Beliefs about generic drugs among elderly adults in hospital-based primary care practices

Objective: This 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. Methods: Older adults (≥65 years) were interviewed in two primary care practices of an inner-city, tertiary care hospital (n = 311). Beliefs about generics were measured using a scale that compared generic and brand name drugs across four domains. Beliefs were modeled with multivariable linear regression. Results: Negative beliefs about generics were associated with non-white race (p < 0.0001), lower education (p = 0.008) and income (p = 0.001), and having Medicaid coverage (p = 0.001). Individuals with low health literacy and who reported that their physicians had poor communication skills were more likely to hold negative views (p < 0.0001 and p = 0.003, respectively). In multivariable analysis, black race (β = -2.30, p = 0.006) and inadequate health literacy (β = -2.17, p = 0.0004) remained strongly associated with negative views about generic drugs. Poor physician communication skills also predicted negative beliefs about generics but the association was not significant for all levels of communication skill. Conclusion: Many low-income seniors mistrust generic medications, especially African-Americans and seniors with low health literacy. Practice implications: Educational efforts to promote generic medications should account for patients' health literacy and cultural backgrounds.