Prescription Of Generic Drugs Research Articles

A study on prescription analysis and utilization of antibiotics in geriatric in-patients admitted in Shimoga institute of medical sciences tertiary care hospital, Shimoga, Karnataka, India

Background: Geriatrics is concerned with population aged 60 and above. Elderly suffer from various problems of the old age and hence prone to suffer from various adverse effects due to multiple drug use. In this regard rational use of drugs assumes importance. Hence the present study was conducted to study the rationality of prescriptions and utilization of antibiotics in the geriatric age group. Methods: 126 inpatient prescriptions were chosen and analysed for their rationality according to WHO core drug use indicators. The prescriptions were chosen randomly during the months of July to November 2013 from inpatients at district Mcgann teaching hospital. Descriptive statistics were used to analyse data. Results: 97% of total drugs prescribed were from essential drug list (EDL). Cephalosporins were the most commonly prescribed group of antibiotics. Respiratory diseases were the maximum cause of admission to the hospital followed by cardiovascular diseases. Prescription by brand name was 57.93% while generic drug prescription was 40.65% of total drugs prescribed. 7.81% of total drugs were prescribed as fixed drug combination average of 6.25 drugs were prescribed per person and 1.39% of prescriptions were illegible. Conclusions: Most of drugs prescribed were from WHO model list of essential drugs which conforms to WHO rational drug use. Also prescription by generic name has to be emphasized to promote rationality of prescriptions. Antibiotic prescriptions should be preceded by microbiological testing wherever indicated and illegible prescriptions should be prevented at all costs. Adherence to guidelines regarding drug use in the elderly can help in rational drug use in elderly.

Drug utilisation in medical intensive care unit: a retrospective analysis from a tertiary care teaching hospital

Background: The World Health Organisation has defined drug utilization study as “the marketing, distribution, prescription and use of drugs in a society, with special emphasis on the resulting medical, social, and economic consequences. The objective was to evaluate drug utilization pattern in medical intensive care unit (MICU) in a tertiary care teaching hospital. Methods: A retrospective observational study was conducted in MICU for adult patients admitted from October to December 2013. Data collected was analysed for demographics, indication, duration of stay, World Health Organisation (WHO) prescribing indicators including anatomical therapeutic chemical classification and defined daily dose (DDD). Results: A six hundred encounters from 63 male and 44 female patients with a mean age of 60.88±16.87 were studied. Average duration of stay was 5.61±3.88 days. The common indications for admission were dyspnoea 20 (18.69%), upper gastrointestinal bleed 16 (14.95%), cerebrovascular accident 14 (13.08%) and sepsis 13 (12.15%). Total number of drugs prescribed was 246. Total drug encounters were 7695. Average number of drugs per encounter was 12.83. Percentage of drugs prescribed by generic name was 38.21%, 44.7% and 40.65% of the drugs were prescribed from National and WHO essential medicine list respectively. Among the drugs prescribed 65.44%, 32.93% and 17.48% were oral, injectable and fixed dose combination preparations respectively. Percentage of encounters resulting in prescription of an antibiotic and an injection were 59% and 85.83% respectively. The most commonly prescribed drugs were pantoprazole (100%), human regular insulin (52.83%), piperacillin + tazobactam (45%) and ceftriaxone (38%). Their DDD/100 bed days were found to be 83.79, 12.78, 12.50, and 17.81 respectively. Conclusions: Overall the prescribing pattern seems to be rational but may be further strengthened by increasing generic drug prescription, judicious use of pantoprazole and periodic longitudinal surveillance studies.

Risk of Confusion in the Prescription and Administration of Generic Drugs

Background In Austria physicians are legally obligated to use trade names instead of active components when prescribing drugs. The increasing number of generics and short term changes in the availability of generics due to reduced inventories of manufacturers and dealers force physicians to frequent changes in their prescriptions. Frequent changes are associated with an increased risk of confusion in prescription and administration of generics. For secure prescription and administration of generics it is necessary that physicians have access to valid information about equivalence and daily disposability of generics.

