Awareness of Generic Medicines and Willingness to Substitute Brand Name Drugs Among Patients in Awka, Anambra State, South East Nigeria

Generic medicine substitution presents a significant opportunity to reduce healthcare costs and improve access to essential medicines in Nigeria. However, patient awareness and acceptance of generic medicines remain inconsistent across communities. This study assessed patient awareness of generic medicines and their willingness to accept brand-to-generic substitution at community pharmacies in Awka, Anambra State, South East Nigeria. A descriptive cross-sectional survey of 350 patients who patronized community pharmacies in Awka was conducted. Respondents were assessed on their understanding of generic medicines, perceptions of safety and efficacy equivalence, and openness to substitution at the pharmacist's recommendation. Findings indicated that 61 percent of respondents had heard of generic medicines, but only 29 percent correctly understood that generics contain the same active ingredients at equivalent doses. Concerns about quality, efficacy, and safety deterred acceptance in 44 percent of respondents. Trust in the pharmacist significantly predicted willingness to accept substitution, with those having established relationships with their pharmacists being twice as likely to agree to substitution. Brand loyalty was particularly strong for chronic disease medications. These results indicate an important role for pharmacists in educating patients on bioequivalence and building trust to facilitate generic substitution. Healthcare policies promoting generic prescribing by generic name should be reinforced, and patient education materials in Igbo and Pidgin should be developed for community use in Anambra State. Keywords: generic medicines, brand substitution, patient awareness, Awka, community pharmacy