Summary
Rising healthcare costs promote the generic substitution among patients because it is identifiable costs. A key concern is that patients should be involved in the decision of switching. The aim of this study was to examine renal transplant patients’ views on generic substitution in the UK. A total of 163 renal patients were surveyed using 36 multiple‐choice questions at Barts and The London Renal Transplant Clinic, in the UK. Transplant recipients over 18 years, able to read and write English and willing to fill in the questionnaire were targeted; 84% of patients were conscious of the availability of generic medicines, 70% understood the terms “generic” and “branded” in relation to medicines and 54% were aware of generic substitution practice. However, 75% did not know if they were taking generics and 84% felt that generics are not equivalent or only equivalent sometimes and they were uncertain that generics had the same quality as branded medicines. Moreover, many patients admitted that they would not accept the generic substitution of ciclosporin when become available in the UK. A number of factors such as patients’ education, knowledge, severity of the disease, efficacy of generic medicines and patients’ involvement in decisions regarding their health appear to drive patients’ attitudes towards generic substitution.
Most medicines in this study complied with the pharmacopeial limits. However, some generics dissolved differently than their branded counterparts. This can clearly question the interchangeability between the branded and its generic counterpart or even among generics.
According to the published work poly-pharmacy can be simply defined as the use of multiple medications by a patient. According to the published studies, the precise minimum number of medications used to define "poly-pharmacy" is variable, but generally ranges from 5 to 10 [3]. It also refers to the effects of taking multiple medications, mostly more than five medications, to manage co-existing health problems [3]. It is clearly highlighted in that the use of greater number of therapies has been independently associated with increased risk for adverse drug events [4]. This indicates that medications should be provided to elderly patients with caution because of age-related changes in pharmacokinetics and also the preclinical drug trials often include young healthy patients which may not be appropriate for the elderly patients [5,6]. Elderly patients are at greater risk for adverse drug events due to metabolic changes which will be proportionately increased with the number of drugs used.
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