Paying physicians to prescribe generic drugs and follow-on biologics in the United States.

Aaron Kesselheim and colleagues examine potential strategies to promote greater prescribing of generic drugs and follow-on biologics.

Need for Multicriteria Evaluation of Generic Drug Policies

Policymakers tend to focus on improving patented drug policies because they are under pressure from patients, physicians, and manufacturers to increase access to novel therapies. The success of pharmaceutical innovation over the last few decades has led to the availability of many off-patent drugs to treat disease areas with the greatest public health need. Therefore, the success of public health programs in improving the health status of the total population is highly dependent on the efficiency of generic drug policies. The objective of this article was to explore factors influencing the true efficiency of generic prescription drug policies in supporting public health initiatives in the developed world. Health care decision makers often assess the efficiency of generic drug policies by the level of price erosion and market share of generics. Drug quality, bioequivalence, in some cases drug formulations, supply reliability, medical adherence and persistence, health outcomes, and nondrug costs, however, are also attributes of success for generic drug policies. Further methodological research is needed to measure and improve the efficiency of generic drug policies. This also requires extension of the evidence base of the impact of generic drugs, partly based on real-world evidence. Multicriteria decision analysis may assist policymakers and researchers to evaluate the true value of generic drugs.

Perception and attitude of physicians toward local generic medicines in Saudi Arabia: A questionnaire-based study

Objectives: The current study aimed to explore the knowledge, perception, and attitude of physicians toward generic medicines in Saudi Arabia.Background: The local market of generic medicine share in Saudi Arabia is low compared to global and regional statistics. The reason for this low market share and the role of physicians has not previously been investigated. The purpose of this study was to assess health practitioner level of perceived knowledge, opinions and attitudes about local generic medication, and identify factors that influence infrequency of generic prescriptions.Methods: A random sample of 231 physicians was recruited from two hospitals in Riyadh (one government one private) and 178 (77%) responded. Information on the physicians’ perceived knowledge, opinions and attitude toward local generic medication was extracted, analyzed and interpreted. Factors that influence infrequent prescription of local generic drugs were identified.Results: Among the 178 participants in the physicians’ survey, 76% and 47% reported that they are knowledgeable about the terms “generic” and “bioequivalence” respectively, while 44% reported that they are able to explain bioequivalence to their patients. Approximately 52% of physicians reported that local generics should be substituted for brands if suitable for the case, and 21.9% reported that they believe SFDA approved local generics are therapeutically equivalent to their brands. Clinical effectiveness was reported by 71.9% of physicians as the most influential factor effecting prescription of brand over local generic medication. The three independent significant predictors for infrequent prescription of local generics among physicians: Government sector employment (OR=3.74, [95%CI 1.50–9.43]), consultant level (OR=3.94, [95%CI 1.50–10.31]) and low level of knowledge about local generics (OR=4.11, [95%CI 1.56–10.84]).Conclusion: The low market share of local generics medicines attributed to low prescription rates is significantly more among senior-level physicians working in governmental hospitals. Low level of knowledge about generic drugs among physicians was the strongest predictive factor for low prescription. Future bigger studies are needed to confirm these results.

