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ext year, we will move into a new financing system for health care with the introduction of universal healthcare coverage for all Indonesians. The euphoria of universal coverage should be followed by concerns on rising healthcare expenditures.

In the United Kingdom, the United States and many European countries, universal coverage has increased healthcare expenditures because people tend to maximize the opportunity of being covered. Not surprisingly, drug expenditures have contributed to up to 60 percent of this increase, according to a report last year.

One way to control the rise in health expenditures is to boost the use of generic drugs, which has been proven to reduce overall healthcare expenditures by up to 50 percent, according to a 2010 World Health Organization (WHO) study. Although we have been living with generic drugs for almost 25 years, Indonesia's average rate of generic drug use was only 10 percent of its national drug consumption as of 2009.

Reports have said that universal coverage is expected to double the rate but it would still be lower than our fellow ASEAN countries such as the Philippines, Malaysia and Thailand, where generic use has reached at least 20 percent of their national drug consumption. Countries such as Australia, the UK and the US, reportedly have recorded more than 60 percent generic drug use.

The fundamental reason why generic drugs are not popular here is because many of us are skeptical about their quality. The drugs are poorly perceived by not only patients but also healthcare providers. In a recent test, four out of 10 people immediately rejected the generic drugs we offered them for medicinal use, while the others had to be repeatedly convinced to take them.

People disbelieve the safety and the effectiveness of generic drugs. They hear rumors that generics are not safe to use and take longer to relieve symptoms or diseases, so people prefer to use brand name drugs, which are much more expensive and unaffordable, especially for the poor.

Our government has delivered several programs to promote generic drugs, yet massive efforts are still needed to increase their use. A nationwide campaign that has been going on since 1989 has thus far been insufficient in educating people about generic drugs, while the mandatory generic prescribing program has also failed to convince prescribers to prescribe generic drugs. Furthermore, labeling drug packaging with generic names showed that only few were aware of the purpose, hence generic substitution for brand name drugs has not boosted generic drug penetration.

Thus, next year, the government plans to give a large space for generic drugs to exist under the insurance scheme. There should be no doubt regarding the quality of generic drugs since they are interchangeable and therapeutically equivalent to brand name and innovator drugs.

Patients and healthcare providers should neither be unreasonably worried to use generic drugs because the drugs contain similar active ingredients to brand name drugs and they have passed all requirements of high quality drugs.

The government is encouraged to employ generic drugs on the list of covered medicine for patients, particularly as the WHO clearly recommended generic drugs as one effective tool to improving a country's accessibility and affordability of essential medicine.

In a nutshell, generic drugs are extremely important to our country and to our people. We have to re-think the existence of generic drugs in the healthcare system and provide wider access for its use. Going by our own trial, we should get the 60 percent swing-users to be enthusiastic about taking generic drugs and convert the remaining 40 percent to generic drugs.

 The drugs' fate will remain the same if the new system does not allow the drugs to develop, and as a consequence, we will have to wait warily for the system to become robust to deal with increasing healthcare expenditures.

The writer is a pharmacist and researcher of generic drugs at the school of pharmacy at Airlangga University in Surabaya.