Community pharmacists' perspectives on generic substitution in Japan

Aim The aim of this study was to evaluate Japanese community pharmacists' attitudes toward and their recommendation of generic substitution, and to identify the barriers towards performing generic substitution. Subject and methods A questionnaire survey was conducted from June 2007 to December 2008. A total of 1,590 community pharmacists working for 449 community pharmacies whose owners agreed to participate in the study were involved in the study. Results A total of 1,253 community pharmacists responded to the survey (response rate: 78.8%). The majority of respondents (72.1%) were in favor of dispensing generic medicine, but they agreed that they would carefully decide if it is appropriate. In spite of these favorable attitudes, more than half of the respondents (55.6%) seldom or never recommend generic substitution to patients. Respondents indicated four barriers preventing them from performing generic substitution: (1) the generic drug is not in stock or no generic drug equivalent is available yet in the market, (2) only a very small cost savings resulting in patients' objections, (3) physicians' objections and (4) presence of skepticism in the quality of generic medicines and inadequate drug information from generic manufacturers Conclusion It is not common for Japanese community pharmacists to recommend generic substitution to patients in spite of their positive attitudes towards generic substitution. Prospective policies on generic substitution are needed to overcome the barriers identified in this study, preventing community pharmacists from performing generic substitutions.