GENERIC VS. BRANDED MEDICINES
Generic versus Branded: Relationship between
Socio-Economic Status, Medical Conditions,
Perception and Preference on Medicines
of Residents of Mojon, Malolos
Gerlyn Freeda A. Agmata
Nathan Cristopher A. Calayag
Federico T. Camua
Ace John R. Mondidu
Jerico J. Roque
Holy Spirit Academy of Malolos
GENERIC VS. BRANDED MEDICINES
March 2018
Chapter 1
The Problem and its Setting
Introduction
Medicines are substances used in treating and preventing the manifestation of
diseases. There are two kinds of medicines - the branded and its generic counterpart. A
branded/brand name medication is the first of its kind and gets to brand the name. Being
first takes lots of time, effort and money. The drug is discovered, researched, tested,
developed, produced and marketed - these steps start in a laboratory, then proceeds to a
clinical testing facility, and go on to a Food and Drug Administration (FDA) office for
approval before ever reaching a pharmacy shelf. The pharmaceutical company ensures
that the drug is safe and effective by conducting a series of laboratory studies that take
years to perform. Once the drug is granted FDA approval, the company can give the
medication a brand name and market it. The brand is protected by a patent so other drugmanufacturers cannot copy the formula and duplicate the drug. This patent allows the
innovating company a period to exclusively sell the medicine so that they can regain the
money invested during drug development and generate a reasonable profit. During this
time, other pharmaceutical companies are not permitted to make or sell the drug without
permission from the developing company (Buzhardt, 2016).
When the patent expires, other pharmaceutical companies may apply to the FDA
for permission to manufacture and sell a generic version of the original compound. The
generic drug manufacturer must prove that their product contains the same active
GENERIC VS. BRANDED MEDICINES
ingredient(s) in the same amount, and does the same job as the branded drug before it can
be used as a substitute. This proves that generic and branded medicines produce the same
effects. Their only difference is the pricing. Manufacturers of generic drugs do not have
to repeat the years of costly laboratory and clinical trials that the developing company
invested in to gain FDA approval. Generic manufacturers simply borrow a finished work
and do not have to spend the time or money to do their own. Since they can produce the
medication at a much lower cost, it is reasonable that they can sell it at a lower cost and
still make a profit. When several companies begin to manufacture the same generic
medication, competition further keeps the price down.
Generic and branded drugs have the same impact in terms of treating diseases.
However, some patients still have the misconception that generic drugs are inferior to
brand name drugs. The Philippines already established a law (Republic Act 6675 –
Generics Act of 1988) to promote require and ensure the production of an adequate
supply, distribution, use and acceptance of drugs and medicines identified by their
generic names. This is already a support to the equivalent effects of both types of drugs
yet patients still tend to deviate from their choices of the medicines they intend to buy.
This quantitative research study sought to determine the relationship between
socio-economic status, medical conditions, perception and the preference of the residents
of Mojon, Malolos in choosing between generic and branded medicines.
GENERIC VS. BRANDED MEDICINES
Statement of the Problem
This study sought to answer: What is the relationship between socio-economic
status, medical conditions, perception and preference among the residents of Baranggay
Mojon in Malolos City?
Specifically, it aims to answer the following questions:
1. How can socio-economic status of the residents of Baranggay Mojon in Malolos
City be described in terms of
1.1 age;
1.2 gender;
1.3 monthly family income and
1.4 occupation?
2. How can medical conditions be described?
3. How can perception of the residents of Baranggay Mojon, Malolos be described
in terms of
3.1 background knowledge about the medicines and;
3.2 the relationship of price and quality?
4. What do the residents of Baranggay Mojon prefer between generic and branded
medicines?
5. Is there a significant relationship between socio-economic status, medical
conditions and preference of the residents of Baranggay Mojon in Malolos City?
GENERIC VS. BRANDED MEDICINES
Significance of the Study
The results of this study will benefit the residents of Malolos City since if the
government and stores will adjust to their needs and preferences, they will be sufficiently
provided. Pharmaceutical stores will also benefit since they will know the common
preference of residents of Baranggay Mojon regarding medicines and may adjust the
supply of medicine they would sell in terms of the demands of the public. This study will
also benefit the city government by knowing the preference in medicines of its residents
so they could provide support programs that are anchored on the needs and preference of
the people. Lastly, the future researchers will also benefit from the study by having a
clearer or a more precise view of the medicine preferences of Malolos City residents and
fill up the gaps that have not been studied in the paper.
