title: Physician perceptions about generic drugs.
abstract: BACKGROUND
  With constrained health-care resources, there is a need to understand barriers to cost-effective medication use.
  
  
  OBJECTIVE
  To study physician perceptions about generic medications.
  
  
  METHODS
  Physicians used 5-point Likert scales to report perceptions about cost-related medication nonadherence, the efficacy and quality of generic medications, preferences for generic use, and the implications of dispensing medication samples. Descriptive statistics were used to assess physician perceptions and logistic regression models were used to evaluate predictors of physician perceptions.
  
  
  RESULTS
  Among the invited sample, 839 (30.4%) responded and 506 (18.3%) were eligible and included in the final study population. Over 23% of physicians surveyed expressed negative perceptions about efficacy of generic drugs, almost 50% reported negative perceptions about quality of generic medications, and more than one quarter do not prefer to use generics as first-line medications for themselves or for their family. Physicians over the age of 55 years were 3.3 times more likely to report negative perceptions about generic quality, 5.8 times more likely to report that they would not use generics themselves, and 7.5 times more likely to state that they would not recommend generics for family members (p < 0.05 for all). Physicians reported that pharmaceutical company representatives are the most common (75%) source of information about market entry of a generic medication. Almost half of the respondents expressed concern that free samples may adversely affect subsequent affordability, yet two thirds of respondents provide free samples.
  
  
  CONCLUSIONS
  A meaningful proportion of physicians expressed negative perceptions about generic medications, representing a potential barrier to generic use. Payors and policymakers trying to encourage generic use may consider educational campaigns targeting older physicians.
authors.affiliation: Brigham and Women's Hospital and Department of Medicine, Division of Pharmacoepidemiology and Pharmacoeconomics, Harvard Medical School, Boston, MA, USA. wshrank@partners.org
authors.forename: William H
authors.initials: WH
authors.lastname: Shrank
authors.forename: Joshua N
authors.initials: JN
authors.lastname: Liberman
authors.forename: Michael A
authors.initials: MA
authors.lastname: Fischer
authors.forename: Charmaine
authors.initials: C
authors.lastname: Girdish
authors.forename: Troyen A
authors.initials: TA
authors.lastname: Brennan
authors.forename: Niteesh K
authors.initials: NK
authors.lastname: Choudhry
mesh_terms: D000328:Adult; D000368:Aged; D000375:Aging; D001291:Attitude of Health Personnel; D003430:Cross-Sectional Studies; D004345:Drug Industry / Q000379:methods; D016568:Drugs, Generic / Q000008:administration & dosage / Q000191:economics / Q000627:therapeutic use; D005192:Family Health; D005260:Female; D006801:Humans; D033181:Information Dissemination / Q000379:methods; D020407:Internet; D008297:Male; D055118:Medication Adherence / Q000523:psychology*; D008875:Middle Aged; D010820:Physicians / Q000523:psychology; D010818:Practice Patterns, Physicians' / Q000191:economics; D011786:Quality Control; D012651:Self Medication; D011795:Surveys and Questionnaires; D014481:United States
chemical_list: D016568:Drugs, Generic