Patient Perceptions of Switching to a Generic Dry Powder Inhaler – Increased Understanding Through Journey Mapping

Abstract

Sarah E Ray,1 Vanessa Boudewyns,1 Christine Davis,1 Janice P Tzeng,1 Ila Srivastava,2 Oluwamurewa Oguntimein,3 Denise S Conti,4 Karen B Feibus2 1Center for Communication Science, RTI International, Research Triangle Park, NC, USA; 2Office of Research and Standards, Office of Generic Drugs, Center for Drug Evaluation and Research, Food and Drug Administration, Silver Spring, MD, USA; 3Office of Medication Error Prevention and Risk Management, Office of Surveillance and Epidemiology, Center for Drug Evaluation and Research, Food and Drug Administration, Silver Spring, MD, USA; 4Office of Safety and Clinical Evaluation, Office of Generic Drugs, Center for Drug Evaluation and Research, Food and Drug Administration, Silver Spring, MD, USACorrespondence: Sarah E Ray, Center for Communication Science, RTI International, Research Triangle Park, NC, USA, Tel [phone], Email [email protected]: This qualitative study explored patients’ attitudes about and perceptions of generic dry powder inhaler (DPI) substitution for the brand product and patients’ views of generic product quality, efficacy, design, and usability.Methods: Forty COPD and asthma patients (36 adults, four adolescents), who were actively using a brand DPI product, participated in one of six focus groups. Participants completed a journey mapping exercise to assess attitudes and opinions about a scenario where they refill their prescription and unexpectedly receive a generic DPI instead of their brand DPI. The focus groups were audio recorded, transcribed, and analyzed thematically.Results: The hypothetical scenario of unexpectedly receiving a generic DPI elicited mixed feelings including: happiness and relief about potential cost savings, confusion, disappointment, anger, and/or frustration with the unexpected switch. Participants in most groups anticipated anxiety or hesitation in using the generic DPI due to concerns about potential differences in usability, uncertainty about correct use, and questions about efficacy. Participants across all groups said they would ask a pharmacist or healthcare provider for information or answers to their questions, and some participants said they would use online resources. When participants held the brand and generic DPI devices, most preferred the brand DPI device and found it easier, less cumbersome, or more convenient to use (due to size and weight). However, many participants reiterated that the potential reduced cost of the generic DPI would be a primary factor in their decision-making related to generic DPI substitution for their brand DPI.Conclusion: Patients experienced a mixture of positive and negative feelings when faced with an unexpected generic DPI substitution. Some patients have doubts about their ability to successfully navigate differences in generic device design, and most expressed the desire to participate in discussions and decision-making with their HCP about generic DPI sameness and substitution.Keywords: COPD, asthma, medical devices, generic drugs, drug-device combination products, focus groups

Keywords

• copd
• asthma
• medical devices
• generic drugs
• drug-device combination products
• focus groups