Parental preferences for generic substitution policies for children in China: a discrete choice experiment

To investigate Chinese parents' preferences regarding generic drug substitution policies for children, to provide references for optimising these policies, enhancing parental acceptance rates of generic drug substitution for children, and improving paediatric medication accessibility.

A discrete choice experiment was employed, and voluntary sampling was used to select parents with at least one child aged 0-12 years from three cities located in the eastern, central and western regions of China for a questionnaire survey. A mixed logit model was used to estimate preference coefficients for various policy attributes, the relative importance (RI) of these attributes and the acceptance rates of different policy scenarios.

A total of 411 participants were included. Except for the generic registration standards, the differences in all other included attributes of the paediatric generic drug substitution policy were statistically significant (p<0.01). Generic consistency evaluation (GCE) (RI=41.30%) and medication control (RI=31.29%) were the most important attributes influencing participants' choice preferences. The acceptance rate of the current paediatric generic drug policy among Chinese parents was only 55.42%. However, if the policy scenario included differentiated registration standards, all generic drugs passing GCE, a 10% increase in reimbursement rate, autonomous choice of generic drugs and full postsubstitution management for all generic drugs, the acceptance rate could reach 83.31%.

Chinese parents show a stronger preference for GCE and medicine use control within paediatric generic drug substitution policies. To enhance policy acceptance rates, it is recommended to continue implementing GCE and to respect parents' autonomy in selecting medications for their children.