Barriers and Facilitators of Generic Medication Substitution Among Healthcare Providers in Pakistan: A Qualitative Study

Problem considered: Generic medicines possess identical therapeutic applications as innovator drugs and are offered at a significantly reduced cost.Nevertheless, inadequate understanding and attitudes among health professionals may restrict its utilization.The principal aim of this research was to assess the knowledge, perceptions, obstacles, and facilitators associated with generic substitution in Pakistan.Methods: Semi-structured interviews were conducted with 40 healthcare providers at three tertiary care facilities in Islamabad and Rawalpindi, Pakistan, from March 2024 to August 2024, utilizing purposive and convenience sampling techniques.Each interview was audio-recorded in Urdu, transcribed, and subjected to thematic analysis employing a phenomenological approach. Results:The study included 40 healthcare providers: physicians (n=15), pharmacists (n=15), and nurses (n=10).The majority were male (n=26), with the largest number in the age range of 32-34 years (n=11).The study identified four themes concerning generic prescribing among healthcare providers: perceptions of the availability of generic medicines, generic prescribing as a strategy for affordable and equitable healthcare, barriers to the adoption of generic medications, and enablers of generic substitution.Generic medications are regarded as more cost-effective and can improve rational prescribing practices; yet some respondents express worries about the efficacy and safety of generic medicines. J o u r n a l P r e -p r o o fConclusion: Despite the seemingly favorable socioeconomic conditions for generic replacement in Pakistan, healthcare providers remain concerned about the reliability and quality of generic medications.The above challenges must be resolved to prove the genuine value of generic medications within the nation's healthcare cost-containment strategy and to implement the generic substitution policy in Pakistan.