title: Patient perceptions of generic medicines: a mixed-methods study.
abstract: BACKGROUND
  In an attempt to benefit from the cost-savings associated with use of generic medicines, in June 2013 Ireland introduced generic substitution and reference pricing for the first time. However, perceptions of Irish patients towards generic medicines have not been published previously. Therefore, the objective of this study was to assess how generic medicines were perceived amongst patients in the time leading up to the enactment of the new legislation.
  
  
  METHODS
  A total of 42 patients were recruited from general practices affiliated with the Graduate Entry Medical School at the University of Limerick and from community pharmacies. Interviews were semi-structured and included quantitative assessments of opinions using 15 structured questions and a five-point Likert scale response system. Interview transcripts were coded and thematically analysed using NVivo (version 9), for qualitative data. Quantitative data were analysed using SPSS (version 20).
  
  
  RESULTS
  Nearly one-third (31 %) of patients had no knowledge of generic medicines and 39 % of those exhibited confusion between the words 'generic' and 'genetic'. Almost one-quarter (24 %) held the view that generics were of poorer quality than originators, while 18 % expressed the opinion that generics do not work as well as originator products. Approximately one-third (30 %) of patients believed that generics were manufactured to a poorer quality, with 29 % holding the view that generics are less expensive due to being of inferior quality. Nearly 90 % of patients stated they would take a generic medicine if it were prescribed by their GP; however, 24 % of patients stated a preference, if offered a choice, for the originator medication. Additionally, a majority of patients (86 %) were in favour of reference pricing and generic substitution. Of the patients interviewed, 50 % stated that a leaflet, or similar, with appropriate, understandable, and accessible information regarding generic medicines would be of use to them.
  
  
  CONCLUSIONS
  This is the first study of patients' attitudes towards generic medicines in Ireland. Conducted in the time period leading up to the implementation of legislation promoting the use of generic medicines, it highlights variable knowledge about generic medicines among this key stakeholder group. Although patients are supportive of their more widespread use, concerns regarding safety, clinical effectiveness, and manufacturing quality of generic medicines were identified.
authors.affiliation: Centre for Interventions in Infection, Inflammation and Immunity (4i), Graduate Entry Medical School, University of Limerick, Limerick, Ireland, suzanne.dunne@ul.ie.
authors.forename: Suzanne
authors.initials: S
authors.lastname: Dunne
authors.forename: Bill
authors.initials: B
authors.lastname: Shannon
authors.forename: Colum
authors.initials: C
authors.lastname: Dunne
authors.forename: Walter
authors.initials: W
authors.lastname: Cullen
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D016568:Drugs, Generic; D005260:Female; D006801:Humans; D007494:Ireland; D008297:Male; D008875:Middle Aged; D010353:Patient Education as Topic; D057240:Patient Preference; D010361:Patients / Q000523:psychology*; D010465:Perception; D055815:Young Adult
chemical_list: D016568:Drugs, Generic