Access to affordable and effective medicines is a cornerstone of equitable healthcare, yet the high cost of branded drugs often creates significant barriers for economically disadvantaged populations. In this context, generic medicines pharmaceutically equivalent to their branded counterparts in dosage, strength, safety, and efficacy present a vital, cost-effective alternative. Despite their clinical equivalence and endorsement by national and international health authorities, generic medicines continue to face skepticism among the general public, largely driven by misconceptions around their quality, effectiveness, and safety [1-3].

In India, where out-of-pocket expenditure on healthcare remains disproportionately high, the promotion of generic drugs is both a policy priority and a public health necessity. Government initiatives like the Jan Aushadhi Scheme aim to increase the availability of affordable generics through dedicated outlets. However, the success of such efforts depends not only on supply chain mechanisms but also on public awareness, trust, and willingness to switch from branded medications.

Unfortunately, widespread misinformation, lack of physician endorsement, and consumer doubts often hinder the acceptance of generics, especially in smaller towns and rural settings [4-6].

Mandi district in Himachal Pradesh, characterized by a mix of urban and rural populations, presents a compelling setting to explore this issue. While generic drugs are available in the region, little is known about the local population’s awareness, perceptions, and purchasing behavior regarding them. Understanding how people in Mandi perceive the price, efficacy, and safety of generics and what influences their preferences can offer valuable insights into the socio-cultural and informational barriers to their adoption.

This study aims to evaluate the level of awareness, attitudes, and preferences toward generic medicines among residents of Mandi. By exploring factors such as trust in quality, belief in effectiveness, price sensitivity, and sources of information, the research seeks to identify key gaps and opportunities for public health interventions. The findings can help inform strategies to enhance the credibility and uptake of generic drugs, contributing to more affordable and inclusive healthcare in the region.

Study Design

This research employed a descriptive, cross-sectional design to assess awareness, perceptions, and preferences related to generic medicines among the residents of Mandi district, Himachal Pradesh. The study was conducted using an online survey method to ensure wide reach and accessibility, especially given the geographical diversity of the region.

Study Area and Population

The study was carried out in Mandi, a district comprising both urban and rural populations. The target population included adult residents (aged 18 years and above) from various socioeconomic and educational backgrounds. Participants included both regular medicine users and caregivers involved in household healthcare decisions, providing a well-rounded perspective on consumer attitudes.

Study Duration

The data collection spanned a period of three months, from January to March 2025, allowing for adequate time to disseminate the survey and ensure a representative sample.

Sample Size and Sampling Technique

A minimum sample size of 400 was calculated using a 95% confidence level, 5% margin of error, and an assumed 50% awareness rate of generic medicines. A buffer of 10% was added to account for incomplete or invalid responses. Participants were recruited through convenience and snowball sampling using digital platforms such as WhatsApp, Facebook, and community forums. Outreach was supported by local influencers, educators, and healthcare volunteers.

Inclusion and Exclusion Criteria

Inclusion Criteria

• Residents of Mandi district aged 18 years and above

• Ability to read and respond in Hindi or English

• Willingness to provide informed digital consent

• Access to a smartphone, tablet, or computer with internet connectivity

Exclusion Criteria

• Healthcare professionals or pharmacy experts (to avoid bias from professional knowledge)

• Individuals with no experience or involvement in medicine purchase or usage

• Incomplete or duplicate responses

Data Collection Instrument

A structured, pre-validated questionnaire was developed in consultation with public health experts and pharmacists. The survey was administered through Google Forms in both Hindi and English. It consisted of four main sections:

• Demographic Details: Age, gender, education, income level, and residential setting (urban/rural).

• Awareness Assessment: Questions on understanding of generic vs. branded medicines, awareness of government schemes (e.g., Jan Aushadhi), and familiarity with generic labels.

• Perception and Trust: Statements assessing beliefs about quality, safety, effectiveness, and trust in doctors’ and pharmacists’ recommendations (measured on a 5-point Likert scale).

• Preference and Behavior: Questions on past purchasing behavior, price sensitivity, willingness to switch, and influence of brand names in decision-making.

Scoring and Data Classification

Responses to awareness and perception items were scored to classify participants into high, moderate, or low knowledge and trust categories. Likert-scale responses were quantified to analyze attitudinal trends. Preference trends were assessed based on frequency of generic vs. branded drug usage and willingness to consider generics in the future.

Data Collection Procedure

Participants were informed about the study’s purpose and confidentiality protocols at the start of the survey. Digital informed consent was obtained before access to the questionnaire. The survey was optimized for mobile use to encourage participation from remote and rural respondents.

