Generic substitution of antiretrovirals: patients’ and health care providers’ opinions

• Published in: International journal of STD & AIDS Vol. 28; no. 12; pp. 1239 - 1246
• Main Authors: Kieran, Jennifer A, O’Reilly, Eimear, O’Dea, Siobhan, Bergin, Colm, O’Leary, Aisling
• Format: Journal Article
• Language: English
• Published: London, England SAGE Publications 01.10.2017
• Subjects: Adult; Anti-Retroviral Agents - therapeutic use; Attitude of Health Personnel; Cross-Sectional Studies; Drug Costs; Drug Prescriptions; Drug Substitution - economics; Drug Substitution - psychology; Drugs, Generic - economics; Drugs, Generic - therapeutic use; Female; Health Knowledge, Attitudes, Practice; Health Personnel - psychology; HIV Infections - drug therapy; HIV Infections - economics; Humans; Ireland; Male; Middle Aged; Patients - psychology; Perception; Surveys and Questionnaires; treatment; generic antiretrovirals; HIV; antiretrovirals; patient opinion; Ireland; antiretroviral therapy; AIDS; health care provider opinion
• ISSN: 0956-4624; 1758-1052
• DOI: 10.1177/0956462417696215

There is interest in introducing generic antiretroviral drugs (ARVs) into high-income countries in order to maximise efficiency in health care budgets. Studies examining patients’ and providers’ knowledge and attitudes to generic substitution in HIV are few. This was a cross-sectional, observational study with a convenience sample of adult HIV-infected patients and health care providers (HCPs). Data on demographics, knowledge of generic medicine and facilitators of generic substitution were collected. Descriptive and univariate analysis was performed using SPSS V.23™. Questionnaires were completed by 66 patients. Seventy-one per cent would have no concerns with the introduction of generic ARVs. An increase in frequency of administration (61%) or pill burden (53%) would make patients less likely to accept generic ARVs. There were 30 respondents to the HCP survey. Concerns included the supply chain of generics, loss of fixed dose combinations, adherence and use of older medications. An increase in dosing frequency (76%) or an increase in pill burden (50%) would make HCPs less likely to prescribe a generic ARV. The main perceived advantage was financial. Generic substitution of ARVs would be acceptable to the majority of patients and HCPs. Reinvesting savings back into HIV services would facilitate the success of such a programme.