Generic Prescribing, Generic Substitution, and Therapeutic Substitution

PEDIATRICS ◽  
1987 ◽  
Vol 79 (5) ◽  
pp. 835-835
Author(s):  
Keyword(s):  
Health Care ◽  
Health Care Professionals ◽  
Generic Substitution ◽  
Drug Product ◽  
Therapeutic Substitution ◽  
General Acceptance ◽  
Conflicting Evidence ◽  
Therapeutic Category ◽  
Generic Prescribing ◽  
The Cost

Pressures generated by a constellation of professional consumer, legislative, and health care provider vider groups in this era of increasing health care costs have led to enactment of generic substitution laws in 50 states. The general acceptance of this concept, despite conflicting evidence that it has reduced the cost of prescription items to the consumer, has led to the concept of therapeutic substitution. Considerable confusion exists among health care professionals regarding the precise meaning of these concepts. Generic prescribing is the prescribing of a drug by a physician using the generic name. This leaves the choice of brand to the dispensing pharmacist. Generic substitution is a pharmacist-initiated act by which a different brand or an unbranded drug product is dispensed instead of a drug brand that was prescribed by the physician. This means substituting the same chemical entity in the same dosage form for one marketed by a different company. Therapeutic substitution is a pharmacist-initiated act by which a pharmaceutical or therapeutic alternate for the physician-prescribed drug is dispensed without consulting the physician. This denotes replacement of the prescribed drug with a chemically different drug within the same therapeutic category, eg, hydrochlorothiazide for furosemide; ranitidine for cimetidine; chloramphenicol for erythromycin. In 1976, the AAP Committee on Drugs published a commentary in Pediatrics (1976;57:275-277) on generic prescribing and concluded that "the lack of data on bioavailability and bioequivalence in children precludes blanket support of generic prescribing for infants and children." The Committee recently reviewed this issue and concluded that the situation has changed little during the past decade.

scholarly journals Prescribing patterns and perceptions of health care professionals about rational drug use in a specialist hospital clinic.

2014 ◽  
Vol 5 (2) ◽  
Author(s):  
Moses A. Ojo ◽  
Cecilia I. Igwilo ◽  
Thomas Emedoh
Keyword(s):  
Health Care ◽  
Drug Use ◽  
Health Care Professionals ◽  
Prescribing Patterns ◽  
Cross Sectional ◽  
Rational Drug Use ◽  
Prescription Practices ◽  
Rational Drug ◽  
Generic Prescribing ◽  
Psychiatric Facilities

Irrational drug use is associated with adverse consequences including drug resistance and avoidable adverse drug reactions. Studies of rational drug use in psychiatric facilities are scanty. This study evaluated prescription practices and perception of health care professionals regarding causes of irrational drug use. A retrospective study conducted at the outpatient clinic of Federal Neuro- psychiatric Hospital, Yaba, Lagos. Data on drug use indicators were analyzed. A cross-sectional assessment of perception of prescribers and dispensers regarding rational drug use was conducted. A total of 600 prescriptions were analyzed. Mean number of drugs per encounter was 3.5 and percentage generic prescribed was 58.5%. Poly-pharmacy (P=0.024, 95% CI=1.082-1.315) and non-generic prescribing (P=0.032, 95% CI=1.495-1.821) were significantly associated with young prescribers. Factors associated with irrational drug use include demand from patients, patients’ beliefs about injection drugs and influence of pharmaceutical sale representatives. Certain aspect of prescribers indicators are still poor in the hospital studied. Health care professionals identified possible associated factors for irrational drug use. Concerted efforts are required to ensure rational drug use especially in psychiatric facilities in Nigeria.

