Generic Perceptions: Measuring Opinions of Patients with Multiple Sclerosis Toward Generic Disease Modifying Therapies (DMTs)

In 2018, the MS world received its first true generic DMT, and more generics will become available over the next few years. Other disease states have studies showing a nocebo effect due to a mistrust of generic medications, leading to worse clinical outcomes and higher medical costs when patients are mandated to switch from a brand maintenance medication to a generic.

This was a multi-site study where patients with MS were surveyed during their monthly refill calls. The surveys were administered verbally by clinical pharmacists and liaisons and recorded in a survey system. The results were then compiled and analyzed to assess patient views towards generic DMTs and observe opportunities for pharmacists to impact patient DMT trust through counseling.

Results: 62 patients opted in to complete the survey. The average years with MS was 11 years, and 87% were diagnosed with RRMS. 42% were being treated with a generic, and 51% had been exposed to a generic DMT during their treatment history. 68% of the overall population trust generic DMTs, with 6% not trusting, and 26% not having an opinion. Comparing those currently being treated with generic DMTs to those on Brand name, there was a 13% difference in those who trusted generic DMTs, 169% difference in not trusting, and 8% difference having no opinion. The top 3 reasons to choose a DMT for the currently generic DMT population were Affordability, Efficacy, and Side Effects, while the top 3 reasons for those currently on Branded DMTs were Efficacy, Affordability and Administration route (tied), and Side Effects.

Conclusions: While the majority of MS patients surveyed trust generic DMTs, there is still a large portion (32%) who don’t trust or don’t have a current opinion on generic DMTs. All of the patients who didn’t trust generic DMTs were being treated with Branded DMTs, and this population valued Efficacy more than Affordability. More research is needed to confirm these results; however, this study shows that there is a population of MS patients who could be susceptible to a nocebo effect should they be mandated to switch to a generic medication. Pharmacists could help prevent this by learning the patient’s values for choosing a DMT and counseling confidence in the treatment they’ve been prescribed.