Antidepressant drugs: evaluation of price variation

Background: Drugs are available in many different brands and costs of all brands are different. Patients of depression have to take the antidepressant drug for a long duration. If the cost of a drug is high patient has to pay more money for complete treatment. It can result in noncompliance and treatment failure. This study was aimed to evaluate the cost of antidepressant drugs of different classes and to analyze price variation in various antidepressant drugs available in India. Hence, we decided to do the study of price variations of antidepressant drugs. Methods: We had evaluated the cost of a different class of antidepressant drugs. Current Index of Medical Specialties October-December 2014 and Indian Drug Review 2015 issue 1 drug manuals were used to derive the cost of antidepressant drugs. Data about the cost of antidepressant drugs were collected for all the strength and dosage forms. The maximum price and minimum price for the different antidepressant drugs were identified, and calculation for the percentage of price variation was done. Results: Maximum percentage of price variation in different groups were 900% in reboxetine 2 mg (tricyclic antidepressants group), 495.23% in escitalopram 10 mg (selective serotonin reuptake inhibitors group), 318.66% in duloxetine 20 mg capsules (serotonin and noradrenaline reuptake inhibitors group), 243.58% in moclobemide 150 mg tablet (reversible monoamine oxidase-A inhibitor), 84.93% in bupropion 150 mg sustained-release tablet (atypical antidepressants group). In combination escitalopram 10 mg + clonazepam 0.5 mg shows maximum price variation of 1101.92%. Conclusion: Price variation was wide for antidepressant drugs. Generic drug prescribing can decrease the expenditure of patient on the drug. Prescribers should be provided updated knowledge of the cost of different drugs. Modifications in pharmaceutical policy are required, and prices of the drug should be controlled in effective way for all the drugs.

The Impact of Modifications of the Formula for Generic Drug Prescription Rate on the Switch To New Brand-Name Drugs With Similar Therapeutic Uses.

The Impact of Modifications of the Formula for Generic Drug Prescription Rate on the Switch To New Brand-Name Drugs With Similar Therapeutic Uses.

Standards of prescription writing in a long-term psychogeriatric unit: a series of clinical audits.

The aim of this study was to improve the quality of prescription writing in a long-term psychogeriatric inpatient unit by a combination of serial audits and interventions designed to address the identified deficiencies. We undertook three clinical audits of the prescription sheets used in an inpatient unit providing continuing care for residents with severe and enduring mental illness and dementia. Based on the findings of the first audit a set of prescribing guidelines was implemented into the ward. Following the second audit a new prescription sheet was developed. The format of the new prescription sheet was designed to account for the needs of the unit and to adhere to Irish and UK best practise guidelines. Two months after its introduction we undertook a third audit. Completion of the drug sensitivity box increased from 25% at audit one to 100% at audit three. Other specific aspects of prescription writing that had been poor at the beginning of the audit cycle also showed improvement: prescribing of generic psychotropic drugs increased by 69% and inclusion of the prescribers Medical Council Registration Number increased by 78%. However, some basic aspects of prescription writing remained weak such as frequency of drug administration and documentation of the stop/review date for 'as required' medication. The results of this study suggest that clinical audit and feedback can improve the quality of prescriptions in an in-patient setting.

Concerns and perceptions of Albanian doctors and pharmacists towards generic drug prescribing and use

Background There has been a continuous annual increase of about 20% on average, in total expenditure on prescription drugs in Albania over the last years. The use of generic drugs in substitution of branded products can offer significant reduction in drug expenditure. Concerns and perceptions of healthcare providers towards generic drug use should be properly addressed by health authorities in their policy-making decisions. This study aims to explore …

231 Lack of Price Transparency: Extreme Variations in Costs for Brand Name and Generic Prescription Drugs as a Barrier for Uninsured Patients

231 Lack of Price Transparency: Extreme Variations in Costs for Brand Name and Generic Prescription Drugs as a Barrier for Uninsured Patients

Knowledge, perceptions and use of generic drugs: a cross sectional study.

Objective To assess the level of knowledge, perceptions and usage profile for generic drugs among laypersons.Methods A cross-sectional study was conducted with 278 volunteers (180 women and 98 men, aged 37.1±15.8 years). A questionnaire was drawn up with questions on their use, perceptions and knowledge of generic drugs.Results Most respondents (99.6%) knew that generic drugs exist, but only 48.6% were able to define them correctly, while 78.8% of the respondents had some information about generics. This information was obtained mainly through television (49.3%). In terms of generic drug characteristics, 79.1% stated that they were confident about their efficacy, 74.8% believed that generic drugs have the same effect as branded medications, 88.8% said that generics were priced lower than branded medications, and 80.2% stated that they bought generic drugs because of price. With regard to drugs prescribed by medical practitioners, 17.6% of the participants said that their doctors never prescribed generics and only 7.5% confirmed that their doctors always prescribed generics.Conclusion For the lay public, the sample in this study has sufficient knowledge of generic drugs in terms of definition, efficacy and cost. Consequently, the volunteers interviewed are very likely to use generics. Furthermore, the results of this study indicate that programs should be implemented in order to boost generic drug prescriptions by medical practitioners.

