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

Int J STD AIDS. 2017 Oct;28(12):1239-1246. doi: 10.1177/0956462417696215. Epub 2017 Mar 2.

Abstract

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.

Keywords: AIDS; HIV; Ireland; antiretroviral therapy; antiretrovirals; generic antiretrovirals; health care provider opinion; patient opinion; treatment.

Publication types

  • Observational Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • 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
  • HIV Infections / drug therapy
  • HIV Infections / economics
  • Health Knowledge, Attitudes, Practice
  • Health Personnel / psychology*
  • Humans
  • Ireland
  • Male
  • Middle Aged
  • Patients / psychology*
  • Perception
  • Surveys and Questionnaires

Substances

  • Anti-Retroviral Agents
  • Drugs, Generic