A nationwide study on generic medicines substitution practices of Australian community pharmacists and patient acceptance

This study evaluated Australian community pharmacists' rate of generic medicine substitution, patient acceptance of generic substitution and cost-savings achieved for patients from substitution.A national stratified sample of 500 Australian pharmacies was randomly selected from different geographical areas. The data of the first 25 original PBS prescription items dispensed on one working day eligible for generic substitution were collected from each pharmacy.Responses were received from 82 pharmacies with a response rate of 16.4%. The pharmacists recommended generics for 96.4% (1461/1515) of the prescription items which were eligible for substitution. The generic substitution recommendation rate in urban (98.7%) and rural areas (98.0%) was significantly higher than remote areas (91.6%). Conversely, patients' acceptance in remote areas (84.5%) was significantly higher than rural (78.6%) and urban areas (73.2%). Patients with chronic diseases demonstrated significantly lower acceptability (72.4%) than patients with acute conditions (81.6%). Through acceptance of substitution, the patients' medicines expenditure reduced by around 21%.Australian community pharmacists demonstrated a high rate of recommending generic substitution. However, to optimize the generic medicines utilization, patients' acceptance requires further improvement.