Knowledge, Attitudes, and Practices of Patients Regarding Generic Drug Substitution in Ogun State

Generic drug substitution is a key strategy for improving medication affordability and access in Nigeria, but patient acceptance is influenced by knowledge and attitudes toward generic medicines. This study investigated the knowledge, attitudes, and practices of outpatients regarding generic drug substitution at a general hospital in Abeokuta, Ogun State, South West Nigeria. A cross-sectional survey was conducted among 280 outpatients using a validated structured questionnaire. The instrument assessed awareness of generic medicines, beliefs about quality equivalence between generics and branded drugs, past experiences with generic substitution, and willingness to accept substitution. Results showed that 58.9 percent of respondents had heard of generic medicines, but only 32.5 percent correctly understood the concept of bioequivalence. Positive attitudes toward generic drugs were held by 47.1 percent of respondents. Previous positive experience with generics was the strongest predictor of favourable attitudes (OR 4.2; 95 percent CI 2.1 to 8.4). Common barriers to acceptance included perceived inferior quality, negative pharmacist or physician influence, and brand loyalty. Willingness to accept generic substitution was significantly higher among patients with tertiary education and lower household income. The study recommends pharmacist counselling on generic bioequivalence, public education campaigns on generic medicines, and policy support for transparent generic labelling as strategies to improve patient acceptance and uptake of generic substitution in Nigerian outpatient settings.

Keywords: generic drug substitution, patient attitudes, bioequivalence, Ogun State, drug affordability