Consumer knowledge, attitudes and perceptions, towards generic medicines - a perspective from the Northern Suburbs of Johannesburg, South Africa
Date
2015-04-17
Authors
Zigomo, Tinashe
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Abstract
In South Africa’s current healthcare structure, about 8.3% of GDP is spent on healthcare. This is
well above the WHO recommended 5% of GDP spend. Despite the heavy spending, health
outcomes remain poor when compared to similar middle-income countries. Solutions need to be
found to cut back on healthcare costs. Approximately half (4.1%) of the healthcare spend is
consumed by the private sector which benefits a very small segment (16%) of the population.
This segment is largely on medical schemes. Using generic medicines can aid in cutting back
on drug costs but are generics being adequately assimilated by the consumers of healthcare in
the private sector?
The objective of the study was to evaluate the perceptions attitudes and knowledge of the
consumers of healthcare in the Northern suburbs of Johannesburg towards generic medicines.
A survey was conducted on a sample of 402 respondents across 9 randomly selected
pharmacies in the Johannesburg north region between November 2012 and February 2013. A
researcher administered questionnaire was the sole data collection tool. Questions asked
covered the research objectives and also included demographic data and other explanatory
variables. Data analysis was carried out in SAS. The 5% significance level was used
throughout, unless specified otherwise. The chi-squared (Χ2 ) test was used to assess the
relationships between categorical variables. Fisher’s exact test was used for 2 x 2 tables or
where the requirements for the Χ2 test could not be met. The strength of the associations was
measured by Cramer’s V and the phi coefficient respectively.
Key results on respondent demographics included high representation of the higher income
earning groups (78% >R10 000); furthermore 44% had completed tertiary education, 60% were
comprehensively insured, 61% regularly visited a pharmacy, 38% were on prescription
medication and 24% on chronic medicine. On knowledge, 5% of respondents were able to most
accurately define generic medicines. On attitudes, 78% had used generics however the level of
agreement was lower for the highest education category (p<0.0001; Cramer’s V=0.18). Trends
favoured brands over generics with increasing severity of illness as generics were chosen by
10% in major illness and 5% in chronic illness. 80% perceived generics as safe while 95%
perceived brands as safe. 75% of respondents felt that generic medicines were as effective as
branded medicines. 15% indicated that branded medicines have fewer side effects. 64%
showed positive perceptions of quality of generics compared to 93% for brands. Bowker’s test of
symmetry was significant (p<0.0001) showing a shift towards slightly more negative perceptions
towards generic medicines amongst those who thought highly of brand quality.
Knowledge of generics was overall low. Perceptions regarding safety, quality, efficacy, and side
effects of generic medicines were generally positive but responses proved more positive for
brands. Attitudes towards generic medicines were mostly positive however willingness to use
generics lessened with increasing severity of illness. Household income, health insurance
(medical aid) status, level of education, experience with medicines and racial demographics
played a key role in explaining consumer beliefs and behaviours. Pharmacists and Doctors had
a positive influence on generic use patterns amongst other factors.
Description
A research report submitted to the Faculty of Health Sciences,
University of the Witwatersrand, in partial fulfilment of the
requirements for the degree of Master of Science in Medicine
(Pharmaceutical Affairs)
Johannesburg, 29 August 2014