title: Brand loyalty, patients and limited generic medicines uptake.
abstract: The sluggish development of European generic drug markets depends heavily on demand side factors, and more specifically, patients' and doctors' loyalty to branded products. Loyalty to originator drugs, to the point where originator prices rise upon generic entry has been described as the 'generics paradox'. Originator loyalty can emerge for a plethora of reasons; including costs, perceptions about quality and physician advice. We know very little about the behavioural underpinnings of brand loyalty from the consumer or patient standpoint. This paper attempts to test the extent to which patients are brand loyal by drawing upon Spain's 2002 Health Barometer survey as it includes questions about consumer acceptance of generics in a country with exceptionally low generic uptake and substitution at the time of the study. Our findings suggest that at least 13% of the population would not accept generics as substitutes to the originator. These results confirm evidence of brand loyalty for a minority. Alongside high levels of awareness of generics, we find that low cost-sharing levels explain consumer brand loyalty but their impact on acceptance of generic substitution is very small. Higher cost-sharing and exempting fewer patients from cost-sharing have the potential to encourage generic acceptance.
authors.affiliation: London School of Economics and Political Science, LSE, United Kingdom.
authors.forename: Joan
authors.initials: J
authors.lastname: Costa-Font
authors.affiliation: London School of Economics and Political Science, LSE, United Kingdom. Electronic address: a.c.rudisill@lse.ac.uk.
authors.forename: Caroline
authors.initials: C
authors.lastname: Rudisill
authors.affiliation: London School of Hygiene and Tropical Medicine, LSHTM, United Kingdom.
authors.forename: Stefanie
authors.initials: S
authors.lastname: Tan
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D001294:Attitude to Health; D017047:Cost Sharing; D057915:Drug Substitution / Q000523:psychology / Q000706:statistics & numerical data; D016568:Drugs, Generic / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D057240:Patient Preference / Q000706:statistics & numerical data*; D012959:Socioeconomic Factors; D013030:Spain / Q000453:epidemiology; D055815:Young Adult
chemical_list: D016568:Drugs, Generic
keywords: Attitudes; Generic drugs; Generics paradox; Generics policy