Knowledge attitude and perception of dispensing doctors regarding generic medicines in Karachi, Pakistan: a qualitative study.

High expenditure and increasing health care costs are prime concerning factors in the health care system globally. In some of the developing countries WHO reported out-of-pocket payments as high as 80% of health care spending.1 At present Pakistan is spending only 1.2% of GDP on pharmaceuticals and despite more than 40000 registered brands in the country2 essential and life-saving drugs are missing from the market. Due to inaccessibility of drugs in the public hospitals, 77% of medicine expenditures are out of pocket and thus, access and affordability of medicines is a vital issue to tackle in Pakistan.3 In an attempt to struggle with the escalating drug cost in Pakistan generic prescribing and dispensing could be a solution to approximately one third of the population living below the poverty line. Although there is no ordinance or authoritative rule for generic prescribing or substitution in the public and private sector in Pakistan, recently the Government of Pakistan highlighted the use of generic medicines in order to check the prices of medicines. In Pakistan there is a need to sensitize patients, prescribers and pharmacists to improve the quality use of generic medicines.3 However, to gain a wider health professionals' support, it is vital to understand the issues surrounding generic medicines.4 Current study is aimed to explore the knowledge, perception and attitude of dispensing doctors towards generic medicines as well as to document the factors hindering and favouring generic medicine use by dispensing doctors of Karachi, Pakistan.