Methods: The modified Delphi method was used to obtain the consensus. The initial indicators, based on a literature review, were evaluated and assessed by members of the expert panel through three rounds of repetition until the consensus was reached. The expert panel members were selected based on their knowledge of or expertise in pharmacy service performance and geographical considerations. Analysis of the expert panel consensus level was determined by calculating the mean and interquartile range.
Results: Fifteen expert panel members started the first round (93.7% of the 16 targets) with 12 of them (75%) completing the third round of the modified Delphi method. Three expert panel members were representatives of the Regency Health Office, and the others were pharmacist practitioners at primary health centres from three different regencies. The consensus results were 26 indicators of drug management, 19 indicators of clinical pharmacy services, and two indicators of overall pharmacy performance.
Conclusion: The consensus indicators for measuring drug management, clinical pharmacy services, and overall pharmacy performance can be used as a reference and standard to measure the quality of pharmacy services at primary health centres. Therefore, the measurement results are more relevant if compared between one and other studies.
METHODS: A 23-item survey instrument that included a question on the bioequivalence limits and Likert-type scale questions regarding the understanding and perceptions of generic medicines among the students was executed. Cronbach's alpha was found to be 0.62.
RESULTS: Responses were obtained from 236 final-year Doctor of Pharmacy students (n=85 from a publicly funded institute; n=151 from a privately funded institute). When comparing a brand-name medicine to a generic medicine, pharmacy students scored poorly on bioequivalence limits. More than 80% of the students incorrectly answered that all the products that are rated as generic equivalents are therapeutically equivalent to each other (P<0.04). Half of the students agreed that a generic medicine is bioequivalent to the brand-name medicine (P<0.001). With regard to quality, effectiveness, and safety, more than 75% of the students disagreed that generic medicines are of inferior quality and are less effective than brand-name medicines (P<0.001). More than 50% of the students disagreed that generic medicines produce more side effects than brand-name medicines (P<0.001).
CONCLUSION: The current study identified a positive perception toward generic medicines but also gaps in the understanding of generic medicines. Pharmacy students lacked a thorough understanding of the concepts of bioequivalence. Pharmacy academia should address these issues, which will help build confidence in generic medicines and increase the generic medicine use in Pakistan.