Preferences of choice between original and generic medicines: pharmaceutical support for patients with coronary heart disease and comorbid conditions

Ukraine ranks fourth globally in mortality from coronary heart disease (CHD). The negative socio-economic impact of martial law is likely to exacerbate this situation. Therefore, the use of original and generic drugs in pharmacotherapy deserves special attention as it may affect the availability of medicines and adherence to treatment. Aim. To study the influence of preferences of doctors, pharmacists, and patients regarding the use of original and generic medicines in the pharmacotherapy of CHD with comorbid conditions, to further identify factors affecting drug availability and patient adherence to treatment. Materials and methods. We analysed the results of an anonymous online survey conducted with the help of Google Forms at the Department of Cardiology of the Shupyk National Healthcare University of Ukraine, from June to September 2024. Statistical, analytical, bibliographic methods, as well as synthesis, analysis, deduction, and induction techniques were used. Results. The reliability of the influence of clinical efficacy and safety of drugs (χ2 = 5.653, p = 0.017) on their choice in the pharmacotherapy of CHD with comorbidities for doctors 87.4 % [CI 95 % 87.400 ± 0.004, p < 0.0001], pharmacists 79.1 % [CI 95 % 79.10 ± 0.02, p < 0.0001] and patients 91.1 % [CI 95 % 91.100 ± 0.007, p < 0.0001] is determined in the study. The absence of certain drugs in the “Affordable Medicines” Reimbursement Program in Ukraine decreases interest among healthcare professionals in the program (χ2, adjusted for plausibility = 4.011, p = 0.050) and negatively affects access to clinically effective and safe drugs for patients with CHD with comorbidities (χ2 = 3.350, p = 0.067). Conclusions. The preferences of choice of doctors, pharmacists, and patients between original and generic medicines are influenced by the clinical effectiveness and safety of the drugs. The absence of certain medicines that are recommended by clinical protocols and guidelines for managing CHD with comorbid conditions in the Reimbursement Program, reduces healthcare professionals’ engagement with the program and negatively affects the availability of effective pharmacotherapy and treatment adherence.