**Author details**

*Advances in Hematologic Malignancies*

medicines and mitigate the same.

comes of cancer care.

**9. Conclusions**

**Conflict of interest**

countries [12, 27, 42, 43]. There is lack of a standard approach for the assessment of knowledge, attitudes, and perceptions about generics. In addition, factors impacting the utilization of generics have not been precisely determined. Sustained and collaborative efforts should be made to understand the perceptions for generic

Educational initiatives should be introduced by manufacturers of generics and biosimilars and healthcare systems to improve knowledge about these drugs and develop positive attitudes towards their adoption. This will empower physicians, patients, and pharmacists to make rational choices in therapy and improve out-

Uniform standards should be developed for high-quality generics and these need

to be implemented at global levels. Maiden efforts in this direction include tools like the generic dRug adoption framework (GRAF) (**Figure 1**). This framework, comprising a 20-item questionnaire, has been developed to enable physicians and pharmacists to make decisions to identify and differentiate high quality generics and facilitate interchangeability. Currently available in three languages (English, Spanish, and Portuguese), the framework has successfully been implemented in Brazil and Colombia. More and more countries should adopt such objective measures to evaluate the perceptions and adoption of high-quality generics. Insights gained from the experience of such frameworks can help to make further reforms to allow the identification, procurement, and prescription of high-quality generic medicines. This can advance the use of cost-effective solutions in cancer care.

Availability of generics and easier access to these drugs can impact the outcomes in oncology settings. The low-priced and affordable generic medicines and biosimilars can improve the adoption and compliance with treatment options in cancer care. However, the low price of these drugs is often construed as compromise in quality. There are myriad perceptions for the use of generics and biosimilars in routine practice. The perceptions are different among physicians in high- and low-income countries; these can possibly be due to differences in regulations and policies, educational opportunities and available drug information sources. Factors like cost, quality, effectiveness, and safety impact the understanding for and adoption of generics and biosimilars. There are several challenges in the substitution and switch from originator products to generics and biosimilars. The widespread and confident adoption of generics requires collaborative efforts of prescribers, health-

care professionals, payers, and the manufacturers of these agents.

The authors have no conflicts of interest.

**144**

Amit Garg1 \*, Deepak CSN1 and Tarveen Jandoo2

1 Dr. Reddy's Laboratories Ltd., Hyderabad, India

2 Independent Medical Affairs Consultant, New Delhi, India

\*Address all correspondence to: amitgarg@drreddys.com

© 2019 The Author(s). Licensee IntechOpen. This chapter is distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/ by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