Drug utilization study in orthopaedic units: Antibiotics prescribed in hospital out-patients in Dhaka, Bangladesh

Antibiotics are generally prescribed for both as prophylactically (before orthopaedics surgery etc.) or to treat ongoing infection (like septic arthritis, osteomyelitis etc.) in the orthopaedics department. But if antibiotics are not use rationally then there will be increase chances of resistance of bacteria as also as deteriorate the patients’ disease condition which ultimately increase the total cost of treatment. The goal of this study was to see the antibiotics utilization pattern. A prospective cross-sectional, multicentre drug utilization study was conducted for a period of 3 months to evaluate the pattern of antibiotics use in orthopaedic unit of various hospitals of Dhaka City, Bangladesh. A total of 498 prescriptions were studied; in which 160 prescriptions contained mono-antibiotic therapy (51.79%) and 147 prescriptions contained poly-antibiotics therapy (48.21%) and the beta-lactam antibiotics were most commonly prescribed (81.68%). Mono-antibiotics prescriptions were the common pattern than combination and brand name has been prescribed frequently than generic. To minimize cost, it is advisable to promote prescription of generic drugs. Also justifying efforts are needed to improve appropriateness of antimicrobial therapy and minimize the development of antimicrobial resistance. Hence the results of the study showed that there is a considerable scope for improvement in the prescription pattern.DOI: http://dx.doi.org/10.3329/icpj.v3i9.19896 International Current Pharmaceutical Journal, August 2014, 3(9): 318-321

Burden of changes in pill appearance for patients receiving generic cardiovascular medications after myocardial infarction: cohort and nested case-control studies.

Generic prescription drugs made by different manufacturers may vary in color or shape, and switching among these drug products may interrupt medication use. To determine whether nonpersistent use of generic drugs among patients with cardiovascular disease after myocardial infarction (MI) is associated with inconsistent appearance of their medications. Cohort and nested case-control studies. Claims from a commercial health insurance database in the United States. Patients discharged after hospitalization for MI between 2006 and 2011 who initiated treatment with a generic β-blocker, angiotensin-converting enzyme inhibitor, angiotensin II-receptor blocker, or statin. Case patients discontinued their index medication for at least 1 month; control patients continued treatment. Control patients were matched to case patients on therapeutic class, number of dispensings before nonpersistence, sex, and age. Rates of changes in pill color and shape during the year after MI were calculated. Next, 2 refills preceding nonpersistence were evaluated to determine whether pill color or shape had changed. Odds of discordance among case and control patients were compared using conditional logistic regression. A total of 29% of patients (3286 of 11,513) had a change in pill shape or color during the study. Statins had the most changes in appearance, whereas β-blockers had the fewest. A total of 4573 episodes of nonpersistence was matched to 19,881 control episodes. The odds of nonpersistence in case patients increased by 34% after a change in pill color (adjusted odds ratio, 1.34 [95% CI, 1.12 to 1.59]) and 66% after a change in pill shape (adjusted odds ratio, 1.66 [CI, 1.43 to 1.94]). Only 3 categories of drugs indicated after MI were evaluated, and clinical outcomes were not addressed. Variation in the appearance of generic pills is associated with nonpersistent use of these essential drugs after MI among patients with cardiovascular disease. Agency for Healthcare Research and Quality and the Harvard Program in Therapeutic Science.

Reducing the burden of medication costs to improve medication adherence

The high cost of medications is one reason that patients do not adhere to treatment plans. Providers can take actions to relieve the economic burden such as prescribing generic medications and offering patients information on various resources, including discount generic drug lists, discount cards, mail-order pharmacies, and prescription assistance programs.