Provider-patient communication about cost of care: Results from a national patient education program.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. 9578-9578 ◽  
Author(s):  
Ivy A. Ahmed ◽  
Allison Harvey ◽  
Marni Amsellem ◽  
Thomas J. Smith
Keyword(s):  
Health Care ◽  
Health Care Professionals ◽  
Cancer Care ◽  
Health Care Team ◽  
Cost Of Care ◽  
Care Team ◽  
Cancer Support ◽  
Support Organizations ◽  
National Patient ◽  
The Cost

9578 Background: A 2010 NIH study indicates direct cancer care expenditures will reach $158 billion in the U.S. by 2020, impacting millions of Americans. The cost of insurance for a family of 4 has increased from $6000 (2000) to over $16,000 (2011). Medical debt is a significant cause of personal bankruptcy, even if insured. The financial realities posed by costs associated with cancer care greatly complicate a cancer diagnosis. The most recent American College of Physicians Ethics Manual recommends all parties must interact honestly, openly, and fairly. (Snyder L, et al. Ann Int Med 2012, p86) This analysis explores the occurrence and value of patient-provider communication surrounding costs associated with care in a national survey of those affected by cancer. Methods: From 2011-12, 505 individuals attending Frankly Speaking About Cancer: Coping with the Cost of Care workshops completed a survey assessing experiences about the costs of cancer care. This is a Cancer Support Community national evidence-based educational program. All attendees (n=708) were eligible to complete survey. Results: Most attendees (71.3%) responded. The majority (62.4%) were people with cancer/survivors; the remainder included spouses/partners, family members, and 8.7% were health care professionals. Most (80.8%) were Caucasian, and averaged 57.2 years. Of those with cancer, 89.9% were insured at diagnosis. 59.4% reported no one on their health care team initiated a discussion about the financial aspects of their care. Included in this figure, 22.7% actively sought information from health care team, and 36.7% received no information about cost. When topic was initiated, it was by social workers (16.2%), physicians (12.3%), nurses (6.3%) or financial specialists (8.2%). When information was provided, 72.1% found it somewhat or very useful. Also, regardless of provider discussion, respondents independently sought resources for managing costs, such as other patients (44.2%), the Internet (41.5%), and patient support organizations (38.1%). Conclusions: Patients want financial information but do not receive it. These data highlight the need and value of providers initiating a dialogue about the cost of cancer care with patients.

Neurosurgical practice and health care reform: moving toward quality-based health care delivery

2013 ◽  
Vol 34 (1) ◽  
pp. E1 ◽  
Author(s):  
Rachel F. Groman ◽  
Koryn Y. Rubin
Keyword(s):  
Health Care ◽  
Health Care Professionals ◽  
Care Delivery ◽  
Physician Patient Relationship ◽  
Patient Centered ◽  
Patient Protection ◽  
The Us ◽  
Us Government ◽  
Centered Care ◽  
The Cost

In an effort to rein in spending and improve patient outcomes, the US government and the private sector have adopted a number of policies over the last decade that hold health care professionals increasingly accountable for the cost and quality of the care they provide. A major driver of these efforts is the Patient Protection and Affordable Care Act of 2010 (ACA or Pub.L. 111–148), which aims to change the US health care system from one that rewards quantity to one that rewards better value through the use of performance measurement. However, for this strategy to succeed in raising the bar on quality and efficiency, it will require the development of more standardized and accurate methods of data collection and further streamlined federal regulations that encourage enhanced patient-centered care instead of creating additional burdens that interfere with the physician-patient relationship.

scholarly journals Outpatient utilization of non-steroidal anti-inflammatory drugs in three largest municipalities in South Backa district

2012 ◽  
Vol 140 (5-6) ◽  
pp. 339-343 ◽  
Author(s):  
Olga Horvat ◽  
Vesna Mijatovic ◽  
Jelena Calasan ◽  
Ana Sabo
Keyword(s):  
Health Care ◽  
Musculoskeletal System ◽  
Health Care Professionals ◽  
Inappropriate Drug ◽  
Number Of Patients ◽  
Inflammatory Drugs ◽  
Anti Inflammatory ◽  
Cost Of Drugs ◽  
Novi Sad ◽  
The Cost

