International Journal of Clinical Pharmacy

, Volume 37, Issue 3, pp 497–503 | Cite as

Consumers’ perception of generic substitution in Iran

  • Nazila Yousefi
  • Gholamhossein MehralianEmail author
  • Farzad Peiravian
  • Samaneh NourMohammadi
Research Article


Background The growth of pharmaceutical expenditure and patients’ out of pocket has motivated policy makers to encourage patients to substitution of brands medicines with their generic alternatives called generic substitution. Objectives As the patients are final decision makers to accept generic substitution, the aim of this study is to evaluate the patient perception about generic medicines and underlying factors which can promote the generic acceptance. Setting The study was done in community pharmacies in Tehran, the capital city of Iran. Method A cross-sectional descriptive study inviting people purchasing their drug at community pharmacies were per-formed using a self-administrated anonymous questionnaire (N=1309). Main outcomes measures besides the demographic section, 16 items of developed questionnaire were categorized to five main factors including: patients’ perception about efficiency, safety and cost of generic medicines, patient trust on physicians and pharmacists’ advice. Results Findings of completed questionnaires showed among the aforementioned factors the physician has the first priority to encourage patients to use of generics medicines which followed respectively by pharmacist’s role, cost of medicines, efficacy, and safety concerns. Conclusion In conclusion, the trust of Iranian’s society on the physicians and pharmacists advice would create a credible opportunity to reduce pharmaceutical expenditures as well as patients’ out of pocket by promotion of generic substitution.


Consumers’ perception Generic substitution Iran Pharmaceutical policy 



No financial support was obtained for this study.

Conflicts of interests

Authors have no conflict of interest.