Scope and Delimitations
This research study aims to determine the relationship between socio-economic
status, medical conditions, perception and the medicine preference of the residents of
Baranggay Mojon in Malolos, Bulacan and the data gathering procedure was conducted
during the month of November 2017 due to the limitations of time for the data gathering .
Residents of Baranggay Mojon were the focus respondents of this study since based from
the 2015 census; the said baranggay is the most populous in Malolos, Bulacan.
Differentiation of classes in Baranggay Mojon is evident, considering that there are
exclusive villages in the vicinity. Furthermore, the study will be limited due to its time
constraint.
GENERIC VS. BRANDED MEDICINES
Chapter 2
Review of Related Literature
Relevant Theory
The Theory of Medical Decision Making under times of uncertainty by Karni
(2009) stated that there are factors that could affect the decision making or choice of a
person when diagnosed with a particular illness. These factors will affect the decision of
the person on whether to opt for a particular procedure with a particular doctor under a
set of circumstances that leads to the decision. The theory will be adapted because of the
presence of the decision or choice making of a person and the factors that affect the
decision. Relating it to our study, we are looking into the effect of the factors such as age,
income, etc. to the choice of medicine of the residents of Baranggay Mojon inMalolos,
Bulacan.
The Theoretical Model and Theory of Pricing Strategy and Practice by Kalita,
Jagpal and Lehmann (2004) stated that firms use prices to indicate quality, regardless of
whether they market durable or nondurable products. Through practice and application,
people tend to believe in the power of price as the dictator of quality even though they
still are not knowledgeable of the specs or information about the product. The theory will
be adapted because it elaborates the relationship between price and quality. In the study
conducted, one of the researchers’ variables is the residents’ perception on branded and
generic medicines. The researchers want to know the effect of this perception on the
preference of the residents of Baranggay Mojon. This theory would greatly help the
researchers because they would already have background knowledge and information on
GENERIC VS. BRANDED MEDICINES
what could dictate and how could the residents’ perception be described when connected
to their preference, in choosing what medicine to buy.
Related Literature / Studies
Research about the factors associated with the preference for purchasing generic
drugs done in the Households of the Municipality of Pelotas, in the State of Rio Grande
do Sul, Brazil. by Guttier, Silveria,Luiza and Bertoldi (2017) showed that people with
better knowledge and understanding about generic drugs have greater preference for
purchasing it. Some have observed that generic drugs are cheaper, and an effective
replacement for branded medicines. Doctors who prescribe generic drugs to their patients
decrease the patients’ negative perception on generic drug. With the reduction of negative
perception on generic drugs, doctors increase the knowledge that lay people have about
generics. The study was conducted in the year 2007 in Brazil, then re-conducted the study
10 years after, having the same results and outcomes that shows people still prefer
generic drugs.
According to the study and analysis of various facts about branded and generic
medicines of the same drugs with the literate population of Maharashtra and Rajasthan
,India conducted by Ahire, Shukla, Gattani, Singh V., and Singh M. (2013), the main
reason why generic drugs were inferior to branded medicines was the lack of
prescriptions received from physicians. More than half of the individuals are aware that
generic drugs are cheaper but they are not aware of the effects of generic medicines; they
have this perception that generics are not as safe as branded medicines.The lack of
generic prescriptions received by the patients mirrors their lack of acknowledgement to
these medicines – making them unaware of its efficiency. As stated by Guttier et al
GENERIC VS. BRANDED MEDICINES
(2017) in their recently concluded research, doctors serve as one of the most influential
factor that can affect the medicine preference of the patients because they act as the
source of generic medicine knowledge, and this awareness can be a factor to either
increase or decrease their generic preference. Guttier et al (2017) also made mention of
the low-priced generic drugs have that corresponds with the results of this study.
A research study was conducted by Losifescu, Halm, Mcginn and Federman (2008)
who focused on adults aged 65 years and older who were enrolled in Medicare, the
federal health insurance program for elderly and disabled adults in USA, and those who
lacked a diagnosis of dementia. The aforementioned study aimed to characterize seniors’
beliefs about generic drugs, and examine potential correlates of these beliefs, including
socioeconomic and health status variables, health literacy, and physician communication
skills that indicated in its results that individuals with low health literacy are more likely
to hold negative views towards generic medications. The study has shown that an
association between education level and understanding about generic medications result
in greater use of these drugs. The association between health literacy and generic
medications beliefs may be connected to patients’ understanding on generics. Overall,
many seniors from a low-income, hospital –based, and inner city clinical practice have
negative beliefs about generic drugs, and that negative beliefs are also common to those
with lower health literacy and physicians who have poor communication skills. The
health literacy of people that affected their preference on generic medicines is connected
to the study of Guttier et. al. (2017) that knowledge of people is a factor to their
preference along with the prescriptions of physicians.
