Physicians’ generic drug prescribing behavior in district hospitals: a case of Phitsanulok, Thailand / Comportamiento de los médicos en prescripción de genéricos en hospitales distritales: el caso de Phitsanulok, Tailandia

Generic prescribing is a sound approach to contain health care costs. However, little is known about physicians' prescribing patterns in the Thai context. Objective: To explore physicians' generic prescription patterns in district hospitals. Methods: Data was collected from three of the eight district hospitals between January and December 2008 (final response rate 37.5%). All participating hospitals were between 30 and 60-bed capacity. The researchers reviewed 10% of total outpatient prescriptions in each hospital. Results: A total of 14,500 prescriptions were evaluated. The majority of patients were under universal health coverage (4,367; 30.1%), followed by senior citizens' health insurance (2,734; 18.9%), and civil servant medical benefit schemes (2,419; 16.7%). Ten thousand six hundred and seventy-one prescriptions (73.6% of total prescriptions) had at least one medication. Among these, each prescription contained 2.85 (SD=1.69) items. The majority of prescriptions (7,886; 73.9%) were prescribed by generic name only. Drugs prescribed by brand names varied in their pharmacological actions. They represented both innovator and branded-generic items. Interestingly, a large number of them were fixed-dose combination drugs. All brand name prescriptions were off patented. In addition, none of the brand-name drugs prescribed were categorized as narrow therapeutic range or any other drug that had been reported to have had problems with generic substitution. Conclusion: The majority of prescriptions in this sample were written by generic names. There is room for improvement in brand name prescribing patterns (AU)

La prescripción genérica es algo que podría contener los costes sanitarios. Sin embargo, se sabe poco de los hábitos de prescripción genérica de los médicos tailandeses. Objetivo. Explorar los hábitos de prescripción genérica de los médicos en hospitales distritales. Métodos. Se recogieron datos de tres de los ocho hospitales de distrito entre enero y diciembre de 2008 (tasa final de respuesta 37,5%). Todos los hospitales participantes estaban entre 30 y 60 camas de capacidad. Los investigadores revisaron el 10% del total de las prescripciones ambulatorias de cada hospital. Resultados. Se evaluó un total de 14500 prescripciones. La mayoría de los pacientes estaban bajo la cobertura sanitaria universal (4367; 30,1%) seguidos del seguro de ciudadanos mayores (2734; 18,9%) y de los sistemas de funcionarios civiles (2419; 16,7%). 10671 prescripciones (73,6% del total de prescripciones) tenían al menos un medicamento. Entre estas, cada prescripción contenía 2,85 (DE=1,69) ítems. La mayoría de las prescripciones (7886; 73,9%) estaban escritas en nombre genérico solamente. Los medicamentos prescritos por marca comercial variaban en sus acciones farmacológicas. Estos representaban tanto ítems innovadores como genéricos con marca. Curiosamente, un gran número de ellos eran combinaciones a dosis fijas. Todas las prescripciones por marca eran medicamentos con patente caducada. Además, ninguna de las marcas prescritas estaba calificada de estrecho margen terapéutico u otros medicamentos que hayan comunicado problemas con la sustitución genérica. Conclusión. La mayoría de las prescripciones en esta muestra estaban escritas en nombres genéricos. Existe espacio para mejorar los patrones de prescripción por marcas (AU)

Physicians' generic drug prescribing behavior in district hospitals: a case of Phitsanulok, Thailand.

UNLABELLED: Generic prescribing is a sound approach to contain health care costs. However, little is known about physicians' prescribing patterns in the Thai context. OBJECTIVE: To explore physicians' generic prescription patterns in district hospitals. METHODS: Data was collected from three of the eight district hospitals between January and December 2008 (final response rate 37.5%). All participating hospitals were between 30 and 60-bed capacity. The researchers reviewed 10% of total outpatient prescriptions in each hospital. RESULTS: A total of 14,500 prescriptions were evaluated. The majority of patients were under universal health coverage (4,367; 30.1%), followed by senior citizens' health insurance (2,734; 18.9%), and civil servant medical benefit schemes (2,419; 16.7%). Ten thousand six hundred and seventy-one prescriptions (73.6% of total prescriptions) had at least one medication. Among these, each prescription contained 2.85 (SD=1.69) items. The majority of prescriptions (7,886; 73.9%) were prescribed by generic name only. Drugs prescribed by brand names varied in their pharmacological actions. They represented both innovator and branded-generic items. Interestingly, a large number of them were fixed-dose combination drugs. All brand name prescriptions were off patented. In addition, none of the brand-name drugs prescribed were categorized as narrow therapeutic range or any other drug that had been reported to have had problems with generic substitution. CONCLUSION: The majority of prescriptions in this sample were written by generic names. There is room for improvement in brand name prescribing patterns.