  1. 1.
    Thomas R. Health services demand and utilization. Health services planning. New York, US: Springer; 2003.CrossRefGoogle Scholar
  2. 2.
    Smith RD, Correa C, Oh C. Trade, TRIPS and Pharmaceuticals. Lancet 2009;373:684–91.Google Scholar
  3. 3.
    Ess SM, Schneeweiss S, Szucs TD. European healthcare policies for controlling drug expenditure. Pharmacoeconomics. 2003;21(2):89–103.CrossRefPubMedGoogle Scholar
  4. 4.
    McManus P, Birkett DJ, Dudley J, Stevens A. Impact of the Minimum Pricing Policy and introduction of brand (generic) substitution into the Pharmaceutical Benefits Scheme in Australia. Pharmacoepidemiol Drug Saf. 2001;10(4):295–300.CrossRefPubMedGoogle Scholar
  5. 5.
    Hassali MA, Shafie AA, Chong CP, Saleem F, Atif M, Chua G, et al. Community pharmacist’s perceptions towards the quality of locally manufactured generic medicines: a descriptive study from Malaysia. J Appl Pharm Sci. 2012;2(1):56–60.Google Scholar
  6. 6.
    Abdollahiasl A. Medicine prices, availability, affordability and price component. In: IranFDO, editor. World Health Organization; 2010.Google Scholar
  7. 7.
    El-Dahiyat F, Kayyali R. Evaluating patients’ perceptions regarding generic medicines in Jordan. J Pharm Policy Pract. 2013;6(1):3.CrossRefPubMedCentralPubMedGoogle Scholar
  8. 8.
    Jamshed S, Babar Z, Ibrahim M, Hassali M. Generic medicines as a way to improve access and affordability: a proposed framework for Pakistan. J Clin Diagn Res. 2009;3(3):1596–600.Google Scholar
  9. 9.
    Omojasola A, Hernandez M, Sansgiry S, Jones L. Perception of generic prescription drugs and utilization of generic drug discount programs. Ethn Dis. 2012;22(4):479.PubMedCentralPubMedGoogle Scholar
  10. 10.
    Galizzi MM, Ghislandi S, Miraldo M. Effects of reference pricing in pharmaceutical markets. Pharmacoeconomics. 2011;29(1):17–33.CrossRefPubMedGoogle Scholar
  11. 11.
    Mendis S, Fukino K, Cameron A, Laing R, Filipe A Jr, Khatib O, et al. The availability and affordability of selected essential medicines for chronic diseases in six low-and middle-income countries. Bull World Health Organ. 2007;85(4):279–88.CrossRefPubMedCentralPubMedGoogle Scholar
  12. 12.
    Barros PP, Nunes LC. The impact of pharmaceutical policy measures: an endogenous structural-break approach. Soc Sci Med. 2010;71(3):440–50.CrossRefPubMedGoogle Scholar
  13. 13.
    Chong CP, March G, Clark A, Gilbert A, Hassali MA, Bahari MB. A nationwide study on generic medicines substitution practices of Australian community pharmacists and patient acceptance. Health Policy. 2011;99(2):139–48.CrossRefPubMedGoogle Scholar
  14. 14.
    Babar Z-U-D, Stewart J, Reddy S, Alzaher W, Vareed P, Yacoub N, et al. An evaluation of consumers’ knowledge, perceptions and attitudes regarding generic medicines in Auckland. Pharm World Sci. 2010;32(4):440–8.CrossRefPubMedGoogle Scholar
  15. 15.
    Sharrad AK, Hassali MA. Consumer perception on generic medicines in Basrah, Iraq: preliminary findings from a qualitative study. Res Soc Adm Pharm. 2011;7(1):108–12.CrossRefGoogle Scholar
  16. 16.
    IranFDO. Pharmaceutical statistics. Food and drug organization of iranian Ministry of Health, Iran; 2013.Google Scholar
  17. 17.
    Heikkilä R, Mäntyselkä P, Ahonen R. Why people refuse generic substitution: a population survey of public opinion on generic substitution in Finland. Drugs Ther Perspect. 2012;28(8):24–6.Google Scholar
  18. 18.
    Cameron A, Mantel-Teeuwisse AK, Leufkens HG, Laing RO. Switching from originator brand medicines to generic equivalents in selected developing countries: How much could be saved? Value Health. 2012;15(5):664–73.CrossRefPubMedGoogle Scholar
  19. 19.
    Hassali MA, Shafie AA, Jamshed S, Ibrahim MI, Awaisu A. Consumers’ views on generic medicines: a review of the literature. Int J Pharm Pract. 2009;17(2):79–88.PubMedGoogle Scholar
  20. 20.
    King DR, Kanavos P. Encouraging the use of generic medicines: implications for transition economies. Croat Med J. 2002;43(4):462–9.PubMedGoogle Scholar
  21. 21.
    Himmel W, Simmenroth-Nayda A, Niebling W, Ledig T, Jansen R-D, Kochen M, et al. What do primary care patients think about generic drugs? Int J Clin Pharmacol Ther. 2005;43(10):472.CrossRefPubMedGoogle Scholar
  22. 22.