GENERIC VS. BRANDED MEDICINES
According to Choudhury et. al. (2017), over 90% of the patients believed that
generic drugs were as effective as branded medicines. Poor people are forced to settle for
generics due to low therapeutic costs. Patients attending the public hospital were socioeconomically and educationally constrained, but they still believed that generic drugs
available in their vicinity were effective.
The study made by Igbinovia (2007) showed that males are less likely to use
generic drugs compared to females. People who are more concerned about the quality and
safety of medicine tend to purchase branded medicines. People who are more concerned
about the price are more likely to use generics than branded because of its cheap cost.
The study also found that the higher the educational level of a person is, the more likely a
person will use generic drugs. The findings of this study correspond to the paper made by
Tavares et al (2016) wherein females are more likely to prefer generic medicine over
branded medicine.
The study of Wong (2015) about the prevalence of Philippine prescribing,
dispensing and use behavior in relation to generic drugs states that the factors that affect
the generics prescribing behavior are patients’ welfare, compliance, socio-economic
status and their fear of punishment. For the consumers, there is actually a preference for
branded medicines over generics. Consumers only purchase generic medicines because of
influence of family and friends, public facility, and it is a requirement by the law to state
the generic names of medicine in the prescriptions that doctors give out.
Results from the study done by Kesselheim et al (2016)showed that a vast majority
of patients prefer asking their physicians to write prescriptions for generic drugs if
available. Patients consider generic drugs to be interchangeable with brand-name drugs.
GENERIC VS. BRANDED MEDICINES
Nearly all respondents reported that generic drugs were less expensive than brand-name
drugs. This study had found a major shift in patients’ positive perception on generic
drugs. This study can be correlated to the involvement of doctors and their prescriptions
according to previous literatures of Guttier et al (2017) and Ahire et al (2013).
According to Mehta and Chouldhry (2009) 94% of the respondents believed that
generics are less expensive than brand-name drugs, and less than 10% of the respondents
believed that generics cause more side effects than branded drugs. Overall, the
respondents agreed that generic drugs are a better value than branded drugs. Patients also
reported that they prefer to use generic medications for the treatment of high cholesterol,
a chronic asymptomatic condition, and back pain. Patients with less education were
significantly more likely to rate generics as greater value. Women were more likely to
value generic drugs than men. The findings of this study correspond to the results of
studies by Guttier et al. (2017) that stated that knowledge plays a key role in one’s
preference in medicine and also the study of Tavares et al (2016) that had results showing
that female has more chances of preferring generic drugs than men.
A research paper done by Bertoldi et. al.(2016) states that half of the respondents
were reported as generic medicine users. There was no difference considering education
level. The prevalence was higher in females. Generic medicines were widely used by
those who belong in the middle class. Many of the respondents prefer purchasing generic
drugs thanks to the availability of these medicines in the market.
Omojasola, Hernandez, Sansgiry and Jones (2012) conducted a study that stated in
the results that race and ethnicity have no impact in the utilization of generic drug
discount programs. When it comes to analyzing their perception, the participants had a
GENERIC VS. BRANDED MEDICINES
positive perception on the safety, quality, and effectiveness of generic prescription drugs.
The education level of a patient directly affects the acceptability of generic drugs.
According to Nardi, Ferraz, Pinhiero, Kowalski and Sato (2015), higher use of
generic drugs was observed in the female and elderly populations. The higher use of
generic drugs among the elderly population may also be related to their lower spending
power, which may cause a preference for cheaper products like generic drugs. Regarding
the participants’ perceptions of the attributes of generic drugs, it was observed that almost
a third believed generic were less effective than branded drugs, and the most negative
opinions were observed in the lower income group and elderly. Although most of
participants had a positive perception regarding the effectiveness of generic drugs, more
than half said that if there was no price difference, they would prefer branded. This
findings reinforce the idea that price has a strong influence on the decision to purchase a
generic drug.
Skipper and Vejlin (2015) stated in their study that the choice of using branded
drugs were mainly determined by the complementary relationship of price and quality.
