scholarly journals Effects of an e-Prescribing interface redesign on rates of generic drug prescribing: exploiting default options

2016 ◽  
Vol 23 (5) ◽  
pp. 891-898 ◽  
Author(s):  
Sameer Malhotra ◽  
Adam D Cheriff ◽  
J Travis Gossey ◽  
Curtis L Cole ◽  
Rainu Kaushal ◽  
...  
Keyword(s):  
Generic Drug ◽  
User Behavior ◽  
Generic Drugs ◽  
Educational Interventions ◽  
Brand Name ◽  
Drug Prescribing ◽  
Ambulatory Care Setting ◽  
Therapeutic Class ◽  
Generic Medications ◽  
Default Options

Abstract Objective Increasing the use of generic medications could help control medical costs. However, educational interventions have limited impact on prescriber behavior, and e-prescribing alerts are associated with high override rates and alert fatigue. Our objective was to evaluate the effect of a less intrusive intervention, a redesign of an e-prescribing interface that provides default options intended to “nudge” prescribers towards prescribing generic drugs. Methods This retrospective cohort study in an academic ambulatory multispecialty practice assessed the effects of customizing an e-prescribing interface to substitute generic equivalents for brand-name medications during order entry and allow a one-click override to order the brand-name medication. Results Among drugs with generic equivalents, the proportion of generic drugs prescribed more than doubled after the interface redesign, rising abruptly from 39.7% to 95.9% (a 56.2% increase; 95% confidence interval, 56.0–56.4%; P  < .001). Before the redesign, generic drug prescribing rates varied by therapeutic class, with rates as low as 8.6% for genitourinary products and 15.7% for neuromuscular drugs. After the redesign, generic drug prescribing rates for all but four therapeutic classes were above 90%: endocrine drugs, neuromuscular drugs, nutritional products, and miscellaneous products. Discussion Changing the default option in an e-prescribing interface in an ambulatory care setting was followed by large and sustained increases in the proportion of generic drugs prescribed at the practice. Conclusions Default options in health information technology exert a powerful effect on user behavior, an effect that can be leveraged to optimize decision making.

The Ability of Anaesthetists to Identify Generic Medications from Trade Names

2009 ◽  
Vol 37 (4) ◽  
pp. 624-629 ◽  
Author(s):  
D. E. P. Bramley
Keyword(s):  
Generic Drug ◽  
Generic Drugs ◽  
Clinical Problem ◽  
Brand Names ◽  
Prescription Medications ◽  
Brand Name ◽  
Drug Substances ◽  
Generic Medications ◽  
Trade Names ◽  
Theoretical Test

The recent proliferation of brand names for prescription medications has made the clinician's task of identifying the corresponding generic drug substances more difficult. A survey of 86 anaesthetists and anaesthetic trainees at two Melbourne hospitals was conducted to measure the extent to which this was perceived to be a clinical problem. In addition, a theoretical test was administered to examine the ability of these anaesthetists to correctly identify generic drugs and therapeutic groups when only the brand name is provided. The results indicated this is perceived to be a genuine clinical problem, with more than 80% of respondents encountering unfamiliar trade names ‘often’ or ‘always’ and the test revealing that fewer than one third of commonly prescribed brand names were identified correctly.

scholarly journals Cost Minimisation Study of the Impact of Generic Drugs on Glaucoma Management: 1-year Indian Experience

1970 ◽  
Vol 12 (4) ◽  
pp. 192-196
Author(s):  
Devindra Sood ◽  
Alka Pandey ◽  
Rajeev Sood ◽  
Nagesh Gupta ◽  
Ravinder Kumar Bajaj ◽  
...  
Keyword(s):  
Generic Drugs ◽  
Open Angle Glaucoma ◽  
Eye Drops ◽  
Brand Name ◽  
Cost Difference ◽  
Medication Costs ◽  
Generic Medications ◽  
The Mean ◽  
The Cost ◽  
The Impact