Data Analysis

Collected data were exported to Microsoft Excel and analyzed using SPSS version 26.0. Descriptive statistics (frequencies, means, percentages) were used to summarize demographic and categorical variables.

Ethical Considerations

Participation was voluntary and anonymous, with no personal identifiers collected. All data were stored securely and used solely for academic and research purposes in accordance with ethical guidelines

Table 1 outlines the socio-demographic characteristics of the 400 participants surveyed in Mandi district. The majority of respondents were in the 26–35 age group (40.5%), followed by 36–45 years (25.8%) and 18–25 years (22.3%), indicating a predominantly young to 
middle-aged population. Gender distribution was relatively balanced, with females representing 52% and males 48%. Education levels varied, with the highest proportion having completed secondary school (35.8%), followed by those with undergraduate degrees (29.3%) and primary school education (19.5%). A small percentage (6.8%) had no formal education. Regarding income, most participants (37.3%) reported monthly earnings between ₹10,000–₹25,000, while 27% earned ₹25,001–₹50,000   and   23.5%   earned   below ₹10,000. The residential profile was predominantly rural (66.5%), highlighting the study’s emphasis on understanding awareness and preferences in less urbanized settings.

Table 1: socio-demographic characteristics of participants

Table 2 captures participants’ awareness and perceptions related to generic versus branded medicines. A large majority (77.3%) correctly identified generics as equivalent drugs with the same active ingredients, and 74% agreed they are as effective as branded medicines. Awareness of cost benefits was very high, with 87.8% recognizing generics as cheaper alternatives. Knowledge of government initiatives like the Jan Aushadhi Scheme was also strong (69.5%). However, while 83.5% acknowledged the need for doctor consultation before switching, only 59.5% believed that doctors in Mandi regularly recommend generics. Trust and safety perceptions varied, with 71.8% disagreeing that generics are less safe, but only 65.8% stating they trust them as much as branded drugs. Encouragingly, 78% of participants indicated they would be willing to switch if generics were recommended, and 85.3% cited cost as a major influencing factor. These findings suggest good foundational awareness but lingering doubts around trust, physician endorsement, and safety.

Table 2: awareness and perceptions of generic vs. branded medicines among participants

Table 3 presents the classification of knowledge and perception scores among respondents. A notable 31.8% of participants demonstrated a “Very Good” level of understanding (≥80% score), while 41.3% were categorized as having “Good” knowledge (60–79%). However, 19.5% scored in the “Fair” category (41–59%), and 7.5% had “Poor” understanding (<40%), indicating that roughly a quarter of the sample still lacks adequate awareness about generic medicines. These disparities were more pronounced among those with lower education and income levels, especially in rural areas. Overall, while the results show promising levels of awareness, they also highlight the need for targeted educational campaigns to address misconceptions and enhance trust in generic medicines across all segments of the population.

Table 3: knowledge and perception score classification

The findings of this study provide a nuanced understanding of the awareness, perceptions, and preferences regarding generic medicines among the residents of Mandi district, Himachal Pradesh. As India strives to reduce healthcare expenditure and enhance medicine accessibility, bridging the gap between policy-level promotion of generics and public acceptance is critical. This research highlights both encouraging trends and persistent gaps that shape consumer attitudes toward generics in semi-urban and rural settings.

A key highlight of the study is the relatively strong foundational awareness of generic medicines among participants, with over 77% correctly identifying generics as equivalent to branded drugs in active ingredients. Furthermore, a significant majority (87.8%) recognized the cost advantage offered by generics, underscoring price sensitivity as a dominant factor in consumer choices. These findings suggest that efforts to promote generics through schemes like Jan Aushadhi are gradually permeating into public consciousness, particularly as nearly 70% of participants were aware of the scheme’s purpose.

        Nevertheless, awareness alone does not equate to trust or preference. While 74% of respondents acknowledged that generics are as effective as branded counterparts, only 65.8% expressed equal trust in them. This discrepancy reveals an underlying skepticism, likely fueled by misinformation, inconsistent messaging from healthcare professionals, and a lack of experiential assurance. For instance, only 59.5% of participants believed that doctors in Mandi routinely recommend generics, highlighting a significant gap in provider endorsement a known influencer of patient behavior. Additionally, while 83.5% agreed that medical consultation is necessary before switching to generics, many remain uncertain about pharmacists' authority to substitute drugs, as only 62.3% were aware of this practice.