But the findings showed that socio-economic characteristics of both patients and doctors
to have very low explanatory power on the choice of medicines. This would mean that
whatever income class they are in, their preference is not affected. Physicians’
prescribing decision also does not affect the variation of the patients’ preferences.
GENERIC VS. BRANDED MEDICINES
Conceptual Framework
Hypotheses
H01: Gender has no significant relationship with the respondents’ preference of medicine.
H02: Medical conditions have no significant relationship with the respondents’ preference
of medicine.
H03: Age has no significant relationship with the respondents’ preference of medicine.
H04: Income has no significant relationship with the respondents’ preference of medicine.
H05: Occupation has no significant relationship with the respondents’ preference of
medicine.
H06: Perception has no significant relationship with the respondents’ preference of
medicine.
H07: Price and quality have no significant relationship with the respondents’ preference
of medicine.
GENERIC VS. BRANDED MEDICINES
Definition of Terms
Branded medicines. Virtual Medical Center (2011) defined branded medicines as
the original products that have been developed by a pharmaceutical company.
Furthermore, these are drugs containing the same dosage of active ingredient as the
generic medicine but does not have inactive ingredients that may contribute to its taste,
texture and color. In this research study, branded medicines are drugs people consider as
expensive and effective.
Generic medicines. Cadth (2015) stated that these medicines are a copy of the
original product; medicines that are equivalent to a branded drug in terms of strength,
dosage, route of administration, quality, performance and intended use. Generic
medicines are generally less expensive that branded medicines. This research study
focuses on generic medicines being less expensive than branded medicines, but is as
effective as its branded counterparts.
Medical conditions. are defined by WebMD as an injury, disease or disorder in the
human body. In this research study, medical conditions are anything that would require
one to take medicine in order to cure it, compelling the people to make use of either of
the two kinds of medicine, generic and branded
Income. In this research study, monthly family income was used wherein it
measures the income of all people in a household.
Occupation. In this research study, occupation refers to the profession of a person
that provides and supports the needs of a family.
Perception. As defined by Williams of College Psychology and Ethics Isthe
Process, it is where we take in sensory information from our environment and use that
GENERIC VS. BRANDED MEDICINES
information in order to interact with our environment and also includes how we respond
to the information. In this research study, perception refers to how the residents of a
certain baranggay apprehend medicines.
GENERIC VS. BRANDED MEDICINES
Chapter 3
Research Methodology
Research Design
In order to assess the degree of relationship between variables — socio-economic
status, medical conditions, perception and preference on the choice of medicines of the
residents of Mojon, Malolos, a descriptive correlational research design was used.
According to Burns and Grove (2013), a descriptive study defines an opinion, attitude, or
behavior held by a group of people on a given subject. It is also used to justify current
practices, make judgments and develop theories. The study was descriptive in nature
since it aims to describe the variables socio-economic status in terms of age, gender,
monthly family income and occupation; people’s varying perceptions in terms of the
complementary relationship of price and quality with respect to the overall preference of
the respondents in choosing which type of medicine to buy. A correlational study aims to
assess the relationships between and among two or more variables and the making of
predictions (Strangor, 2011). The correlational nature of the research design was to
determine if there is a significant relationship between the variables of the study. It was
also used to test if the formulated hypotheses on the relationships would be accepted or
not accepted.
Population and Sampling Technique
The focus population of the study was the whole residents of Barangay Mojon.
This barangay is the most populous in Malolos according to the 2015 census conducted
by the National Statistics Office (NSO), having a population size of 18,239. Since this is
GENERIC VS. BRANDED MEDICINES
too big to handle, the study would use a sample (n) to represent the population (N). Using
the standard formula, the sample size computed and used was 377 (5% margin of error,
95% confidence interval and 50% standard of deviation).
The sampling technique used in the study was cluster convenience sampling. The
researchers divided the population into clusters (subdivisions and villages within Mojon –
Felicissima, San Felipe, Maunlad, Menzyland, San Jose, Golden Grain).The
questionnaires prepared were given to respondents who were available at the time the
researchers are conducting the data gathering in Mojon.
