Opinion and behaviour of pharmacists towards the substitution of branded drugs by generic drugs: survey of 1,000 French community pharmacists

Objective: In 1999, a new law was introduced, giving French pharmacists the right to switch from branded to generic drugs, unless the prescriber had specified that substitution was not permitted. The purpose of this study was to assess the opinion and behaviour of community pharmacists towards substitution. Design: Self-completion, postal close-ended questionnaires were filled out. Sample and setting: 1,000 French community pharmacists were included. Results: 90% of the pharmacists were favourable to the implementation of the substitution right. 42.5% declared they systematically offered patients the generic drug, whereas 55% chose to target specific populations for substitution. The reluctance of pharmacists could be commercial ('How do I get paid for the time spent? Is it worth risking loosing a customer?'), or cultural ('How do I work this out? Who should I offer generic drugs to? What strategy should I use to offer them?'). Conclusion: Generic drug distribution is very recent in France and is not yet common practice. Pharmacists and patients must be informed and trained because substitution is a collaborative act. It does not depend solely on the will and experience of pharmacists.