title: Perception and attitude of physicians toward local generic medicines in Saudi Arabia: A questionnaire-based study.
abstract: OBJECTIVE
  The current study aimed to explore the knowledge, perception, and attitude of physicians toward generic medicines in Saudi Arabia.
  
  
  BACKGROUND
  The local market of generic medicine share in Saudi Arabia is low compared to global and regional statistics. The reason for this low market share and the role of physicians has not previously been investigated. The purpose of this study was to assess health practitioner level of perceived knowledge, opinions and attitudes about local generic medication, and identify factors that influence infrequency of generic prescriptions.
  
  
  METHODS
  A random sample of 231 physicians was recruited from two hospitals in Riyadh (one government one private) and 178 (77%) responded. Information on the physicians' perceived knowledge, opinions and attitude toward local generic medication was extracted, analyzed and interpreted. Factors that influence infrequent prescription of local generic drugs were identified.
  
  
  RESULTS
  Among the 178 participants in the physicians' survey, 76% and 47% reported that they are knowledgeable about the terms "generic" and "bioequivalence" respectively, while 44% reported that they are able to explain bioequivalence to their patients. Approximately 52% of physicians reported that local generics should be substituted for brands if suitable for the case, and 21.9% reported that they believe SFDA approved local generics are therapeutically equivalent to their brands. Clinical effectiveness was reported by 71.9% of physicians as the most influential factor effecting prescription of brand over local generic medication. The three independent significant predictors for infrequent prescription of local generics among physicians: Government sector employment (OR = 3.74, [95%CI 1.50-9.43]), consultant level (OR = 3.94, [95%CI 1.50-10.31]) and low level of knowledge about local generics (OR = 4.11, [95%CI 1.56-10.84]).
  
  
  CONCLUSIONS
  The low market share of local generics medicines attributed to low prescription rates is significantly more among senior-level physicians working in governmental hospitals. Low level of knowledge about generic drugs among physicians was the strongest predictive factor for low prescription. Future bigger studies are needed to confirm these results.
authors.affiliation: School of Public Health, King Saud bin AbdulAziz University for Health Sciences, Riyadh, Saudi Arabia; Alghadeer Primary Healthcare Centre, Primary Healthcare Sector and Healthcare Affairs, MOH, Riyadh, Saudi Arabia.
authors.forename: Huda O
authors.initials: HO
authors.lastname: Salhia
authors.affiliation: School of Public Health, King Saud bin AbdulAziz University for Health Sciences, Riyadh, Saudi Arabia.
authors.forename: Anna
authors.initials: A
authors.lastname: Ali
authors.affiliation: School of Applied Medical Sciences, Taibah University, Madina, Saudi Arabia; Andor Laboratories, Durham, NC, USA.
authors.forename: Naser L
authors.initials: NL
authors.lastname: Rezk
authors.affiliation: School of Public Health, King Saud bin AbdulAziz University for Health Sciences, Riyadh, Saudi Arabia; Epidemiology Group, Institute of Applied Health Sciences, University of Aberdeen, UK.
authors.forename: Ashraf
authors.initials: A
authors.lastname: El Metwally
keywords: Attitude; Knowledge; Local generic medicine; Market share; Opinion; Physician; Saudi Arabia