Aim: To study the medication costs of various topical glaucoma medications using data collected from real world use by patients.Methods: Patients with primary open angle glaucoma treated at glaucoma clinics in 5 hospitals (1 rural and 4 urban) in northern India from 1 January to 30 June 2008 were enrolled. The number of days each bottle of medication lasted was recorded, and the mean cost per day was computed from the maximum retail price and mean number of days each medication lasted.Results: 790 of 801 eligible patients completed the study. The mean number of days that a bottle of medication lasted was found to be highest for Xalatan® and Xalacom® at 35.23 days and 35.00 days, respectively. The brand name prostaglandin analogues all lasted for a mean of more than 30 days: Xalatan, 35.23 days (SD, 4.14 days); Lumigan®, 31.37 days (SD, 5.31 days); and Travatan®, 34.84 days (SD, 6.51 days), while the generic eye drops lasted for about 21 days: latanoprost, 20.69 days (SD, 3.69 days) and bimatoprost, 21.39 days (SD, 4.34 days). The cost of the generic medication was less than the brand name medication in all groups (for example, bimatoprost, Indian rupees 9.76 versus Indian rupees 12.33) except for brimonidine/timolol (Indian rupees 8.73 versus Indian rupees 8.66). Further analysis in 2009 showed that, for latanoprost, brimonidine and brimonidine/timolol, the difference between the brand name and generic medications decreased in 2009 over 2008 (in the latanoprost group, the cost difference over the year reduced from Indian rupees 592 in 2008 to Indian rupees 523 in 2009); the cost difference for bimatoprost increased from 2008 to 2009.Conclusion: When both cost and number of days a bottle lasts were considered over the long term, use of generic medications might not minimise the cost of glaucoma medical management by much when compared with the brand name medication.

scholarly journals Generic drugs in Brazil: known by many, used by few

2005 ◽  
Vol 21 (6) ◽  
pp. 1808-1815 ◽  
Author(s):  
Andréa D. Bertoldi ◽  
Aluísio J. D. Barros ◽  
Pedro C. Hallal
Keyword(s):  
Drug Utilization ◽  
Generic Drug ◽  
Practical Knowledge ◽  
Generic Drugs ◽  
Population Based ◽  
Recall Period ◽  
Brand Name ◽  
Group A

This study evaluated knowledge and use of generic drugs in a population-based sample of adults from a southern Brazilian city. The outcomes were: the proportion of generics in total medicines used; theoretical and practical knowledge about generics; and strategies used to buy medicines on medical prescriptions. The recall period for drug utilization was 15 days. The proportion of generics in total medicines was 3.9%. While 86.0% knew that generics cost less and 70.0% that the quality is similar to brand name medicines, only 57.0% knew any packaging characteristics that distinguish generics from other medicines. The highest proportion of generic drug utilization was in the antimicrobial pharmacological group. A brand name medicine (with a brand similar to the generic name) was mistakenly classified as a generic through photos by 48.0% of the interviewees. Among subjects who bought medicines in the 15-day period, 18.9% reported buying a generic, but this result should be interpreted with caution, because the population frequently fails to differentiate between generics and other medicines.

Generic Substitution for Psychotropic Drugs

CNS Spectrums ◽  
2009 ◽  
Vol 14 (9) ◽  
pp. 1-7 ◽  
Author(s):  
Pierre Blier
Keyword(s):  
Generic Drug ◽  
Psychotropic Drugs ◽  
Generic Substitution ◽  
Generic Drugs ◽  
Drug Application ◽  
The United States ◽  
Third Party ◽  
Brand Name ◽  
Branded Drug ◽  
United States Food

Most antidepressants and other psychotropics in clinical use are available as generic formulations (Table). The availability of lower-priced, generic drugs can benefit patients and third-party payers, but it should not be assumed that all generic drugs are equally beneficial. There are numerous reports in the literature of unexpected and untoward consequences that occur when a generic drug is substituted for the original brand-name drug. A previously stable clinical response may suddenly deteriorate, or the patient may experience new or more severe adverse events (AEs). The United States Food and Drug Administration requires that manufacturers of generic drugs demonstrate that their formulation has pharmacokinetic properties similar (or bioequivalent) to the brand-name drug. Bioequivalency studies are conducted in healthy volunteers, not in patients who would be treated with that drug. Moreover, bioequivalency studies are conducted on a current lot of the branded drug and do not account for variability between lots of the generic formulation. The manufacturer is only required to submit bioequivalency data that support the Abbreviated New Drug Application (ANDA); the FDA does not require disclosure of failed bioequivalence studies. Unlike brand-name drugs, lengthy and costly clinical studies are not required to show that the generic drug is effective and safe.Although the FDA has taken the position that bioequivalence and therapeutic equivalence are equal, many questions related to the use of generic drugs remain unanswered. The following question-and-answer session is an excerpt of an interview with Pierre Blier, MD, PhD, conducted by Diane Sloan, PharmD, which addresses the issue of generic substitution of psychotropic drugs.

