Background and importance In France, since 1999, pharmacists have been authorised to substitute the original medicine with a generic product, provided the patient agrees and that the doctor has not excluded a drug by affixing, in handwritten words, ‘not substitutable’ on the prescription. The success of generics depends on the propensity of the patient to accept substitutions.

Aim and objectives The aim of the study was to determine patient perceptions of generic drugs 20 years after the substitution right was granted to pharmacists.

Material and methods We carried out a survey from 1 April to 30 June 2019 on a sample of people representative of the French population aged 18 years and over, through an online questionnaire using the Cawi system (Computer AssistedWeb Interview) and in paper format. A questionnaire of 17 questions was developed. The questionnaire was validated by a sample of 20 randomly selected people. Feedback from these people helped with adjustment of the questionnaire before the survey was conducted.

Results We collected 467 questionnaires (264 paper questionnaires and 203 online questionnaires). Of these, 42% of patients reported high confidence in generic drugs and 45.6% freely chose generics. We found that 57% of patients accept unreservedly the generic substitution when it was proposed by the pharmacist (vs 49.7% in the survey by Ostan¹): 73% said generic drugs are as effective as brand name drugs; 81% said generic drugs have as many side effects as brand name drugs; 15% of patients reported that generic drugs have more side effects and 4% reported the opposite; and 12% of patients said they were asking for ‘non-substitutable’ on their prescription (vs 20.3% in the survey of Ostan¹). In 34% of cases, this statement ‘not substitutable’ was a doctor’s decision. Also, 1% of patients reported not knowing generic drugs.

Conclusion and relevance In our study, 45.6% of the general public freely chose generic drugs. This reached 57% when generic drugs were offered by pharmacists. Lack of knowledge about generic drugs affects patients’ perceptions of generic medicines. To overcome this lack of confidence, we have developed an information leaflet on generic drugs.

References and/or acknowledgements 1. Ostan I. Perception du médicament générique dix ans après le droit de substitution, ThèsePharmacie, Toulouse, 2009.

No conflict of interest.