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Table 3 Reasons for not substituting indicated by frequent (≥ 5%) and less frequent (< 5%) users of the Not for Generic Substitution mention

From: Factors influencing the use of the “not for generic substitution” mention for prescriptions in primary care: a survey with general practitioners

Reasons for not substituting medication a NGS b mention < 5%: n (%) NGS b mention ≥5%: n (%) p value
Patient age over 65 17 (14.5) 69 (44.0) <  0.001
Higher efficacy of the brand-name drug 19 (16.1) 44 (28.2) 0.02
Does not believe in bioequivalence 21 (17.7) 45 (28.9) 0.03
Benign adverse effect 21 (17.7) 37 (23.7) 0.22
Severe adverse effect 27 (22.7) 31 (20.0) 0.59
Monographies and scientific journals 7 (6.2) 15 (10.1) 0.26
Regulatory agency guidelines 11 (9.6) 8 (5.5) 0.21
Advice by specialist 20 (17.2) 32 (20.7) 0.48
Patient request 47 (39.8) 102 (65.0) <  0.001
Patient comorbidity 11 (9.3) 56 (36.4) <  0.001
Polypharmacy 16 (13.7) 61 (39.4) < 0.001
Physician’s personal choice for other reasons (routine, desire to use drug names the patient is familiar with …) 4 (3.4) 12 (7.9) 0.12
  1. aVery often/always a reason for not substituting medication. Percentages were calculated using available data
  2. bNGS Not for Generic Substitution