Table 3 Descriptive statistics and Cronbach’s Alpha on survey scales

Attitude towards generic drug substitution (Cronbach’s alpha = 0.553)

3.78

0.85

49 (16)

35 (12)

219 (72)

1.I support generic substitution for all brand-name drugs for which generics are available.

3.55

1.01

30 (20)

25 (16)

97 (64)

2.It is acceptable that pharmacists perform generic substitution without obtaining permission from the prescribing physician.

4.01

1.03

19 (12)

10 (7)

122 (81)

Attitude towards unified medical prescription (Cronbach’s alpha = 0.529)

3.16

0.77

200 (33)

122 (20)

277 (46)

1.I support the implementation of the unified medical prescription.

2.94

1.22

58 (39)

36 (24)

55 (37)

2.The unified medical prescription helps promote the use of generic drugs in Lebanon.

3.09

1.25

53 (35)

31 (21)

66 (44)

3.The unified medical prescription helps identify physicians who are influenced by medical representatives.

3.89

1.09

20 (13)

22 (15)

107 (72)

4.The unified medical prescription helps regulate the pharmaceutical industry.

2.83

1.2

69 (46)

33 (22)

49 (32)

Layout/structure of form (Cronbach’s alpha = 0.705)

3.16

0.77

88 (29)

78 (26)

138 (45)

1.I am satisfied with the overall layout of the form.

2.89

1.09

57 (38)

40 (26)

55 (36)

2.The form is user-friendly.

3.32

1.01

31 (20)

38 (25)

83 (55)

Pharmacist practices (Cronbach’s alpha = 0.566)

3.30

0.64

186 (25)

193 (26)

376 (50)

1.Pharmacists are adhering to the laws that govern the unified medical prescription.

2.11

1.18

29 (19)

33 (22)

90 (59)

2.I have substituted brand drugs for generic equivalents in most of the prescriptions I have dispensed (excluding those prescriptions where the NS option was ticked).

3.04

1.14

53 (35)

38 (25)

60 (40)

3.I feel empowered to speak to patients about generic drug substitution since the implementation of the policy.

2.99

1.01

50 (33)

51 (34)

50 (33)

4.I sometimes consult with the physician when I feel the NS option is used unjustifiably.

3.32

1.18

42 (28)

27 (18)

82 (54)

5.I have been adhering to the Ministry of Public Health’s (MOPH) agreed list of substitutable generic drugs.

3.65

0.85

12 (8)

44 (29)

94 (63)

MOPH responsiveness (Cronbach’s alpha = 0.324)

117 (29)

173 (29)

311 (42)

1.The MOPH performs regular audits on the prescription forms collected by the pharmacy.

3.21

1.13

36 (24)

43 (29)

71 (47)

2.Generic drug equivalents approved by the MOPH are almost always in stock.

3.56

0.81

16 (11)

42 (28)

92 (61)

3.The MOPH’s national list of substitutable generic drugs is updated, accessible and easy to use.

3.18

1

38 (25)

51 (34)

63 (41)

4.The existing price structure discourages me from performing generic drug substitution.^b

2.51

1.01

27 (18)

37 (25)

85 (57)

Functionality of form (Cronbach’s alpha = 0.452)

180 (75)

88 (12)

486 (13)

1.Physicians are adhering to the laws that govern the unified medical prescription form.

2.11

1.18

108 (72)

19 (13)

23 (15)

2.There are technical problems with the implementation of the unified medical prescription form.^b

2.14

0.9

17 (11)

16 (11)

119 (78)

3.There are no clear guidelines on how to use the forms.^b

2.36

1.06

27 (18)

21 (14)

104 (68)

4.Physicians in general are abusing the NS option.^b

1.83

0.99

12 (8)

12 (8)

127 (84)

5.Some patients still show up with the old prescription form.^b

2.03

1.08

16 (11)

20 (13)

113 (76)

Consumer acceptance (Cronbach’s alpha = 0.472)

168 (50)

130 (22)

305 (28)

1.Consumers generally express negative attitudes towards generic drugs.^b

2.61

1.13

39 (26)

28 (19)

83 (55)

2.Consumers are not generally happy with the unified medical prescription.^b

2.2

0.89

13 (9)

34 (22)

105 (69)

3.Consumers have been actively requesting generic substitutions for brand-name drugs.

2.89

1.06

62 (41)

39 (26)

50 (33)

4.Consumers have accepted most of the substitution suggestions offered by the pharmacy.

3.1

1.06

54 (36)

29 (19)

67 (45)

Relation with drug companies (Cronbach’s alpha = 0.629)

2.76

0.92

140 (47)

68 (23)

92 (31)

1.My drug substitution choice is influenced by information from medical drug representatives.

2.6

1.01

79 (52)

36 (24)

36 (24)

2.It is acceptable that pharmacists rely on medical drug representatives to learn about alternative drug substitutions.

2.91

1.15

61 (41)

32 (21)

56 (38)

Outcome of the policy (Cronbach’s alpha = 0.511)

2.67

0.61

299 (50)

188 (25)

271 (25)

1.The number of generic dispensing at my pharmacy has increased considerably since the implementation of the policy.

2.59

0.97

81 (53)

39 (26)

32 (21)

2.There was an initial peak in generic dispensing following the implementation of the policy that was subsequently attenuated.

2.72

1.02

73 (48)

39 (26)

40 (26)

3.The overall patient expenditure on medicine has decreased since the implementation of the policy.

2.86

1.09

69 (45)

31 (20)

52 (34)

4.There has been a noticeable shift in pharmaceutical companies’ promotional strategies targeting pharmacists.

2.97

1.05

53 (35)

53 (35)

46 (30)

5.The policy is creating conflicts between the physician, the pharmacist, and the patient.^b

3.77

1.09

23 (15)

26 (17)

101 (67)