Research Instrument
The questionnaire used in this study was divided into three sections: the socioeconomic status, perception of the respondents and their preference on the choice of
medicine. The socio-economic status section consisted of the respondents’ age, gender,
monthly family income, and occupation. The middle section, composed of questions that
measure the respondents’ perception, was adapted from an existing questionnaire of a
recent study conducted by Ahire et al (2013). The existing questionnaire was designed to
check the awareness, and knowledge of the respondents’ regarding generic and branded
medicines. Considering the similarity on the objectives, the researchers decided to adapt
the questionnaire and modifications were made to answer the research questions and
objectives of the study. The last section contains a dichotomous close-ended question that
determines what type of medicine – branded or generic, they prefer. The first and last
sections of the questionnaire were improvised by the researchers.
After designing the questionnaire, the validity and reliability were established.
Validity of a questionnaire assures that the content accurately measures the study’s
GENERIC VS. BRANDED MEDICINES
objectives, and what needs to be measured. Reliability, on the other hand, refers to the
ability of the questionnaire to reproduce results (Pineda, 2017). In pursuance of achieving
validity and reliability, the research instrument was assessed by professionals –
professors and doctors from the faculty of the Senior High School Department of Holy
Spirit Academy of Malolos based on construct and face validity. The suggestions and
feedback of the validators were all taken into consideration while reconstructing the final
research instrument.
After the improvement of the questionnaire in terms of validity, it was then
subjected to a pilot test to establish reliability. Printed questionnaires were distributed to
30 random Grade 12 students of HSAM and their responses were tabulated and recorded
using Microsoft Excel. Cronbach’s Alpha was not used in the pilot testing procedure,
since there were no Likert-scale questions in the research instrument. After all, a
questionnaire can be reliable but invalid, but a valid questionnaire is always reliable
(Pineda, 2017).
Data Gathering Procedure
Printed questionnaires in form of pen and paper were handed out to residents of
Barangay Mojon, Malolos, Bulacan. The contents of the questionnaires were explained to
each respondent in detail before and during the answering process, then the
questionnaires were collected after the respondents have completed answering all
questions. Deviation from the original random cluster sampling was necessary since the
data gathering was done during weekdays that limited the presence of available
respondents in every household leading the researchers to use convenience sampling with
approximately 63 respondents spread evenly through all six subdivisions of Barangay
GENERIC VS. BRANDED MEDICINES
Mojon. The data gathering proper was conducted during the weeks of October 29 to
November 4 and November 19 to 25, 2017.
Data Analysis Procedure
The responses of the respondents were tabulated and summarized in Microsoft
Excel, which served as the basis for the development of the study’s charts, graphs and
tables. Charts and graphs are classified under descriptive statistics –the statistics
concerned with describing the population under study (Surbhi, 2016). For the purpose of
describing properties, descriptive statistics uses the measures of central tendency (mean,
median, and mode), and measures of dispersion (range, standard deviation, and variance)
wherein in this study, only the variable age has numerical attributes that allowed the
calculation of the measures of central tendency and dispersion. To further represent the
data in a visually meaningful way, charts and graphs were used. Majority of the questions
were dichotomous close-ended questions, which allowed the utilization of pie charts to
represent the data. Bar graphs were also present in representing data that do not sum up to
a meaningful whole (100%). Along with these graphs are the percentages that represent
all tabulated and counted responses. Charts and graphs were applied to all questions in
the research instrument, to organize and represent the dataset.
Inferential statistics was also used in the study. Taylor (2016) stated that
inferential statistics is used to determine the probability of properties of the sample. The
chi-square test of independence was used as the statistical model of the study which
determines if there is a significant relationship between two nominal variables (Fisher et.
al, 2015). The Chi-square test always tests the null hypothesis, which states that there is
no significant difference between the expected and observed result (Fisher et al, 2015).
GENERIC VS. BRANDED MEDICINES
The software Statistical Package for the Social Science (SPSS) was used to compute for
the Chi-square statistical test. An association between two variables is statistically
significant if the asymptotic significance (2-sided) is equal or less than the designated
alpha value, which in this study’s case is 0.05. Phi and Cramer’s V are both tests of the
strength of the association. Phi is used to measure the strength of the association between
two variables, each of which has only two categories. Cramer’s V is used to measure the
strength of the association between one nominal variable with another nominal or ordinal
variable (Lab Manual, n.d.) The table below shows the value of the level of association
Level of Association
Verbal Description
0.00
No Relationship
.00 to .15
Very Weak
.15 to .20
Weak
.20 to .25
Moderate
.25 to .30
Moderately Strong
.30 to .35
Strong
.35 to .40
Very Strong
.40 to .50
Worrisomely Strong
.50 to .99
Redundant
1.00
Perfect Relationship
GENERIC VS. BRANDED MEDICINES