        Trust in generics also seems tempered by safety concerns. While 71.8% denied that generics are inherently less safe, 68.5% still expressed concern about side effects, and only 64% were aware that generic quality is regulated in India. This reveals a partial understanding of regulatory standards, which, if addressed through public awareness campaigns, could reduce apprehensions significantly.

        Demographic factors further contextualize these insights. Participants from rural areas (66.5% of the sample) and those with lower income and education levels were disproportionately represented in the “Fair” and “Poor” knowledge categories. These individuals may rely more heavily on informal sources of information or face barriers in accessing reliable healthcare guidance, thus perpetuating misconceptions. This calls for tailored outreach strategies that go beyond urban-centric messaging and incorporate vernacular language, community health workers, and local media to improve health literacy.

        The willingness to adopt generics, as shown by 78% of participants expressing readiness to switch if recommended, indicates a fertile ground for intervention. This willingness, however, is contingent on credible endorsements especially from doctors and pharmacists whose role must be strengthened through targeted training and incentivization to promote generics without bias. The study also reveals that packaging differences (identified by 82%) and brand recognition continue to influence perceptions, suggesting that uniform branding or more standardized packaging for generics could help alleviate consumer doubt.

        Overall, the data suggest that while Mandi’s population has a relatively high level of functional awareness about generics, emotional and behavioral acceptance is still evolving. Strategic steps must be taken to translate awareness into trust and consistent usage. This includes enhancing provider-patient communication, ensuring the availability and visibility of generics at pharmacies, debunking myths through community education, and involving local stakeholders in building a pro-generic narrative [7-9].

        Lastly, while the online methodology enabled broad participation across the district, it may have excluded individuals without digital access, potentially skewing findings toward more informed or literate respondents. Nevertheless, the results offer a valuable baseline for designing localized, equity-driven policies and health promotion programs aimed at maximizing the adoption of generic medicines in Mandi and comparable districts across India.

In conclusion, this study underscores a promising yet incomplete transition toward acceptance of generic medicines among the people of Mandi district. While a substantial portion of the population demonstrates sound awareness of generics’ affordability and therapeutic equivalence, persistent doubts regarding safety, quality, and physician endorsement continue to hinder full-scale adoption. These knowledge gaps are especially evident among rural residents and those with lower educational and income levels, highlighting the need for targeted, culturally sensitive public health initiatives. Strengthening the role of healthcare providers in endorsing generics, improving community-level education on regulatory standards, and ensuring greater visibility and accessibility of generics through schemes like Jan Aushadhi are vital steps forward. Bridging the trust deficit through transparent communication and policy-backed interventions can pave the way for broader public confidence, ultimately advancing the goal of equitable and affordable healthcare access in Mandi and beyond.

1. Basak, S. C., and D. Sathyanarayana. "Exploring knowledge and perceptions of generic medicines among drug retailers and community pharmacists." Indian Journal of Pharmaceutical Sciences, vol. 74, no. 6, Nov. 2012, pp. 571–575.

2. Aivalli, P. K. et al. "Perceptions of the quality of generic medicines: implications for trust in public services within the local health system in Tumkur, India." BMJ Global Health, vol. 2, 2018, article e000644.

3. Hebbar, S. K. et al. "Assessment of awareness on generic drugs among health care professionals and laypersons." International Journal of Basic and Clinical Pharmacology, vol. 6, no. 3, 2017, pp. 680–683.

4. Malav, V. et al. "Consumer perception towards generic medicine in Vadodara City." International Research Journal of Modern Engineering and Technology Science, vol. 6, no. 5, May 2024, pp. 353–380.

5. Gupta, R. et al. "A study on assessment of awareness on generic drugs among doctors in a tertiary care teaching hospital in North India." International Journal of Research in Medical Sciences, vol. 6, no. 4, 2018, pp. 1362–1367.

6. Panigrahy, S., and S. Chaudhari. "Knowledge and perceptions of generic drugs: a cross-sectional study." Journal of Drug Delivery and Therapeutics, vol. 12, no. 2-s, 2022, pp. 53–57.

7. Priyadarsini, R. et al. "A comparative study on perception and use of generic drugs between public and private health practitioners." Journal of Family Medicine and Primary Care, vol. 12, no. 12, Dec. 2023, pp. 3222–3227.

8. Kumari, A. et al. "Knowledge and perceptions of medical students about generic medicines in a medical college in North India." Journal of Primary Care Specialist, vol. 4, no. 2, May–Aug. 2023, pp. 82–86.

9. Sanyal, S. et al. "Patients' perception regarding generic and branded medicines." Tobacco Regulatory Science, vol. 7, no. 6-1, Jan. 2022, pp. 7414–7424.