Most physicians perceive generic drugs to be as safe and effective as their branded counterparts

Nearly 90 percent of physicians perceived generic medications as effective and 91 percent perceived them to be as safe as their branded counterparts, according to a survey of American Board of Internal Medicine-certified doctors.

In addition, 73 percent of physicians said generic drugs do not cause more adverse effects than branded drugs, while 70 percent preferred prescribing generic medications.

Lead researcher Aaron S. Kesselheim, MD, JD, MPH, of Brigham and Women’s Hospital in Boston, and colleagues published their findings online in JAMA Internal Medicine on May 9.

“These results suggest an overall shift in the perceptions of board-certified internal medicine physicians and certain specialists about generic drugs toward greater confidence in their quality and safety,” the researchers wrote. “Still, generic skepticism remains common, particularly among physicians who reported pharmaceutical sales representatives as sources of the last times they learned about generic drugs becoming available.”

The researchers randomly selected 300 clinically active internists and 900 specialists in endocrinology, hematology and infectious disease and sent them a link to the survey. The doctors received a $50 honoraria for completing the survey.

The FDA’s Research Involving Human Subjects Commission authorized the survey, while Brigham and Women’s Hospital Institutional Review Board approved the survey. The FDA’s Office of Generic Drugs also funded the study with a grant.

In all, 718 physicians responded to the survey. The mean age of respondents was 46 years old, while 54 percent of patients were males, 58 percent were white and 61 percent trained at U.S. medicals schools. The mean age of nonrespondents was 49 years old, while 57 percent were males.

Of the respondents, 32 percent were classified as generic skeptics, which the researchers defined as “answering neutral or negative to whether generic drugs were as safe and effective as brand-name drugs, or answering neutral or positive to whether generic drugs cause more adverse effects.”

The generic skeptics had no significant variation in demographic or practice characteristics. Approximately half of generic skeptics said they “sometimes,” “rarely” or “never” knew when generic medications became available.

In addition, approximately 35 percent of respondents said they prescribed branded medications only more than 5 percent of the time.

After adjusting for numerous variables, the researchers found that learning about the availability of a generic medication from a pharmaceutical representative was positively associated with brand name-only prescribing. However, it was not associated with generic skepticism.

“While several tests of significance were conducted—increasing the likelihood that at least 1 significant result may be a false positive—our data suggest that limiting interactions with pharmaceutical marketing and directed educational outreach could help ensure that generic drug prescribing remains widespread for the benefit of patients and to help slow the rate of increase of health care costs,” the researchers wrote.