Knowledge and attitudes of the pharmacists, prescribers and patients towards generic drug use in Istanbul – Turkey

Main Article Content

Hale Z. Toklu
Gül A. Dülger
Seyhan Hidiroğlu
Ahmet Akici
Aslıhan Yetim
H M. Gannemoğlu
Hasim Güneş



The use of generic drugs has increased significantly in recent years. Since generic drugs are available at a lower cost, they provide an opportunity for savings in drug expenditure. Thus, use of generic drugs is encouraged especially in developing countries. There are only a few studies concerning the perceptions and attitudes of the healthcare providers and patients towards generic drug use.

Methods: The present study was conducted by a face to face questionnaire in the Kadikoy district of Istanbul in April 2010. From randomly chosen respondents, 68 pharmacists, 56 prescribers and 101 patients consented to participate in the study.

Results: Thirty one and 32 % of the pharmacists and prescribers, respectively, expressed that they believed that the generics did not differ from the original drugs, whereas only 24% of the patients believed so. Forty percent of the pharmacists and 82% of the prescribers told that they were unsure about the bioequivalence of the generics. Ten percent of the patients claimed that they immediately accept generic substitution by the pharmacist, while 26% accepted it if it was substituted by the prescriber. Cost was the most important factor taken into consideration about generic substitution (92% for prescribers; 83% for patients and 82% for pharmacists).

Conclusion: Our findings demonstrated that healthcare providers as well as the drug consumers have insufficient knowledge about generic drugs. Therefore, they should be better educated with respect to generic substitution.

Abstract 2986 | PDF Downloads 853


1. Ministry of Health of Turkey, General Directorate of Pharmaceuticals and Pharmacy. Regulation on the Registration of Medicinal Products for Human Use. Official Gazette #25705 of 19.01.2005 and last amended published by Official Gazette # 27208 of 22.04.2009.

2. Weekes L, Ramzan I. Generic medicines--how confident should we be? Pac Health Dialog. 2010;16(2):109-111.

3. Godman B, Shrank W, Andersen M, Berg C, Bishop I, Burkhardt T, Garuoliene K, Herholz H, Joppi R, Kalaba M, Laius O, McGinn D, Samaluk V, Sermet C, Schwabe U, Teixeira I, Tilson L, Tulunay FC, Vlahović-Palčevski V, Wendykowska K, Wettermark B, Zara C, Gustafsson LL. Comparing policies to enhance prescribing efficiency in Europe through increasing generic utilization: changes seen and global implications. Expert Rev Pharmacoecon Outcomes Res. 2010;10(6):707-722.

4. 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.

5. García Rada A. Mandatory generic prescribing is expected to save Spain €2bn a year. BMJ 2011;343:d4803.

6. Tsiantou V, Zavras D, Kousoulakou H, Geitona M, Kyriopoulos J. Generic medicines: Greek physicians' perceptions and prescribing practices. J Clin Pharm Ther. 2009;34(5):547-554.

7. Kersnik J, Peklar J. Attitudes of Slovene general practitioners towards generic drug prescribing and comparison with international studies. J Clin Pharm Ther. 2006;31(6):577-583.

8. Kjoenniksen I, Lindbaek M, Granas AG.Patients' attitudes towards and experiences of generic drug substitution in Norway. Pharm World Sci. 2006;28(5):284-289.

9. Suh DC.Trends of generic substitution in community pharmacies. Pharm World Sci. 1999;21(6):260-265.

10. Spiegel W, Mlczoch-Czerny MT, Jens R, Dowrick C. Quality circles for pharmacotherapy to modify general practitioners' prescribing behaviour for generic drugs. J Eval Clin Pract. 2012;18(4):828-834.

11. Decollogny A, Eggli Y, Halfon P, Lufkin TM.Determinants of generic drug substitution in Switzerland. BMC Health Serv Res. 2011;11:17.

12. Babar ZU, Grover P, Stewart J, Hogg M, Short L, Seo HG, Rew A. Evaluating pharmacists' views, knowledge, and perception regarding generic medicines in New Zealand. Res Social Adm Pharm. 2011;7(3):294-305.

13. Granlund D. Are private physicians more likely to veto generic substitution of prescribed pharmaceuticals? Soc Sci Med. 2009;69(11):1643-1650.

14. Andersson K, Sonesson C, Petzold M, Carlsten A, Lönnroth K. What are the obstacles to generic substitution? An assessment of the behaviour of prescribers, patients and pharmacies during the first year of generic substitution in Sweden. Pharmacoepidemiol Drug Saf. 2005;14(5):341-348.

15. 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):366-374.

16. Country Report Turkey. Pharmaceutical Market Europe 2011; 55-61 Available from: (Accessed: 31.07.2012)

17. Chong CP, Hassali MA, Bahari MB, Shafie AA. Exploring community pharmacists' views on generic medicines: a nationwide study from Malaysia. Int J Clin Pharm. 2011;33(1):124-131.

18. Kobayashi E, Karigome H, Sakurada T, Satoh N, Ueda S. Patients' attitudes towards generic drug substitution in Japan. Health Policy. 2011;99(1):60-65.

19. Ministry of Health of Turkey, General Directorate of Pharmaceuticals and Pharmacy. Regulation on the Evaluation of Pharmaceutical Products for Bioavailability and Bioequivalence. Official Gazette #21942 of 27 May 1994.

20. Daşdemir S, Mercan S, Balta E, Özcan V. Eşdeğer İlaç. Türk Eczacıları Birliği Eşdeğer İlaçlar Raporu, 2009 Available in: (Accessed: 31.07.2012)

21. Kanavos P. Generic policies: rhetoric vs reality. Euro Observer The Health Policy Bulletin 2008;10(2):1-6.

22. Toklu HZ, Akici A, Oktay S, Cali S, Sezen SF, Keyer Uysal M. The pharmacy practice of community pharmacists in Turkey. Marmara Pharm J 2010; 14: 53-60. Available from: (Accessed: 31.07.2012)

23. Kobayashi E, Satoh N, Uedain S.Community pharmacists’ perspectives on generic substitution in Japan.Journal of Public Health 2011;19:249-256.

24. Himmel W, Simmenroth-Nayda A, Neibling W, Ledig T, Jansen RD, Kochen MM, Gleiter CH, Hummers-Pradier E. What do primary care patients think about generic drugs? Int J Clin Pharmacol Ther. 2005;43(10):472-479.

25. Shrank WH, Cox ER, Fischer MA, Mehta J, Choudhry NK. Patients’ perceptions of generic medications. Health Aff (Millwood). 2009;28(2):546-556.

26. Lebanova H, Manolov D, Getov I. Patients’ attitude about generics –Bulgarian perspective. Marmara Pharm J 2012;16:36-40.

27. Ganther JM, Kreling DH. Consumer perceptions of risk and required cost savings for generic prescription drugs. J Am Pharm Assoc. 2000;40(3):378-383.

28. Alghasham AA. Generic drug prescribing in central Saudi Arabia: perceptions and attitudes of physicians. Ann Saudi Med 2009;29(1):24-29.

29. Gossell-Williams M. Generic Substitutions: A 2005 Survey of the Acceptance and Perceptions of Physicians in Jamaica. West Indian Med J 2007;56(5):458-463.

30. Kirking DM, Gaither CA, Ascione FJ, Welage LS. Pharmacists' Individual and Organizational Views on Generic Medications.J Am Pharm Assoc. 2001;41(5):723-728.

Most read articles by the same author(s)

1 2 3 4 5 6 7 8 9 10 > >>