{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T17:20:16Z","timestamp":1787678416029,"version":"build-2784847793"},"reference-count":30,"publisher":"International Union Against Tuberculosis and Lung Disease","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["public health action"],"accepted":{"date-parts":[[2026,5,7]]},"published-print":{"date-parts":[[2026,8]]},"abstract":"\n SETTING<\/jats:title>\n Selected public health facility pharmacies, private pharmacies, and Jan Aushadhi Kendras (JAKs) outlets dispensing generic medicines in four districts of Tamil Nadu, India.<\/jats:p>\n <\/jats:sec>\n \n OBJECTIVE<\/jats:title>\n To compare essential medicine availability, affordability, and knowledge on generic medicines among clients across pharmacy types. Additionally, to explore barriers to the use of generic medicines.<\/jats:p>\n <\/jats:sec>\n \n DESIGN<\/jats:title>\n A concurrent mixed-methods study with a quantitative cross-sectional assessment of the availability of 50 essential medicines in 70 pharmacies and structured interview of 1,750 clients. Eight focus group discussions with clients and 24 in-depth interviews with health care providers to qualitatively explore barriers.<\/jats:p>\n <\/jats:sec>\n \n RESULTS<\/jats:title>\n \n The median number of essential medicines available in private pharmacies (43) was higher than that in public pharmacies (30) and JAKs (29) (\n P<\/jats:italic>\n < 0.001). The medicine purchase was unaffordable (expenditure >6USD) for 92% of clients in JAKs and 98% of private pharmacies. Knowledge of generic medicine was low among clients attending public (24%) and private (31%) pharmacies. Barriers to generic medicine use included unavailability of medicines, concerns about effectiveness, and suboptimal marketing.\n <\/jats:p>\n <\/jats:sec>\n \n CONCLUSION<\/jats:title>\n JAKs have to address the unavailability of medicines, high unaffordability, and barriers to utilisation by expanding their drug baskets, further reducing costs, and implementing strategies to build trust in generic medicines.<\/jats:p>\n <\/jats:sec>","DOI":"10.5588\/pha.26.0033","type":"journal-article","created":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T16:23:05Z","timestamp":1787674985000},"page":"195-201","source":"Crossref","is-referenced-by-count":0,"title":["Gaps in access and trust: essential medicine availability, affordability, and barriers to generic medicine use"],"prefix":"10.5588","volume":"16","author":[{"given":"R.","family":"Sathiyamoorthy","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P.R.","family":"Naik","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J.","family":"Cherian","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.H.","family":"Rao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"V.","family":"Dwarakanathan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"V.","family":"A","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P.","family":"Thekkur","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"3554","published-online":{"date-parts":[[2026,8,1]]},"reference":[{"key":"2026082509224521000_16.3.195.1","unstructured":"United Nations Department of Economic and Social Affairs . The Sustainable Development Goals Report 2025. New York, 2025."},{"key":"2026082509224521000_16.3.195.2","unstructured":"Tracking universal health coverage: 2023 global monitoring report. Geneva: World Health Organization and International Bank for Reconstruction and Development \/ The World Bank; 2023."},{"key":"2026082509224521000_16.3.195.3","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2017-018020"},{"key":"2026082509224521000_16.3.195.4","doi-asserted-by":"crossref","first-page":"1594542","DOI":"10.3389\/fpubh.2025.1594542","article-title":"Understanding out-of-pocket expenditure in India: a systematic review","volume":"13","author":"Kamath","year":"2025","journal-title":"Front Public Health"},{"key":"2026082509224521000_16.3.195.5","unstructured":"An Overview of Drug Pricing @ NPPA 25 Year Odyssey . New Delhi, India: National Pharmaceutical Pricing Authority, 2022."},{"key":"2026082509224521000_16.3.195.6","unstructured":"Pharmaceuticals & Medical Devices Bureau of India . About PMBJP. New Delhi: PMBI. https:\/\/janaushadhi.gov.in\/about-pmbjb."},{"issue":"1","key":"2026082509224521000_16.3.195.7","doi-asserted-by":"crossref","first-page":"5964","DOI":"10.1038\/s41598-020-62318-y","article-title":"Comparative effectiveness of branded vs. generic versions of antihypertensive, lipid-lowering and hypoglycemic substances: a population-wide cohort study","volume":"10","author":"Tian","year":"2020","journal-title":"Sci Rep"},{"issue":"5","key":"2026082509224521000_16.3.195.8","doi-asserted-by":"crossref","first-page":"1074","DOI":"10.18203\/2319-2003.ijbcp20191603","article-title":"Analysis of cost between branded medicines and generic medicines in a tertiary care hospital","volume":"8","author":"N","year":"2019","journal-title":"Int J Basic Clin Pharmacol"},{"key":"2026082509224521000_16.3.195.9","first-page":"1","article-title":"Patient knowledge, perceptions, and acceptance of generic medicines: a comprehensive review of the current literature","volume":"6","author":"Alrasheedy","year":"2014","journal-title":"Patient Intell"},{"issue":"12","key":"2026082509224521000_16.3.195.10","doi-asserted-by":"crossref","first-page":"3222","DOI":"10.4103\/jfmpc.jfmpc_905_23","article-title":"A comparative study on perception and use of generic drugs between public and private health practitioners","volume":"12","author":"Priyadarsini","year":"2023","journal-title":"J Fam Med Prim Care"},{"key":"2026082509224521000_16.3.195.11","unstructured":"Creswell JW , Clark VLP . Designing and conducting mixed methods research. UK: SAGE, 2011, pp. 489."