title: Perceptions of generic medication in the general population, doctors and pharmacists: a systematic review.
abstract: OBJECTIVE
  To investigate negative perceptions about generic medicines and evaluate the proportions of lay people, doctors and pharmacists who hold these perceptions.
  
  
  METHODS
  A systematic review of observational studies.
  
  
  METHODS
  MEDLINE, EMBASE, PsycInfo and Scopus.
  
  
  METHODS
  Quantitative data from cross-sectional and prospective studies published in English after 1980, using self-report measures to evaluate perceptions about generic medicines, presented as percentages of the total sample assessed.
  
  
  RESULTS
  After screening 2737 articles, 52 articles were included in the final analysis. A high proportion of doctors, pharmacists and lay people had negative perceptions of generics. Lay people were significantly more likely to view generics as less effective than branded medication (35.6%, 95% CI 34.8% to 36.4%) compared to doctors (28.7%, 27.5% to 29.9%) and pharmacists (23.6%, 21.2% to 26.2%), p<0.0001. Pharmacists (33.4%, 31.0% to 35.9%) were significantly more likely to believe generics were of inferior quality compared to branded medication than were doctors (28.0%, 26.3% to 29.9%), p=0.0006, and lay people (25.1%, 24.2% to 26.0%), p<0.0001. Doctors believed generics caused more side effects than branded medication (24.4%, 22.2% to 26.9%), compared to pharmacists (17.6%, 15.3% to 20.1%) and lay people (18.8%, 17.8% to 19.8%), p<0.0001. Doctors (28.5%, 26.9% to 30.2%) and pharmacists (25.4%, 21.4% to 29.9%) had significantly more safety concerns about generics than did lay people (18.0%, 17.0% to 19.0%), p ≤ 0.0002. A greater proportion of lay people felt negatively about generic substitution (34.0%, 33.2% to 34.9%), compared to doctors (24.1%, 22.0% to 26.4%) and pharmacists (11.0%, 9.6% to 12.7%), p<0.0001. Rates of negative perceptions of generics do not appear to have changed substantially over time in the general population or among physician groups, p ≥ 0.431, but such negative beliefs show a decreasing trend in pharmacists over the study period, p=0.034.
  
  
  CONCLUSIONS
  A significant proportion of doctors, pharmacists and lay people hold negative perceptions of generic medicines. It is likely these attitudes present barriers to the wider use of generics.
authors.affiliation: Department of Psychological Medicine, University of Auckland, Auckland, New Zealand.
authors.forename: Sarah
authors.initials: S
authors.lastname: Colgan
authors.affiliation: Department of Psychological Medicine, University of Auckland, Auckland, New Zealand.
authors.forename: Kate
authors.initials: K
authors.lastname: Faasse
authors.affiliation: Department of Psychology, La Sierra University, Riverside, California, USA.
authors.forename: Leslie R
authors.initials: LR
authors.lastname: Martin
authors.affiliation: Department of Psychological Medicine, University of Auckland, Auckland, New Zealand.
authors.forename: Melika H
authors.initials: MH
authors.lastname: Stephens
authors.affiliation: Department of Medicine, University of Auckland, Auckland, New Zealand.
authors.forename: Andrew
authors.initials: A
authors.lastname: Grey
authors.affiliation: Department of Psychological Medicine, University of Auckland, Auckland, New Zealand.
authors.forename: Keith J
authors.initials: KJ
authors.lastname: Petrie
mesh_terms: D003258:Consumer Behavior / Q000706:statistics & numerical data*; D057915:Drug Substitution / Q000592:standards*; D016568:Drugs, Generic / Q000592:standards*; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D064887:Observational Studies as Topic; D010595:Pharmacists / Q000706:statistics & numerical data*; D010820:Physicians / Q000706:statistics & numerical data*
chemical_list: D016568:Drugs, Generic
keywords: GENERAL MEDICINE (see Internal Medicine); HEALTH ECONOMICS; PUBLIC HEALTH