Do people regard cheaper medicines effective? Population survey on public opinion of generic substitution in Finland.
OBJECTIVE
Generic substitution (GS) is an important way to decrease medical costs. We aimed to study the opinions and attitudes of Finnish people about GS five years after it was introduced, the reasons for substituting and what people think about generic medicines.


METHODS
We sent a postal survey to a random stratified population sample of 3000 Finnish people aged at least 18 years in 2008. The random sample was drawn from five mainland counties. The sampling was conducted by the Finnish Population Register Centre. The response rate was 62% (n=1844) after exclusion of unobtainable addressees (n=34).


RESULTS
Most of the respondents (70.9%) considered GS a good law reform. However, there were many respondents who were unsure about their opinion (26.9%). The respondents also held the opinion that cheaper medicines are effective (80.9%) and that GS does not cause any risk to drug safety (84.9%). Most of the respondents (88.4%) who had substituted their medicines had not noticed any difference between the previously used and substituted medicines. Two main reasons for substituting were a desire to save money and recommendation by pharmacists. Of the respondents, 16.3% had experience with both substituting and refusing it. The percentage of the respondents who only had experience with refusing GS was 8.6%. Female gender, older age and use of prescription drugs were associated with refusing.


CONCLUSIONS
Finnish people consider GS a good reform. They also have confidence in the effect of cheaper medicines. Savings are the main reason for accepting GS.
Faculty of Health Sciences, School of Pharmacy, Social Pharmacy, University of Eastern Finland, Kuopio, Finland. reeta.heikkila@uef.fi
Reeta
R
Heikkilä
Pekka
P
Mäntyselkä
Riitta
R
Ahonen
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D016009:Chi-Square Distribution; D003257:Consumer Product Safety; D017046:Cost Savings; D016527:Drug Costs; D057915:Drug Substitution / Q000009:adverse effects / Q000191:economics / Q000523:psychology*; D016568:Drugs, Generic / Q000009:adverse effects / Q000191:economics / Q000627:therapeutic use*; D005260:Female; D005387:Finland; D019538:Health Care Surveys; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007356:Insurance, Pharmaceutical Services; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009313:National Health Programs; D016017:Odds Ratio; D017060:Patient Satisfaction; D011639:Public Opinion; D018570:Risk Assessment; D012737:Sex Factors; D011795:Surveys and Questionnaires; D013997:Time Factors; D016312:Treatment Refusal; D055815:Young Adult
D016568:Drugs, Generic