},{"key":"2026082509224521000_16.3.195.12","unstructured":"Pharmaceuticals & Medical Devices Bureau of India . Pradhan Mantri Bhartiya Janaushadhi Kendras \u2013 Tamil Nadu list. In: Department of pharmaceuticals. New Delhi: Government of India. https:\/\/janaushadhi.gov.in\/."},{"key":"2026082509224521000_16.3.195.13","unstructured":"Measuring Medicine Prices . Availability, affordability and price components. 2nd ed. Switzerland: Health Action International and World Health Organization, 2008, pp. 310."},{"issue":"1","key":"2026082509224521000_16.3.195.14","doi-asserted-by":"crossref","first-page":"643","DOI":"10.1186\/s12913-022-08022-1","article-title":"Improving access to medicines by popularising generics: a study of \u201cIndia\u2019s People\u2019s Medicine\u201d scheme in two districts of Maharashtra","volume":"22","author":"Lavtepatil","year":"2022","journal-title":"BMC Health Serv Res"},{"key":"2026082509224521000_16.3.195.15","unstructured":"Government of Tamil Nadu \u2013 Labour Welfare and Skill Development Department . G.O. (2D) No. 21 \u2014 The Minimum Wages Act, 1948 (Central Act XI of 1948): revision of minimum rates of wages for employment in agriculture and ancillary works. Chennai, Tamil Nadu, India: Government of Tamil Nadu, Labour Welfare and Skill Development Department, 2025."},{"issue":"6","key":"2026082509224521000_16.3.195.16","doi-asserted-by":"crossref","first-page":"349","DOI":"10.1093\/intqhc\/mzm042","article-title":"Consolidated criteria for reporting qualitative research (COREQ): a 32-item checklist for interviews and focus groups","volume":"19","author":"Tong","year":"2007","journal-title":"Int J Qual Health Care J Int Soc Qual Health Care"},{"key":"2026082509224521000_16.3.195.17","unstructured":"United Nations General Assembly . Political declaration of the high-level meeting on universal health coverage: \u201cuniversal health coverage. Moving together to build a healthier world. New York: United Nations, 2019."},{"key":"2026082509224521000_16.3.195.18","unstructured":"World Health Organization. WHO guideline on country pharmaceutical pricing policies, second edition. Geneva: WHO, 2020."},{"issue":"9","key":"2026082509224521000_16.3.195.19","doi-asserted-by":"crossref","first-page":"3723","DOI":"10.4103\/jfmpc.jfmpc_368_25","article-title":"Access to essential medicines in aspirational districts of India; A multi-site cross sectional study","volume":"14","author":"Meher","year":"2025","journal-title":"J Fam Med Prim Care"},{"issue":"1","key":"2026082509224521000_16.3.195.20","doi-asserted-by":"crossref","first-page":"43","DOI":"10.1186\/s40360-015-0043-8","article-title":"Availability of medicines in public sector health facilities of two North Indian states","volume":"16","author":"Prinja","year":"2015","journal-title":"BMC Pharmacol Toxicol"},{"issue":"1","key":"2026082509224521000_16.3.195.21","doi-asserted-by":"crossref","first-page":"152","DOI":"10.4103\/jfmpc.jfmpc_78_17","article-title":"Access and availability of essential medicines in Chhattisgarh: situation in public health facilities","volume":"7","author":"Tripathi","year":"2018","journal-title":"J Fam Med Prim Care"},{"issue":"9","key":"2026082509224521000_16.3.195.22","doi-asserted-by":"crossref","first-page":"131","DOI":"10.7324\/JAPS.2015.50925","article-title":"Comparative availability of selected essential medicines for selected chronic diseases in Bhiwani District, Haryana, India","volume":"5","author":"Jangra","year":"2015","journal-title":"J Appl Pharm Sci"},{"issue":"12","key":"2026082509224521000_16.3.195.23","doi-asserted-by":"crossref","first-page":"1467","DOI":"10.1111\/tmi.13494","article-title":"Availability, price and affordability of essential medicines for managing cardiovascular diseases and diabetes: a statewide survey in Kerala, India","volume":"25","author":"Satheesh","year":"2020","journal-title":"Trop Med Int Health"},{"issue":"5","key":"2026082509224521000_16.3.195.24","first-page":"645","article-title":"Prices & availability of common medicines at six sites in India using a standard methodology","volume":"125","author":"Kotwani","year":"2007","journal-title":"Indian J Med Res"},{"key":"2026082509224521000_16.3.195.25","doi-asserted-by":"crossref","first-page":"1629835","DOI":"10.3389\/fpubh.2025.1629835","article-title":"Medicine affordability and access in India: lessons from generic\u2013branded price variation under the Jan Aushadhi Scheme","volume":"13","author":"Behera","year":"2025","journal-title":"Front Public Health"},{"key":"2026082509224521000_16.3.195.26","doi-asserted-by":"publisher","DOI":"10.1136\/bmjgh-2018-001379"},{"issue":"5","key":"2026082509224521000_16.3.195.27","doi-asserted-by":"crossref","first-page":"2182","DOI":"10.18203\/2394-6040.ijcmph20191841","article-title":"Knowledge, attitude and practices regarding generic medicines and its usage: a community-based study","volume":"6","author":"Ballala","year":"2019","journal-title":"Int J Community Med Public Health"},{"issue":"3","key":"2026082509224521000_16.3.195.28","doi-asserted-by":"crossref","first-page":"1390","DOI":"10.4103\/jfmpc.jfmpc_2157_20","article-title":"Opinion of primary care physicians regarding prescription of generic drugs: a cross-sectional study","volume":"10","author":"Charan","year":"2021","journal-title":"J Fam Med Prim Care"},{"key":"2026082509224521000_16.3.195.29","doi-asserted-by":"crossref","unstructured":"Patel K , Acceptability and perceptions of generic drugs among patients, pharmacists, and physicians. 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