Is it possible to shift people’s perceptions of generic drugs?


Researchers have investigated whether interventional videos could change perceptions and effectiveness of generics versus brand name drugs in study participants

They recruited 103 participants with frequent tension headaches from the University of Auckland, New Zealand, between September and November 2018. The sample was 66% female and 27 years old on average.

Participants were randomised to one of three groups—one of two interventional videos, or the control video.

One of the interventional videos explained the process of approval of generic medicines (n = 34), while the other explained the bioequivalence between brand name and generic drugs (n = 35).

The control video informed participants about the epidemiology and etiology of headaches (n = 34).

Prior to watching the allocated video, participants across all three intervention groups tended to perceive brand name medicines to be of higher quality and more effective than their generic counterparts.

Results showed that, after watching the allocated video, participants in the generic drug approval process video group (p = .002) and in the bioequivalence video group (p < .001) indicated that they better understood generic medicines than individuals in the control video group.

However at follow-up 2 (post-medication), only participants in the bioequivalence video group had a significantly better understanding of generic medicines compared to the control group (p = .013).

At the second follow-up (post-medication), participants who watched the generic drug approval process video rated the perceived quality of generic medicines significantly higher than participants in the bioequivalence video group (p = .010) and in the control group (p = .011).

Post hoc tests showed that participants who watched the generic drug approval process video had a significantly enhanced perception of the effectiveness of generic medicines at post-video compared to participants who watched the bioequivalence video (p = .007) or the control video (p = .024).

Participants who watched the generic drug approval process video also had a significantly enhanced perception of the safety of generic medicines at post-video compared to participants watching the bioequivalence video (p = .005) or the control video (p < .001).

Before watching the video, participants across all groups had in general the tendency to prefer the generic over the brand name drugs. After watching the allocated video, the preference for generic medicines significantly increased in participants in the bioequivalence video group compared to individuals in the generic drug approval process video group (p = .009) and in the control group (p < .001).

Another part of the study involved headache treatment: after watching the allocated video, participants treated their next two consecutive episodes of headache with a brand name and a generic analgesic in randomised order.

Results showed that in participants in the control group, pain intensity was significantly higher after taking the generic compared to the brand name drug (p = .047).

No participants in the drug approval process video group (p = .477) or in the bioequivalence video group (p = .547) reported differences in the headache intensity after taking the generic compared to the brand name drug.

The researchers from the University of Otago and the University of Auckland initially hypothesised that the generic drug approval process video would have a better effect on all outcomes measured in participants with headache, compared to a video focusing on bioequivalence or a control video.

“The first important finding was that, contrary to our hypothesis, the generic drug approval process video and the bioequivalence video had similarly positive effects on the understanding of generic drugs,” they said.

However the interventional videos had differential effects.

The video explaining how generics are approved was more successful in enhancing participants’ perception of the quality, effectiveness and safety of generic medicines than explaining bioequivalence.

Meanwhile participants who received information about bioequivalence preferred generic medicines more often than participants in the control group or those watching the generic drug approval process video.

Interestingly, participants prior to the intervention showed a tendency to prefer generic over brand name drugs, but at the same time, they perceived brand name medicines to be of higher quality and effectiveness.

“Different factors that could explain this conflicting difference between perceptions and preferences should be considered,” said the authors.

“It has to be considered that students are often short of money. This could explain why they showed tendentially a higher preference for cheaper generic medicines at baseline.

“Switching from brand name to generic drugs can have substantial positive financial effects, for health-care systems as well as consumers,” said the researchers.

“Generics typically offer cost savings of between 30% and 60% of the price of brand name medicines.”

However “the label ‘generic’ in itself has been associated with negative expectations and beliefs that can contribute to less efficacy and more side effects from the drug,” they explained.

A 2015 systematic review found around 20–30% of the population view generic drugs as less effective and of poorer quality than their branded counterparts.

The research was published in Research in Social and Administrative Pharmacy

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