International Journal of Clinical Pharmacy

, Volume 39, Issue 5, pp 1101–1109 | Cite as

Perceptions and behaviors of patients and pharmacists towards generic drug substitution in Lebanon

  • Shadi SalehEmail author
  • Clara Abou Samra
  • Stewart Jleilaty
  • Joanne Constantin
  • Nour El Arnaout
  • Hani Dimassi
  • Dania Al-Bittar
Research Article


Background Patients, physicians and pharmacists are key stakeholders in the implementation of generic substitution policies. Objectives To explore Lebanese patients’ perceptions and experience, and pharmacists’ dispensing patterns towards the newly enacted unified health prescription policy promoting generic substitution. Setting Pharmacies in Beirut, the capital of Lebanon. Methods A cross-sectional design employing self-administered questionnaires to survey a total of 128 patients and 25 pharmacists. Chi square test and multiple logistic regression were performed. Main outcome Perceptions and behaviors of patients and pharmacists towards the unified health prescription and generic substitution. Results Fourty-eight percent of the patients knew the definition of generic drugs, among which 59.0% perceived that generic drugs have the same effectiveness as their branded alternatives and 59.0% perceiving that generic drugs could reduce Lebanon’s medical bill as well. Sixty-one percent of the patients were aware of the unified health prescription. Only 13.6% of the pharmacists suggested to patients to replace prescribed brand drug by a generic when their prescriptions were not marked with non-substitution. Conclusions Progress has been made with regards to enhancing generic substitution in the Lebanese healthcare field. However, it remains important to educate patients about generic medicines and plan context-specific schemes that promote prescribing and dispensing of generic drugs among physicians and pharmacists.


Access to medicine Generic drugs Health policy Lebanon Outpatients Pharmacy 



The authors wish to thank all the patients and pharmacists who participated in the survey. We also thank Ms. Angie Farah for her contribution.


This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

Conflicts of interest

The authors declare that they have no conflict of interest.

Ethics approval

The American University of Beirut’s Institutional Review Board approved the protocol from March 8, 2016 to March 7, 2017 inclusive (FHS.SS.17).

Informed consent

Informed consent was obtained from all individual participants included in the study.


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Copyright information

© Springer International Publishing AG 2017

Authors and Affiliations

  • Shadi Saleh
    • 1
    Email author
  • Clara Abou Samra
    • 1
  • Stewart Jleilaty
    • 1
  • Joanne Constantin
    • 1
  • Nour El Arnaout
    • 1
  • Hani Dimassi
    • 2
  • Dania Al-Bittar
    • 1
  1. 1.Department of Health Management and Policy, Faculty of Health SciencesAmerican University of BeirutBeirutLebanon
  2. 2.School of PharmacyLebanese American UniversityBeirutLebanon

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