“No generics, Doctor!” The perspective of general practitioners in two French regions

Abstract Background Generic medicines are essential to controlling health expenditures. Their market share is still small in France. The discourse and practices of prescribers may play a major role in their use. The purpose of this study was to explore the knowledge, attitudes and practices of general practitioners (GPs) toward generic medicines in two French regions with the lowest penetration rate of these products. Methods An observational study was carried out from October 2015 to February 2016 in Guadeloupe and Martinique. The first qualitative phase involved a diversified sample of 14 GPs who underwent semi-structured interviews. The second phase involved a random sample of 316 GPs (response rate = 74%) who were administered a structured questionnaire developed from the results of the first phase. Results Seventy-eight percent of the participants defined a generic drug as a drug containing an active substance identical to a brand-name drug, but only 11% considered generic drugs to be equivalent to brand-name drugs, and the same proportion believed that the generic drugs were of doubtful quality. The primary recognized advantage of generic medicines was their lower cost (82%). The main drawbacks cited were the variability of their presentation (44%), the confusion that they caused for some patients (47%), frequent allegations of adverse side effects (37%) and a lack of efficacy (24%), and frequent refusal by patients (26%). Seventy-four percent of the participants stated that they adapted their prescribing practices to the situation, and of this group, 47% prescribed the originator product simply on demand. Conclusion Most surveyed GPs were not hostile towards generic medicines. They were caught between the requirements of health insurance regimes and the opposition of numerous users and suggested that the patient information provided by health authorities should be improved and that drug composition and packaging should be made uniform

Medicinal Plants and Plant-Based Remedies in Grande-Terre: An Ethnopharmacological Approach

The island of Grande-Terre is a French overseas region that belongs to the Guadeloupean archipelago, a biodiversity hotspot with unique flora. Herbal medicine is widely used in the island for therapeutical purposes; however, there is a significant knowledge gap in the records relating to medicinal plants and their associated uses. Ethnobotanical survey methodology using quantitative parameters (informant consensus factor, species use value, relative frequency of citation, frequency use of a treatment and plant for an ailment) provided insights into the traditional medicinal use of a given plant. Ninety-six different plant species distributed among 56 families were identified and 523 remedies were documented in the survey. After data filtering, 22 plants species were associated with 182 remedies. The most frequent plant families were Poaceae, Myrtaceae, Cucurbitaceae and Rubiaceae. Aerial parts of these plants were the most common parts of the plant used for the remedies and the most frequent mode of administration was oral ingestion. This study highlights a valuable traditional knowledge of folklore medicine and helps to document and preserve the association of a plant with—and its use frequency for—a given ailment. These findings might be the starting point for the identification of biologically active phytocompounds to fight common health debilities