title: Generic medicines and generic substitution: contrasting perspectives of stakeholders in Ireland.
abstract: BACKGROUND
  The Health (Pricing and Supply of Medical Goods) Act 2013 passed into law in July 2013 and legislated for generic substitution in Ireland. The aim of the study was to ascertain the knowledge and perceptions of stakeholders i.e. patients, pharmacists and prescribers, of generic medicines and to generic substitution with the passing of legislation.
  
  
  METHODS
  Three stakeholder specific questionnaires were developed to assess knowledge of and perceptions to generic medicines and generic substitution. Purposive samples of patients, prescribers and pharmacists were analysed. Descriptive quantitative and qualitative analyses were undertaken.
  
  
  CONCLUSIONS
  A total of 762 healthcare professionals and 353 patients were recruited. The study highlighted that over 84% of patients were familiar with generic medicines and are supportive of the concept of generic substitution. Approximately 74% of prescribers and 84% of pharmacists were supportive of generic substitution in most cases. The main areas of concern highlighted by the healthcare professionals that might impact on the successful implementation of the policy, were the issue of bioequivalence with generic medicines, the computer software systems used at present in general practitioner (GP) surgeries and the availability of branded generics. The findings from this study identify a high baseline rate of acceptance to generic medicines and generic substitution among patients, prescribers and pharmacists in the Irish setting. The concerns of the main stakeholders provide a valuable insight into the potential difficulties that may arise in its implementation, and the need for on-going reassurance and proactive dissemination of the impact of the generic substitution policy.
  
  
  CONCLUSIONS
  The existing positive attitude to generic medicines and generic substitution among key stakeholders in Ireland to generic substitution, combined with appropriate support and collaboration should result in the desired increase in rates of prescribing, dispensing and use of generic medicines.
authors.affiliation: National Centre for Pharmacoeconomics, St. James's Hospital, Dublin 8, Ireland. aoleary@stjames.ie.|School of Pharmacy, Royal College of Surgeons, St. Stephens Green, Dublin 2, Ireland. aoleary@stjames.ie.
authors.forename: A
authors.initials: A
authors.lastname: O'Leary
authors.affiliation: National Centre for Pharmacoeconomics, St. James's Hospital, Dublin 8, Ireland. cusher@stjames.ie.
authors.forename: C
authors.initials: C
authors.lastname: Usher
authors.affiliation: School of Pharmacy, Royal College of Surgeons, St. Stephens Green, Dublin 2, Ireland. Matthewlynch@rcsi.ie.
authors.forename: M
authors.initials: M
authors.lastname: Lynch
authors.affiliation: Department of Pharmacology and Therapeutics, St. James's Hospital, Dublin 8, Ireland. Mhall@stjames.ie.
authors.forename: M
authors.initials: M
authors.lastname: Hall
authors.affiliation: Department of Pharmacology and Therapeutics, St. James's Hospital, Dublin 8, Ireland. LHemeryk@stjames.ie.
authors.forename: L
authors.initials: L
authors.lastname: Hemeryk
authors.affiliation: National Centre for Pharmacoeconomics, St. James's Hospital, Dublin 8, Ireland. sspillane@stjames.ie.
authors.forename: S
authors.initials: S
authors.lastname: Spillane
authors.affiliation: School of Pharmacy, Royal College of Surgeons, St. Stephens Green, Dublin 2, Ireland. pgallagher@rcsi.ie.
authors.forename: P
authors.initials: P
authors.lastname: Gallagher
authors.affiliation: National Centre for Pharmacoeconomics, St. James's Hospital, Dublin 8, Ireland. mbarry@stjames.ie.|Department of Pharmacology and Therapeutics, St. James's Hospital, Dublin 8, Ireland. mbarry@stjames.ie.
authors.forename: M
authors.initials: M
authors.lastname: Barry
mesh_terms: D001291:Attitude of Health Personnel; D057915:Drug Substitution / Q000523:psychology*; D016568:Drugs, Generic / Q000627:therapeutic use*; D005260:Female; D058005:General Practitioners / Q000523:psychology* / Q000706:statistics & numerical data; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007494:Ireland; D008297:Male; D010361:Patients / Q000523:psychology* / Q000706:statistics & numerical data; D010595:Pharmacists / Q000523:psychology* / Q000706:statistics & numerical data; D011795:Surveys and Questionnaires
chemical_list: D016568:Drugs, Generic