    Kjoenniksen I, Lindbaek M, Granas AG. Patients’ attitudes towards and experiences of generic drug substitution in Norway. Pharm World Sci. 2006;28(5):284–9.CrossRefPubMedGoogle Scholar
  23. 23.
    Meredith PA. Potential concerns about generic substitution: bioequivalence versus therapeutic equivalence of different amlodipine salt forms. Curr Med Res Opin. 2009;25(9):2179–89.CrossRefPubMedGoogle Scholar
  24. 24.
    Quintal C, Mendes P. Underuse of generic medicines in Portugal: an empirical study on the perceptions and attitudes of patients and pharmacists. Health Policy. 2012;104(1):61–8.CrossRefPubMedGoogle Scholar
  25. 25.
    Heikkilä R, Mäntyselkä P, Ahonen R. Do people regard cheaper medicines effective? Population survey on public opinion of generic substitution in Finland. Pharmacoepidemiol Drug Saf. 2011;20(2):185–91.CrossRefPubMedGoogle Scholar
  26. 26.
    Heikkilä R, Mäntyselkä P, Hartikainen-Herranen K, Ahonen R. Customers’ and physicians’ opinions of and experiences with generic substitution during the first year in Finland. Health Policy. 2007;82(3):366–74.CrossRefPubMedGoogle Scholar
  27. 27.
    Heikkilä R, Mäntyselkä P, Ahonen R. Price, familiarity, and availability determine the choice of drug-a population-based survey five years after generic substitution was introduced in Finland. BMC Pharmacol Toxicol. 2011;11(1):20.Google Scholar
  28. 28.
    Lambert ZV, Doering PL, Goldstein E, McCormick WC. Predispositions toward generic drug acceptance. J Consum Res. 1980;7(1):14–23.Google Scholar
  29. 29.
    Gaither CA, Kirking DM, Ascione FJ, Welage LS. Science & practice-reviews-consumers’ views on generic medications. J Am Pharm Assoc. 2001;41(5):729–36.Google Scholar
  30. 30.
    Rathe J, Larsen P, Andersen M, Paulsen M, Jarbøl D, Thomsen J, et al. Associations between generic substitution and patients’ attitudes, beliefs and experiences. Eur J Clin Pharmacol. 2013;69(10):1827–36.CrossRefPubMedGoogle Scholar
  31. 31.
    Allenet B, Barry H. Opinion and behaviour of pharmacists towards the substitution of branded drugs by generic drugs: survey of 1,000 French community pharmacists. Pharm World Sci. 2003;25(5):197–202.CrossRefPubMedGoogle Scholar
  32. 32.
    Shepherd M. Consumer drug purchases are based on perceptions of quality, survey on generics finds. Am J Hosp Pharm. 1988;45:1245.Google Scholar
  33. 33.
    Al-Gedadi NA, Hassali MA, Shafie AA. A pilot survey on perceptions and knowledge of generic medicines among consumers in Penang, Malaysia. Pharm Pract. 2008;6(2):93–7.Google Scholar
  34. 34.
    Figueiras MJ, Marcelino D, Cortes MA. People’s views on the level of agreement of generic medicines for different illnesses. Pharm World Sci. 2008;30(5):590–4.CrossRefPubMedGoogle Scholar
  35. 35.
    Ganther JM, Kreling DH. Consumer perceptions of risk and required cost savings for generic prescription drugs. Am Pharm. 1999;40(3):378–83.Google Scholar
  36. 36.
    Mehralian G, Rangchian M, Rasekh HR. Client priorities and satisfaction with community pharmacies: the situation in Tehran. Int J Clin Pharm. 2014;36(4):707–15.CrossRefPubMedGoogle Scholar
  37. 37.
    Mehralian G, Rangchian M, Javadi A, Peiravian F. Investigation on barriers to pharmaceutical care in community pharmacies: a structural equation model. Int J Clin Pharm. 2014;36(5):1087–94.Google Scholar
  38. 38.
    Mehralian G, Yousefi N, Hashemian F, Maleksabet H. knowledge, attitude and practice regarding dietary supplements: a community pharmacy-based survey in Tehran. Iran J Pharm Res. 2014;13(4):1455–63.Google Scholar
  39. 39.
    Ud-Din Babar Z, Grover P, Butler R, Bye L, Sheridan J. A qualitative evaluation of general practitioners’ perceptions regarding access to medicines in New Zealand. BMJ Open 2012;2:e000518PubMedCentralPubMedGoogle Scholar

Copyright information

© Koninklijke Nederlandse Maatschappij ter bevordering der Pharmacie 2015

Authors and Affiliations

  • Nazila Yousefi
    • 1
  • Gholamhossein Mehralian
    • 1
    Email author
  • Farzad Peiravian
    • 1
  • Samaneh NourMohammadi
    • 2
  1. 1.Department of Pharmacoeconomics and Pharma Management, School of PharmacyShahid Beheshti University of Medical SciencesTehranIran
  2. 2.School of PharmacyIslamic Azad UniversityTehranIran

Personalised recommendations