Recent Developments in Health Law

2012 ◽  
Vol 40 (1) ◽  
pp. 165-170
Author(s):  
Brenna Jenny
Keyword(s):  
Generic Drug ◽  
Generic Drugs ◽  
Tort Law ◽  
Drug Manufacturer ◽  
Recent Change ◽  
Brand Name ◽  
Drug Companies ◽  
Drug Regulations ◽  
Recent Developments ◽  
The Individual

When the Supreme Court in PLIVA v. Mensing determined that certain state tort law failure-to-warn claims against generic drug companies were pre-empted by federal drug regulations, the pronouncement was met with substantial criticism. In light of the Court's decision two years earlier in Wyeth v. Levine, where the Court allowed a similar claim against a brand-name drug manufacturer to proceed, many complained the resulting Levine-Mensing dichotomy created an arbitrary distinction between brand-name and generic drugs, allowing an injured patient's ability to recover to hinge solely on the happenstance of whether the individual had taken the brand-name or generic version. But, although Mensing cut back significantly on the ability of plaintiffs to make state law failure-to-warn claims against generic drug manufacturers, the case did not completely prohibit such claims. Instead, the Court banned only failure-to-warn claims premised on an argument that the generic drug company needed to change its label in order to meet state tort law duties. If plaintiffs can advance other theories independent of a formal label change, such as a failure to adequately warn a physician about a recent change to the drug's label, then they may still be able to proceed against generic drug manufacturers.

scholarly journals COMPARISON BETWEEN GENERIC DRUGS AND BRAND NAME DRUGS FROM BIOEQUIVALENCE AND THERMOEQUIVALENCE PROSPECTIVE

2017 ◽  
Vol 9 (6) ◽  
pp. 1 ◽  
Author(s):  
Mosab Arafat ◽  
Zahaa Ahmed ◽  
Osama Arafat
Keyword(s):  
Generic Drug ◽  
Active Ingredient ◽  
Generic Drugs ◽  
Pharmacokinetic Parameters ◽  
Drug Preparation ◽  
Brand Name ◽  
Drug Bioavailability ◽  
Polymer Carrier ◽  
Inactive Ingredients ◽  
Brand Name Drugs

The belief that generic drugs are inferior to brand name drugs has been always under debate. Especially since the price of generic drugs is generally far cheaper than brand-name drugs. Although, this is because of waiving the preclinical studies and clinical trials for the generic drug, the quality, and purity of materials used for generic drug preparation is still arguable. Thus, the objective of this overview was to find out the tolerable deviations between generic and brand name drugs which should not alter the pharmacology. Using inactive additives in the generic drug different than in the brand name drug, such as binders, glidants, diluents, anti-adherents, disintegrants or polymer carrier material and filler should not change the drug bioavailability and pharmacokinetic parameters as long as both products using the identical active ingredient(s) in equivalent amounts. Even if both drug products are bioequivalent to each other in terms of active ingredient, they are not in terms of inactive ingredients. Hence, the probability of unexpected adverse drug reaction and allergies from the generic formulation are possible, especially, when people react sensitive toward specific component. Therefore, the occasional negative response occurring upon the switch from brand-name drug to the generic drug can be attributed to intra-and inter-patient variations toward inactive ingredients. Variations toward inactive ingredients can be obtained experimentally by utilizing a proper thermoanalytical technique. As a result, thermoequivalence of generic drugs to brand name drugs can be determined based on thermal information obtained from both products. In conclusion, thermoequivalence study can be a useful tool to demonstrate any possible variation between the inactive ingredients of both products.

scholarly journals Continuing trends in U.S. brand-name and generic drug competition

2021 ◽  
pp. 1-1
Author(s):  
Henry Grabowski ◽  
Genia Long ◽  
Richard Mortimer ◽  
Mehmet Bilginsoy
Keyword(s):  
Generic Drug ◽  
Brand Name

scholarly journals A Review of Clinical Studies of Brand-name and Generic Drugs Used in Arrhythmia

2016 ◽  
Vol 25 (4) ◽  
pp. 417-429
Author(s):  
Kaoru Ito ◽  
Shunya Ikeda ◽  
Masaki Muto
Keyword(s):  
Clinical Studies ◽  
Generic Drugs ◽  
Brand Name

The generic drug market in Japan: will it finally take off?

2010 ◽  
Vol 6 (3) ◽  
pp. 369-389 ◽  
Author(s):  
Toshiaki Iizuka ◽  
Kensuke Kubo
Keyword(s):  
Health Care ◽  
Generic Drug ◽  
Generic Substitution ◽  
Drug Market ◽  
Government Policies ◽  
Brand Name ◽  
Market Exclusivity ◽  
Market Participants ◽  
The Government ◽  
Generic Usage

AbstractHistorically, brand-name pharmaceuticals have enjoyed long periods of market exclusivity in Japan, given the limited use of generics after patent expiration. To improve the efficiency of the health-care system, however, the government has recently implemented various policies aimed at increasing generic substitution. Although this has created expectations that the Japanese generic drug market may finally take off, to date, generic usage has increased only modestly. After reviewing the incentives of key market participants to choose generics, we argue that previous government policies did not provide proper incentives for pharmacies to boost generic substitution. We offer some recommendations that may help to increase generic usage.

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