Introduction. Nonsteroidal anti-inflammatory drugs (NSAIDs) are used in the treatment of musculoskeletal system diseases (MSD) and are associated with numerous adverse effects. Objective. To determine the amount and structure of outpatient consumption of NSAIDs and its correlation with musculoskeletal system diseases in three municipalities in South Backa district with different levels of health care. To examine whether the cost of drugs and the level of health care influence the choice of drugs. Methods. Data on the quarterly consumption of NSAIDs have been collected from all pharmacies in Novi Sad, Vrbas and Backa Palanka. Data are presented by the number of defined daily dosage (DDD) per1000 inhabitants. Cost (in RSD)/DDD was also calculated. The drug utilization 90% (DU90%) methodology was used. Data on the incidence of MSD from the three municipalities were obtained from the Institute of Public Health of Vojvodina and were presented as the number of patients/1000 inhabitants. Results. The highest total outpatient consumption of NSAIDs was recorded in Backa Palanka, a municipality with the highest prevalence of MSD. The lowest NSAIDs consumption and the lowest number of patients were observed in Vrbas. Diclofenac was NSAID with the highest consummation in all three municipalities, while ibuprofen, meloxicam and nimesulide were dispensed in much smaller amounts. The cheapest NSAIDs were found to be piroxicam and naproxen, diclofenac was the third in terms of price/DDD, while ibuprofen was the sixth. Conclusion. In order to improve prescription practice and the profile of drug usage in the population, it is important to educate health care professionals, and to inform general population about the risks of inappropriate drug use.

Comparison of Self and Health Professionals' Ratings of the Health of Community-Based Elderly

1987 ◽  
Vol 25 (1) ◽  
pp. 11-25 ◽  
Author(s):  
Cindy C. Wilson ◽  
F. Ellen Netting
Keyword(s):  
Health Care ◽  
Health Services ◽  
Health Professionals ◽  
Health Care Professionals ◽  
Program Planning ◽  
The Elderly ◽  
Elderly Persons ◽  
Care Needs ◽  
Community Based ◽  
The Cost

Perceptions of 269 community-based elderly persons and eighty health-care professionals were compared for opinions related to the health-care needs of the elderly, and major barriers faced by the elderly to the utilization of health services. The data indicate a high degree of incongruence between the perceptions of the elderly and those of the professionals. Health professionals were not good predictors of the health status of the elderly, and they did not accurately predict the barriers faced by the elderly seeking health care. Congruence of responses was found only related to the cost of health services. Reasons for these differences were explored, and recommendations for future program planning were made.

scholarly journals Generic prescribing in India: a stumbling block

2020 ◽  
Vol 8 (9) ◽  
pp. 3426
Author(s):  
Sukhpreet Kaur
Keyword(s):  
Health Care ◽  
Clinical Practice ◽  
Health Care Professionals ◽  
Healthcare Setting ◽  
Generic Medicine ◽  
Health Issues ◽  
Regulatory Standards ◽  
Medicine Prescription ◽  
Generic Prescribing ◽  
Set Up

In India, there is 62% out-of-pocket health expenditure per capita and only 15% are covered by health insurance. The use of generics can save a lot of money which can be used for other health issues. But lack of knowledge about cost effectiveness of generic medicines among various health-care professionals had led to a low rate of generic medicine prescription in India. This review aims to identify the barriers in adoption of generic prescribing in clinical practice in India. A systematic literature review was conducted using various healthcare databases such as PubMed and google scholar. The literature search using various combination of keywords retrieved 2360 articles. After excluding duplicates, articles in languages other than English and based on relevance to subject only 15 articles were selected. The barriers to generic prescribing identified from reported literature can be broadly classified based on stakeholders of healthcare setting such as physicians, patients, pharmacist and government policies. The major barriers to generic prescribing identified were negative perception of various stakeholders, lack of awareness of regulatory standards, maturity of health care system, vulnerability of patients, lack of standard guidelines in brand substitution, incentives and influence of drug advertisements. In Indian set up, studies on impact evaluation of generic prescription, emphasizing the quality and cost saving by their use in clinical practice should be conducted. This evidence will help to build the confidence of various stakeholders towards implementing generic prescribing in clinical practice.

Sign in / Sign up

Export Citation Format

Share Document