Perceptions and utilization of generic medicines in Guatemala: a mixed-methods study with physicians and pharmacy staff

Abstract

BackgroundAccess to low-cost essential generic medicines is a critical health policy goal in low-and-middle income countries (LMICs). Guatemala is an LMIC where there is both limited availability and affordability of these medications. However, attitudes of physicians and pharmacy staff regarding low-cost generics, especially generics for non-communicable diseases (NCDs), have not been fully explored in Guatemala.MethodsSemi-structured interviews with 30 pharmacy staff and 12 physicians in several highland towns in Guatemala were conducted. Interview questions related to perceptions of low-cost generic medicines, prescription and dispensing practices of generics in the treatment of two NCDs, diabetes and hypertension, and opinions about the roles of pharmacy staff and physicians in selecting medicines for patients. Pharmacy staff were recruited from a random sample of pharmacies and physicians were recruited from a convenience sample. Interview data were analyzed using a thematic approach for qualitative data as well as basic quantitative statistics.ResultsPharmacy staff and physicians expressed doubt as to the safety and efficacy of low-cost generic medicines in Guatemala. The low cost of generic medicines was often perceived as proof of their inferior quality. In the case of diabetes and hypertension, the decision to utilize a generic medicine was based on multiple factors including the patient’s financial situation, consumer preference, and, to a large extent, physician recommendations.ConclusionsInterventions to improve generic medication utilization in Guatemala must address the negative perceptions of physicians and pharmacy staff toward low-cost generics. Strengthening state capacity and transparency in the regulation and monitoring of the drug supply is a key goal of access-to-medicines advocacy in Guatemala.

Prescription Pattern of Cardiovascular and/or Antidiabetic Drugs in Abuja District Hospitals

“…Again generic prescription leads to clarity of information among the health professionals [36]. The poor generic prescribing may be attributed to physicians' doubt towards prescribing low-cost generic medicines for hypertensive and diabetic patients [37].…”

Perceptions and Challenges for Adoption of Generics and Biosimilars in Oncology

“…Most experience about the knowledge and perceptions regarding generics comes from interviews and surveys conducted in cross sections of populations in various countries [12,27,42,43]. There is lack of a standard approach for the assessment of knowledge, attitudes, and perceptions about generics.…”

Prescribing Generic Drugs: Perception, Obedience, and Supervision at Kalisat District Hospital

“…Based on the study conducted by Flood et al (2017) about the perception and utilization of generic drugs in Guatemala, the research targets were doctors and pharmacists. There were 12 doctors and 30 pharmacy staff from three locations in Central Guatemala.…”

“…The doctors who became the respondents admitted that the quality of generic drugs depended on the capability of companies which produced the generic drugs, and the low price of generic drugs showed their inadequate quality. From the research conducted by Flood et al (2017), it could be concluded that doctors' perception of generic drugs influenced their willingness to use generic drugs for patients, therefore it also influenced their adherence in medicines prescription by using generic drugs. Whereas basically, generic drugs are one of the pharmaceutical preparations that have fulfilled the pharmacopeia requirements and passed the manufacturing process according to the article about how to produce proper medicinal drugs (Yusuf, 2016).…”