Hassali Mohamed Azmi, Wong Zhi Yen, Alrasheedy Alian A, Saleem Fahad, Mohamad Yahaya Abdul Haniff, Aljadhey Hisham
Discipline of Social and Administrative Pharmacy, School of Pharmaceutical Sciences, Universiti Sains Malaysia, 11800 Minden, Penang, Malaysia.
Pharmacy Department, Hospital Teluk Intan, Jalan Changkat Jong, 36000 Teluk Intan, Perak, Malaysia.
Health Policy. 2014 Sep;117(3):297-310. doi: 10.1016/j.healthpol.2014.07.014. Epub 2014 Aug 1.
This review was conducted to document published literature related to physicians' knowledge, attitudes, and perceptions of generic medicines in low- and middle-income countries (LMICs) and to compare the findings with high-income countries.
A systematic search of articles published in peer-reviewed journals from January 2001 to February 2013 was performed. The search comprised nine electronic databases. The search strategy involved using Boolean operators for combinations of the following terms: generic medicines, generic medications, generic drugs, generic, generic substitution, generic prescribing, international non-proprietary, prescribers, doctors, general practitioners, physicians, and specialists.
Sixteen articles were included in this review. The majority (n=11) were from high income countries and five from LMICs. The main difference between high income countries and LMICs is that physicians from high income countries generally have positive views whereas those from LMICs tend to have mixed views regarding generic medicines. Few similarities were identified among different country income groups namely low level of physicians' knowledge of the basis of bioequivalence testing, cost of generic medicines as an encouraging factor for generic medicine prescribing, physicians' concerns towards safety and quality of generic medicines and effect of pharmaceutical sales representative on generic medicine prescribing.
The present literature review revealed that physicians from LMICs tend to have mixed views regarding generic medicines. This may be due to differences in the health care system and pharmaceutical funding system, medicine policies, the level of educational interventions, and drug information sources in countries of different income levels.
开展本综述以记录与中低收入国家（LMICs）医生对仿制药的知识、态度和认知相关的已发表文献，并将研究结果与高收入国家进行比较。
对2001年1月至2013年2月在同行评审期刊上发表的文章进行系统检索。检索包括九个电子数据库。检索策略涉及使用布尔运算符组合以下术语：仿制药、通用药物、通用药品、通用名、通用名替换、通用名处方、国际非专利名、处方者、医生、全科医生、内科医生和专科医生。
本综述纳入了16篇文章。大多数（n = 11）来自高收入国家，5篇来自中低收入国家。高收入国家和中低收入国家之间的主要差异在于，高收入国家的医生总体上持积极看法，而中低收入国家的医生对仿制药的看法往往不一。不同国家收入组之间几乎没有发现相似之处，即医生对生物等效性测试基础的了解程度较低、仿制药成本作为仿制药处方的激励因素、医生对仿制药安全性和质量的担忧以及药品销售代表对仿制药处方的影响。
目前的文献综述表明，中低收入国家的医生对仿制药的看法往往不一。这可能是由于不同收入水平国家的医疗保健系统和药品资助系统、药品政策、教育干预水平以及药品信息来源存在差异。
