BRIDGING THE PERCEPTION GAP: PATIENT ATTITUDES TOWARD MULTINATIONAL AND LOCAL MEDICINES IN A RESOURCE-CONSTRAINED SETTING OF QUETTA, PAKISTAN

Abstract

Background: Patient and caregiver perceptions are important to consider when examining adherence, cost management, and health outcomes of pharmaceuticals. The study explored the attitudes of the people of Quetta, Pakistan, toward the use of multinational and local prescription drugs. Methods: A prospective cross-sectional study was conducted in the Quetta area from September 2022 to March 2023, recruiting 816 patients and caregivers (ages 16-58). Demographic and clinical data, knowledge of medicines, and purchasing preferences were collected using structured questionnaires across various scenarios. Attitudes toward multinational and local pharmaceutical products were compared using a chi-square test and Spearman rank correlation. Results: Of 816 participants, 429 (52.6%) were male, and 641 (78.7%) lived in urban areas. Local medicines had significantly higher awareness than multinational products (80.4% vs. 76.0%, χ²=8.43, p=0.015). Across all ten drug attributes, multinational products were strongly preferred: quality (46.1% vs. 27.1%, p<0.001), effectiveness (41.7% vs. 24.9%, p<0.001), safety (37.1% vs. 21.3%, p<0.001), and quick relief (40.7% vs. 22.8%, p<0.001). Medicines from other countries were perceived as more expensive (51.0% strongly agreed, χ²=46.31, p<0.001). Multinational preference ranged from 40.8% (spouse, acute disease) to 54.7% (parents, chronic disease; χ²=119.4, p<0.001) across the nine purchasing scenarios. Preferences were highly consistent (rₛ=0.94, p<0.001). Conclusions: Across all diseased conditions, patients and caregivers in Quetta consistently prefer multinational medicines, with their preference based on perceived efficacy, quality, and packaging rather than cost. To bridge this gap, bioequivalence standards need to be tightened, communication among local manufacturers and the public needs to be improved, and public education should be targeted to ensure the rational and equitable use of medicines in Pakistan.

Keywords: Prospective cross-sectional study, Local Medicine, Multinational, Perception, Attitude, and Adherence.