[Substitution of generic for brand medicines in primary care. Factors associated to refuse the change].
OBJECTIVE
In Spain prescription of generic drugs is still low. We have attempted first to estimate the proportion of patients who switch from brand-name medication to generics once properly informed, and secondly to determine the variables associated with the resistance to make this switch.


METHODS
Cross-sectional study.


METHODS
Primary care.


METHODS
We ask to participate in our study to 360 family doctors, each of them should choose the first 5 patients who take prescribed drugs with generic alternatives. 110 doctors refuse and 48 had incomplete or illegible information. Finally 202 doctors and 1006 patients formed our sample. Main measurements. We estimated the percentage of non acceptance and also the variables associated by bivariate analysis and logistic regression.


RESULTS
13% (11%-15%) of patients were unwilling to switch to generic medicine. Variables associated with non acceptance were old age, having a low educational level and being "retired" --which means not having to pay for drugs. The non acceptance was also higher if the patient did not know what a generic drug was, had never taken a generic drug before, and the doctor that originally prescribed the medicine was a hospital specialist. The two characteristics independently associated to non acceptance were the fact that the patient ignored what a generic drug was (odds ratio [OR]=4,0; 95% CI, 2,6-6,4), and the fact hat the doctor that originally prescribed the drug was not the family doctor but a hospital one (OR=3,7; 95% CI, 2,3-5,8).


CONCLUSIONS
The percentage of patients that did not accept switching to generic drugs is very low. To increase the substitution for generics we need to better inform and educate the population and to increase the use of generics in the hospital setting.
Sagardui-Villamor
J K
JK
Centro de Salud de Boadilla del Monte, Area 6, Madrid, Spain. jksagardui@terra.es
Lacalle Rodríguez-Labajo
M
M
Casado-Buendía
S
S
D003430:Cross-Sectional Studies; D011307:Drug Prescriptions / Q000706:statistics & numerical data; D016568:Drugs, Generic / Q000627:therapeutic use*; D005194:Family Practice; D005260:Female; D006801:Humans; D008297:Male; D017060:Patient Satisfaction / Q000706:statistics & numerical data*; D011320:Primary Health Care
D016568:Drugs, Generic