10.5639/gabij.2012.0101.008

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