Influence these two factors and the use of generics will increase

Generics and biosimilars Initiative

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Influence these two factors and the use of generics will increase

Genéricos/Investigación | Posted 05/08/2011 0 Post your comment

According to Assistant Professor William Shrank of Harvard Medical School, Boston, USA, we may be able to increase the use of generic alternatives over brand-name medications if we influence the following two factors: communication about generics between patients and their physicians or pharmacists and the patients’ comfort with generic substitution.

The team of Shrank et al. performed a study to evaluate any relationships that may exist between the beliefs held by the patient and any communication they may have been exposed to concerning generic drugs and their use [1].

In a random sample of 2,500 commercially-insured adults, patient responses were correlated to pharmacy claims data. With just less than 50% response rate from their mailed survey and adjusting for all factors involved, they found that generic drug use was only associated with the patients’ comfort with substituting their prescription with generic medication (P = 0.021) and communication with providers about generic drugs (P = 0.012).

Influencing prescribing behaviour

There have been many approaches by participants in the healthcare system to influence prescribing behaviour with the aim to increase the use of the most cost-effective treatments. These have included targeting the physician, the pharmacist and the patient. The variation in generic prescription drug use has also been studied in detail, including variables associated with the physician, the pharmacy, cost-sharing requirements, the patients’ socio-demographics and any administrative barriers to the brand-name medications [1].

However, what has not been previously investigated is the possible relationship between the patients’ own reported perceptions of using generic medications and what they actually purchase when collecting their prescription from the pharmacy. Furthermore, little is known about the potential influence that any communication with providers may have.

The team of Professor Shrank analysed the returned surveys from 971 patients (~ 33% male with a mean age of 52 years). After they controlled for the age of the patients, their self-reported health status, education, income, ethnicity, pharmacy benefit design and benefit generosity they found that a significant correlation existed between the patients’ generic drug use and five factors that represent preferences for generic drugs (P = 0.049), perceptions about generic safety and efficacy (P = 0.006), perceptions about generic costs and value (P = 0.044), the patients’ comfort with generic substitution (P = 0.001) and communication with providers about generics (P = 0.001).

Fitting the above scales into a single, fully adjusted model revealed that only two scales were significantly associated with generic drug use: the patients’ comfort with substituting their prescription for brand-name medications to generic versions and the communication between the patient and physician or pharmacist about generic drugs. All other perceptions or beliefs about generics were not significant in this fully adjusted model.

Conclusion

This first study into linking the beliefs of patients with their actual medication use has highlighted the opportunity to increase the use of cost-effective treatments through generic substitution, by appropriate educational campaigns that focus on enhancing both the frequency that patients talk to their physicians and pharmacists about generic medications and the comfort level with which these conversations can take place.

Editor’s comment

Are these two factors the same in your country or field of medicine? Are there any more factors you think should be considered more important?

Please feel free to share your thoughts via email to editorial@gabionline.net or in the comments section below.

Related article

Factors that influence generic drug use

Reference

1. Shrank WH, Cadarette SM, Cox E, Fischer MA, Mehta J, Brookhart AM, Avorn J, Choudhry NK. Is there a relationship between patient beliefs or communication about generic drugs and medication utilization? Med Care. 2009 Mar;47(3):319-25.