title: Perception and attitude of general practitioners regarding generic medicines in Karachi, Pakistan: A questionnaire based study.
abstract: OBJECTIVE
  In developing countries out-of-pocket payments (OOP) are as high as 80% of healthcare spending. Generic medicines can be instrumental in reducing this expenditure. The current study is aimed to explore the knowledge, perception, and attitude of general practitioners towards generic medicines in Karachi, Pakistan.
  
  
  METHODS
  This exploratory, descriptive study was conducted on a sample of 289 randomly selected general practitioners who were dispensing at their private clinics in Karachi, Pakistan. The questionnaires were distributed and collected by hand. Data was entered to SPSS version 17. Fischer's exact test was applied to see the association between variables.
  
  
  RESULTS
  A total of 206 questionnaires were included in the study. A response rate of 71.3% was achieved. Out of 206 respondents, 139 (67.5%) were male while 67 (32.5%) respondents were female. Close to three quaters of the respondents (n= 148; 71.8%) showed correct knowledge about generic medicines being a 'copy of the brand name medicines' and 'interchangeable with brand name medicines' (n= 148; 71.8%). 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. The total percentage of correct responses was seen in 53% of the respondents. More than half of the respondents agreed that locally manufactured medicines are of the same effectiveness as brand name medicines (n=114; 55.4%). Male practitioners with practice experience of 11-15 years showed positive perception towards the quality of multinational products. The Majority of respondents believed that their prescribing decision is influenced by medical representatives (n=117; 56.8%). More than three-quarters of the respondents expressed their wish to prescribe low cost medicines in their practice (n=157; 76.2%). More than one third of the respondents expressed their uneasiness to prescribe products from all local manufacturers (n=72; 35%).
  
  
  CONCLUSIONS
  There were gaps identified in the knowledge of respondents. Although good perception and attitude were noted among the respondents, dissemination of information regarding generic medicines may perhaps strengthen generic prescribing. There is a need to introduce 'Quality by Design' concept in local manufacturing units. This, in turn, can inculcate confidence in prescribers towards locally manufactured generic medicines.
authors.affiliation: Kulliyyah of Pharmacy, International Islamic University Malaysia (IIUM), Kuantan, Malaysia.
authors.forename: Shazia Qasim
authors.initials: SQ
authors.lastname: Jamshed
authors.forename: Mohamed Izham Mohamed
authors.initials: MI
authors.lastname: Ibrahim
authors.forename: Mohamed Azmi Ahmad
authors.initials: MA
authors.lastname: Hassali
authors.forename: Imran
authors.initials: I
authors.lastname: Masood
authors.forename: Bee Yean
authors.initials: BY
authors.lastname: Low
authors.forename: Asrul Akmal
authors.initials: AA
authors.lastname: Shafie
authors.forename: Zaheer-Ud-Din
authors.initials: ZU
authors.lastname: Babar
keywords: Karachi; Pakistan; attitude; dispensing doctor; general practitioner; generic medicines; perception