Prescribing of Original Brand Name Drugs and Opinion of Physicians on Strategies to Reduce its Prescription

Abstract

This survey research was aimed at determining rate of prescribing of original brand name drugs, reasons for prescribing original brand name drugs, opinion of physicians on strategies to reduce such prescription and compare the opinion between physicians who had different characteristics. Subjects were physicians working in medical department of general and regional hospitals of the Ministry of Public Health in Thailand. Five rating-scale self-developed questionnaires were sent to heads of medical department of every hospital and asked them to distribute to other physicians in the department. Of 470 sets of questionnaire sent, 95 (20.21%) were returned. Data were collected during July-August 2010.

It was found that the top 3 reasons for prescribing the original brand name drugs were more confidence in treatment outcomes, patients’ ability to pay for the cost of the drugs, and narrow therapeutic index of the drugs. The first 3 strategies to reduce prescribing of the drugs that most of the physicians agreed with were the development of good quality generic drugs, the Ministry of Public Health should have database of quality control of both the original brand name drugs and generic drugs that could be used by physicians countrywide, and pharmacists should have accessible database regarding comparability between original brand name drugs and generic drugs.

The results also indicated that physicians working for the regional hospitals were more likely than physicians working for general hospitals to agree with the strategy to reduce prescribing of original brand name drugs regarding the availability of a nationwide guideline on prescribing original brand name drugs; especially on the drugs that had high prescription volume (p 0.02). In addition, physicians who had more than 10-year experiences were more likely than those with less than 10-year experiences to agree with these strategies; availability of a standard criteria that accepted by physicians regarding brand name drug prescribing conditions (p 0.03); limited numbers of medications per prescription (p 0.003); a system to inform physicians regarding cost of brand name drugs that they had prescribed (p 0.04). Physicians who had also worked part-time in another hospital or private clinic were more likely than physicians who did not work part-time in another hospital or private clinic to agree with the strategy that the Pharmaceutical and Therapeutic Committee should have a strict criteria in including a brand name drug in the hospital formulary (p 0.02).

In conclusion, the results of this study showed that most of physicians in medical department believed that original brand name drugs had better efficacy than generic drugs. They also believed that effective strategies to reduce brand name prescribing would be the development of generic drugs quality to be as good as brand name drugs and the accessible and reliable data on comparison of the two.