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

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.
Key words: prescribing, original brand name drugs, strategies to reduce prescribing