Please cite this article in press as: Zerbini C, et al. Leveraging consumer’s behaviour to promote generic drugs in Italy. Health Policy (2017), http://dx.doi.org/10.1016/j.healthpol.2017.01.008 ARTICLE IN PRESS G Model HEAP-3685; No. of Pages 10 Health Policy xxx (2017) xxx–xxx Contents lists available at ScienceDirect Health Policy journa l h om epa ge: www.elsevier.com/locate/healthpol Leveraging consumer’s behaviour to promote generic drugs in Italy Cristina Zerbini, Beatrice Luceri * , Donata Tania Vergura Department of Economics and Management, University of Parma, Parma, Italy a r t i c l e i n f o Article history: Received 17 February 2016 Received in revised form 1 December 2016 Accepted 24 January 2017 Keywords: Generic drugs Purchase intention Theory of Planned Behaviour Perceived risk Brand sensitivity Trust Self-identity Structural equation modelling a b s t r a c t Objective: The aim of this study was to fill the lack of knowledge regarding a more grounded exploration of the consumer’s decision-making process in the context of generic drugs. In this perspective, a model, within the theoretical framework of the Theory of Planned Behaviour (TPB), for studying the consumers’ purchase intention of generic drugs was developed. Methods: An online survey on 2,222 Italian people who bought drugs in the past was conducted. The proposed model was tested through structural equation modelling (SEM). Results: Almost all the constructs considered in the model, except the perceived behavioural control, contribute to explain the consumer’s purchase intention of generic drugs, after con- trolling for demographic variables (age, income, education). Specifically, attitude, subjective norm, past behaviour, self-identity and trust in the pharmacist have a positive influence on the intention to buy generic drugs. On the contrary, perceived risk towards products and brand sensitivity act negatively. Conclusions: The results of the present study could be useful to public policy makers in developing effective policies and educational campaigns aimed at promoting generic drugs. Specifically, marketing efforts should be directed to inform consumers about the generic drugs’ characteristics to mitigate the perceived risk towards these products and to raise awareness during their decision-making process. © 2017 Elsevier B.V. All rights reserved. 1. Introduction Health expenditure measures the value of goods and services necessary for people’s health prevention and care. Among the components that make it up, pharmaceutical spending stands out in importance: on average, it accounts for almost 20% of the health expenditure across EU coun- tries, while prescription volume increased more than 100% in several key therapeutic areas from 2005 to 2015 [1]. Therefore, reducing pharmaceutical costs has become a * Corresponding author. E-mail addresses: beatrice.luceri@unipr.it, beatri.luceri@gmail.com (B. Luceri). high-priority target for European governments, in order to provide a sustainable healthcare system. Functional to the achievement of this objective have been the respon- sible use of drugs and the increase of the market share of generic drugs. These are unbranded medicines bioequiva- lent to the originator brands – that is, characterized by the same amount of active ingredients and the same bioavail- ability – but sold at a lower price. Policies aimed at promoting generic drugs are urgently required in countries where the public debt exceeds the GDP, like Italy. Despite the controls introduced by legislation on physicians (mandatory prescription of the international non-proprietary name) and pharma- cists (mandatory generic substitution), together with the http://dx.doi.org/10.1016/j.healthpol.2017.01.008 0168-8510/© 2017 Elsevier B.V. All rights reserved.