Physicians’ perceptions towards brand medicine and its effect on prescribing: A narrative review

Abstract

The purpose of this paper is to examine existing literature on physicians' perceptions towards brand medicines, to examine the extent to which brands influence drug prescription and whether pharmaceutical industry influences the prescription of brands, as well as to examine the loyalty of physicians to a brand when prescribing drugs or willingness to switch to generic drugs. Methods: Related articles published in different online databases from 2000 to 2017 were surveyed; 38 scientific articles indexed in Google Scholar, Science Direct, and PubMed were selected for review. Articles focused on physicians' perceptions towards brand drugs and its effect on prescribing were extracted. The experimental design and quantitative and qualitative methods used in the studies were analyzed. The deductions made in each study were examined in tandem with the objective of the review. Findings: The studies showed that physicians from high-income countries are inclined to prescribe generic drugs more than brand, whereas those from low-income countries heavily prescribe the brand drugs. The studies also revealed that brand influences the prescribing behavior of physicians. Five studies reported that marketing endeavors encourage the physicians to prescribe brand medicines, while three studies stated that physicians have a high loyalty toward brand medicines irrespective of country's income. Other studies provided evidence that physicians are disposed to switching from brand to generic medicines under certain conditions. Marked differences in the prescribing generic drugs use by physicians among different age were observed. General physicians and pediatrics were more likely to suggest switching from the brand to generic drugs. The majority of physicians were familiar with biosimilars drugs. Conclusion: Generally, the studies showed that physicians tend to have mixed views regarding prescribing brand medicines. The perceptions of physicians towards the brand drugs were found to differ in relation to the nature of healthcare system and level of development.

Representative sample survey on factors determining the Czech physicians’ awareness of generic drugs and substitution

“…Since the opinions on ensuring safety measures and guaranteeing the quality of generic drugs compared to their original counterparts were also very positive, higher confidence in the processes of approval of medicinal products on the Czech market can be expected. Similarly, positive opinions have been reported in studies conducted in developed countries, where transparent, clear, and effective regulatory rules for generic substitution had been set up [27, 28]. On the other hand, healthcare professionals from countries with a less mature healthcare system appeared to have more concerned about the manufacturing sources of generics [20, 29, 30].…”

“…Therefore, it is not possible to summarize the influence of age, length of practice or specialization on the physicians´ attitudes towards generic substitution. The results can be associated with the diversity of national healthcare policies, including various strategies of regulatory authorities, physicians´ knowledge, or the general development of the given country, as well as with the changes that may occur over time [11, 28].…”

“…In some countries, the reimbursement of generic and brand name drugs is the same, and the financial relief for the patient is therefore not a generic substitution motivating priority [33]. Consequently, the choice of drug to be prescribed by the physician may be affected by the specific brand to which the physician wishes to be loyal; also marketing efforts by the pharmaceutical industry can play a role [28]. The consumer (i.e., the patient) does not even have to see the difference in the price and may choose the drug according to their own preferences.…”

Adherence to a generic medicine policy: A developing country's experience

“…Lastly, Murshid and Mohaidin in 2017 examined existing literature on physicians' perceptions towards brand medicine, their loyalty to brands, and the influence of pharmaceutical companies, compared favorably with the work done by this researcher. 32 Murshid and Mohaidin in 2017 also noticed that physicians above 55 years old were over three times more hostile to generic medicine than younger physicians and prescribed branded medicine even when the generic counterpart was available.…”

Views of community pharmacists in Lebanon on the unified prescription: a mixed method study

“…Possible explanations could be the poor trust of physicians in generic drugs as well as promotional incentives given to them by pharmaceutical companies. A review of physicians' perceptions on proprietary medicine concluded that the poor knowledge of physicians about biosimilar generic medicines was the main reason for such practice (17). A study in Jordan showed that 50-80% of physicians in Jordan were likely to oppose the replacement of brand drugs with generic substitutes (18).…”