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July 2, 2016

Patients want generics information from GPs

More than 95 per cent of patients want information on generic substitution from GPs rather than pharmacists, a survey by a Tralee-based general practice has found.
The survey was conducted by GP Registrar Dr Peadar Ó Fionnain and Dr John Kenneth Holmes of the Brandon Medical Centre in Tralee as part of a research project under the Cork GP Training Scheme.

Some 93 patients, most of whom had medical cards, had their medications switched from branded to generic proton pump inhibitors (PPI). Dr Ó Fionnain presented the study findings at the ICGP conference, ‘Strengthening General Practice Through Research and Audit’, which ran in parallel with this year’s Summer School in Kilkenny.
The survey measured the attitudes and symptoms of the patients before and after the switch to generic substitutes. Patients were given a written information leaflet about generic substitution by their GP.
Only 14 per cent of patients said they wanted information on generic substitution from their pharmacists and 1.5 per cent would accept the information from the HSE.
Some 82 per cent of patients were satisfied with the switch, but satisfaction was higher amongst those who understood why the medication had been changed.
Only 5 per cent of patients requested to be switched back to the original brand.
“After eight to 12 weeks, we re-assessed the patients on a number of questions and almost 60 per cent couldn’t recall why we had substituted their medication, even though we had given a written leaflet telling them why,” Dr Ó Fionnain said. Patients who did not understand what had been done were much more distrustful and suspicious of the process, he added.
The doctor’s role will be critical in the substitution process, he said. “I suppose if a patient’s medication is being changed, people generally like to have the switch made by the person who put them on the medicine in the first place,” Dr Ó Fionnain said. “We must get involved in explaining the process to patients because the Department of Health can’t make us do that. It’s something that GPs have to take on themselves.”
This pilot study saved €360 per patient annually and could save the HSE up to €300 million per year on the difference between the price of proprietary and generic medication. Patients’ symptoms after the switch had remained the same or slightly improved.
PPI drugs were chosen for the study because the largest savings in Irish expenditure on drugs can be made through generic substitution of such drugs.
However, it looks unlikely from the current Department of Health policy that GPs will have a very central role in generic substitution of patients’ medication because switching will predominantly be made by pharmacists, Dr Ó Fionnain said.
The survey will also be presented in October at the WONCA Europe conference in Malaga.