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ACP calls for doctors to prescribe generic drugs over name brand

In a recently published paper, the ACP has stated that generic medications, rather than more expensive name-brands, should be prescribed to patients whenever possible.

“While the use of generic drugs has increased over time, clinicians often prescribe more expensive brand name drugs when equally effective, well-proven, and less-expensive generic versions are available. The use of generic drugs is a High Value Care way to improve health, avoid harms and eliminate wasteful practices,” Wayne J. Riley, MD, MPH, MBA, MACP, ACP president, said in a press release.

Wayne J. Riley

Niteesh K. Choudhry, MD, PhD, associate professor, Harvard Medical School, and colleagues conducted a literature review to assess five questions surrounding generic medications, including:

• How frequently brand names are prescribed when generic medications are available;
• Do generic medications influence medication adherence;
• Do brand name and generic medications have similar clinical effects;
• What barriers are prohibiting greater use of generic medications; and,
• What strategies would influence use of generic medications?

Results demonstrated that generic medications were not less superior to molecularly identical brand-name medications. However, various studies found discrepancies among the prescription rates of generic drugs rather than brand names, with one study finding that between 23% and 45% of prescriptions were written for brand-name medications when identical generics were available.

The researchers estimated that among patients with diabetes, a $1.4 billion savings to Medicare would be possible with the use of generic medications and therapeutic interchange.

Review findings showed that out-of-pocket costs were lowered among patients who were prescribed generic medications, compared with patients who had been prescribed name brands. Additionally, patients who had been prescribed generic medications, particularly patients with chronic diseases, were more likely to follow their medication therapies, according to the researchers.

Concerns regarding the safety and efficacy of generic medications, compared with name brands, influenced physicians prescribing habits, according to Choudry and colleagues. Moreover, physicians were more likely to prescribe a medication if they had received a sample.

Patients were found to perceive generic medications as less effective due to their lower costs.

Chouldry and colleagues found an association between nonadherence and variation in medication appearance.

Electronic health records that display medication formulations and costs, tiered copayment systems, and more education for both physicians and patients, may increase the prescription and use of generic medications, according to the researchers.  

When prescribing medications, physicians should discuss the benefits and concerns patients may have regarding generic medications, such as the similar efficacy, appearance and dosage variations, and reduction in out-of-pocket costs, according to the researchers.

“The discrepancy between health care spending and achieved outcomes in the United States has fueled efforts to identify and address situations where unnecessarily expensive therapies are used when less costly, equally effective options are available. The underuse of generic medications is an important example,” Choudhry and colleagues wrote. – by Casey Hower

Disclosures: Choudhry reports receiving grants from CVS Caremark, Sanofi, AstraZeneca, Merck, PhRMA Foundation and the NIH. All other authors’ have reported no relevant financial disclosures.