title: Consumer choice between common generic and brand medicines in a country with a small generic market.
abstract: BACKGROUND
  Generic medicines offer an opportunity for governments to contain pharmaceutical expenditures, since generics are generally 10%-80% lower in price than brand medicines. Belgium has a small generic market that takes up 15% of the total pharmaceutical market in packages sold.
  
  
  OBJECTIVE
  To determine the knowledge of consumers about the different available packages of a common over-the-counter medicine (acetaminophen) with regard to price advantage, quality, and effectiveness in a country with a small generic market.
  
  
  METHODS
  We conducted an online survey in the general Flemish population using a questionnaire with 25 statements. The questionnaire also contained 2 informative interventions. First, we showed the price per package and per tablet that the patient would pay in the pharmacy. Second, we provided the respondent with general information about generic medication (equivalence, effectiveness, price, and recognition). Before and after the interventions, we probed for preferences and knowledge about the different packages. Multivariate logistic models were used to examine the independent effects of consumer characteristics on responses to the survey statements.
  
  
  RESULTS
  We obtained a sample of 1,636 respondents. The general attitude towards generic medication was positive-only 5% would rather not use a generic. Nevertheless, only 17% of the respondents were able to recognize a generic medicine. Older consumers (aged 60 years and above) were more often confused about the different packages (OR = 2.59, 95% CI = 1.76-3.80, P ≤ 0.001). Consumers without a higher education degree tended to be more doubtful about the difference in effectiveness and quality between the different brands (OR = 0.59, 95% CI = 0.44-0.79, P ≤ 0.001). Consumer recognition of the name of the active substance of acetaminophen was poor. When different brands were displayed, possible price advantage seemed to be an important motive to switch to a cheaper brand. Consumers generally found medicines to be too expensive; however, consumers with medical or paramedical training had a different opinion.
  
  
  CONCLUSIONS
  Two main recommendations can be made to increase the knowledge and enhance the trust in cheaper equivalent medicines. First, highlighting the name of the active substance on the label of medicine packages can reduce confusion and avoid health risks, especially among older consumers. Second, new investments or reallocation of budgets should be considered in order to provide consumers with authoritative information on the bioequivalence and price differences between the different available brands. This would be a cost-effective and potentially cost-saving investment for health care payers.
authors: University of Antwerp, Universiteitsplein 1, 2610 Wilrijk (Antwerp), Belgium. jessica.fraeyman@uantwerpen.be.
authors: Jessica
authors: J
authors: Fraeyman
authors: Lies
authors: L
authors: Peeters
authors: Guido
authors: G
authors: Van Hal
authors: Philippe
authors: P
authors: Beutels
authors: Guido R Y
authors: GR
authors: De Meyer
authors: Hans
authors: H
authors: De Loof
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001530:Belgium; D002755:Choice Behavior; D003258:Consumer Behavior / Q000191:economics; D016527:Drug Costs; D016568:Drugs, Generic / Q000191:economics; D005260:Female; D019981:Health Care Sector / Q000191:economics; D006801:Humans; D008297:Male; D008875:Middle Aged; D004366:Nonprescription Drugs / Q000191:economics; D011795:Surveys and Questionnaires; D055815:Young Adult
chemical_list: D016568:Drugs, Generic; D004366:Nonprescription Drugs