When we’re having issues with our health, as well as visiting the doctor or hospital, one option we have is purchasing over-the-counter (OTC) medicines to treat ourselves at home.
OTC drugs can be purchased without a prescription from a doctor. They tend to be affordable and have low production costs.
With our healthcare systems needing to increase spending as populations are living longer, OTC drugs can help reduce the financial pressure on governments. Yet while OTC medicines can be an efficient way of treating medical issues, people have been hesitant to source their medicines in this way.
IGHI researchers have been seeking to better understand why this is. In particular, their recent study wanted to understand how branding and pricing information on OTC medicines can affect people’s purchasing choices.
We spoke to Dr Lisa Aufegger, an honorary research fellow at IGHI and co-author of the study to find out more.
Why are European countries facing financial pressures in sustaining their healthcare systems? Is this unique to Europe or an issue globally?
High public spending, chronic diseases becoming more common, and mounting demographic pressure with more and more people living longer are all contributing factors. In light of these circumstances, many official institutions, both inside and outside the European Union (e.g. the European Parliament and the World Health Organization), have emphasised the importance of an active and targeted promotion of responsible self-medication with OTC drugs as a critical building block for effective and efficient healthcare.
How can promoting generic over-the-counter medicines help relieve this pressure?
Generics are regarded as the best way for patients to receive medical treatment at a lower cost. Generics are non-branded copies of drugs that enter the market once the patent of a branded drug has expired. They contain the same active ingredients as their branded counterpart, and go through the same rigorous testing, and so they are just as effective. But they’re considerably cheaper because of the costs saved on research and development.
Strategies to promote the use of OTC drugs vary across Europe, ranging from reclassifying prescription-only drugs to OTC status, increasing the availability of cheaper non-branded OTC drugs, and prescription order systems that strongly encourage the prescription of generic alternatives. As OTC drugs are excluded from statutory and private health insurance coverage, the aim is to reduce healthcare expenditure by transferring certain costs from the government to the individual consumer.
What might influence people’s choices when buying over-the-counter medicines?
Economic theory suggests that a perfectly rational consumer would choose the least expensive product available. Yet research shows that people have been hesitant to buy generic OTC drugs.
So why are people reluctant to purchase generics? What we know so far is that price and brand cues may influence people’s perceptions of the quality and risk associated with OTC drugs, and therefore their buying behaviour. Having said this, it also appears that the public lack information about OTC medicines.
Tell us about your recent study in this area.
We wanted to find out more about the factors that can influence people’s purchase behaviour, such as brand loyalty, and how this may help to bridge the gap between the obvious economic benefit of generics and their slow market diffusion.
We created a survey-based questionnaire presenting participants with one of six print adverts showing either a well-known OTC brand or a generic alternative. The design of the advertisements was inspired by existing pharmaceutical ads and used an identical background and promotional slogan. Four of the six advertisements showed price information, presenting a high or a low price. We then asked a series of questions to assess the influence of various factors on participants’ decision-making process.
What were the main findings from your research?
We found that there was a relationship between price/brand information and how likely participants were to purchase a drug. People were least likely to purchase a high-priced generic, as well as a brand without a price. They were also more likely to purchase the low-priced generic than the generic without a price, suggesting that the display of low-price information may have an effect on consumers’ purchase intention.
However, we found that this was heavily influenced by people’s perceptions of drug quality and risk. While brand information decreased their perception of risk and increased their perception of quality, the opposite was found for the display of a generic drug. Hence, well-known brands act as a cue for better quality and lower risk.
In addition, we found that if people perceived the quality to be higher, this reduced their perception of risk which, in turn, increased the perceived value of the drug. This is a novel finding, which suggests that people’s evaluation of OTC drugs is not only based on the quality and associated risk, but also their value for money.
The data from our interviews showed that past experiences with either a generic or branded drug also had an important effect on purchase intention, and that consumers heavily rely on pharmacists’ recommendations.
What more needs to be done to help people when making decisions about over the counter medicines?
Our research has important implications for both policy and industry.
In terms of marketing, advertising prices may not be enough to incentivise people to switch from a branded OTC drug to a generic one. Yet, price advertising campaigns may help create awareness of generic drugs’ (economic) benefits among the public. This growing awareness through advertising and educational campaigns appears to encourage purchase and, if expanded, may help generics to better penetrate the market.
Promotional and educational efforts should target people’s perceptions of risk while improving their trust and confidence in the quality of generic drugs. Communicating more objective information about generic drugs, such as their effectiveness and safety standards, may help educate people about their quality and comparability to national brands to reduce perceptions of risk.
Lastly, our research highlights the need for policymakers to make use of the direct contact between consumers and pharmacists (or physicians) as a key communication channel. It is important to ensure healthcare professionals are appropriately trained and willing to inform people about generic medications to help broaden acceptance of generic alternatives.
What are the next steps for research in this area?
Our research focused on printed media, but marketing includes a broad range of communication channels and formats to promote medicines, such as television, social media and drug packaging. Different channels might reach different target groups such as the older generation.
Investigating the different effects of these forms of advertising would provide further valuable insights into the most powerful way to promote the use of generic OTC drugs.