Trends of prescribing and utilisation of antibiotics in the paediatric out-patient population of a secondary care hospital in Gurgaon, India

ABSTRACT Background Antibiotics misuse is a global problem. To study the knowledge and practice regarding antibiotic use in care-givers of children and antibiotic prescription pattern in paediatrics out-patient department of a secondary care hospital at Gurgaon, Haryana, India. Methods The present study was undertaken to screen rational use of antibiotics among paediatric outpatient population in Gurgaon. As per WHO guidelines, 100 prescriptions were collected from paediatrics out-patient department and prescriptions containing antibiotics were analysed. One hundred caregivers were interviewed using a structured questionnaire to determine the knowledge of antibiotics. Results 45% of patients were prescribed antibiotics and out of the total antibiotics prescribed, 87% were generic drugs, 93% were from the WHO Essential Drugs List and 71% were as per National Formulary of India guidelines. 36% caregivers had knowledge of antibiotics and 14% knew that antibiotics are used for bacterial infections. Very few of the caregivers believed that antibiotics have side-effects (33%), 8% were aware of antibiotic resistance. Knowledge of antibiotics was significantly associated with high education and socioeconomic status ( p Conclusions Though the prescription of generic drugs and drugs from WHO Essential Drugs List is satisfactory, the low rate of rational prescriptions and poor knowledge of antibiotics among the caregivers and poor compliance to the given course of treatment is a matter of concern. Copyright © 2014, Indian Journal of Medical Specialities. Published by Reed Elsevier India Pvt. Ltd. All rights reserved.

Adesão dos utentes aos medicamentos genéricos

ObjectivesThis transversal study aims to characterize adherence to generic drugs for users and identify factors that influence such adherence. MethodologyThis study was conducted from October 2011 to June 2012. The sample consisted of 375 individuals, aged over 18 years. A questionnaire was used as an instrument of data collection that included socio‐demographic and adherence to generic drugs variables, to which individuals responded voluntarily. ResultsFrom 375 respondents, only 1.3% (n=5) never heard of generic drugs. It is seen that the means that have reported the existence of generic drugs, the doctor and the pharmacy are the ones that stand out the most, with 69.7% (n=258) and 66.2% (n=245) respectively. From the 292 (78.9%) individuals who already bought generic drugs, 64.6% (n=188) acquired such drugs using medical. From the 78 (21.1%) individuals who had never bought generic drugs, 39.7% (n=31) reported that the reason was the absence of generic drugs prescription by the doctor and 24.4% (n=19) reported having no confidence in generic drugs. ConclusionThe characterization of adhesion to generic drugs contributes not only to the knowledge of the evolution of the consumption of these drugs, but also to analyze the impact of the measures that have been taken in Portugal, to encourage and promote the consumption of MG have on the population.

Perceptions of physicians from private medical centers in Malaysia about generic medicine usage: a qualitative study

Introduction: The healthcare sector is one of the most rapidly expanding and dynamic industries in the world. Pharmaceutical expenditure is now growing faster than other components of healthcare overheads. Globally, pressures to manage pharmaceutical spending have led to increased prescribing of generic drugs. Use of

Can authorities appreciably enhance the prescribing of oral generic risperidone to conserve resources? Findings from across Europe and their implications.

BackgroundGeneric atypical antipsychotic drugs offer health authorities opportunities for considerable savings. However, schizophrenia and bipolar disorders are complex diseases that require tailored treatments. Consequently, generally there have been limited demand-side measures by health authorities to encourage the preferential prescribing of generics. This is unlike the situation with hypertension, hypercholaesterolaemia or acid-related stomach disorders.The objectives of this study were to compare the effect of the limited demand-side measures in Western European countries and regions on the subsequent prescribing of risperidone following generics; to utilise the findings to provide future guidance to health authorities; and where possible, to investigate the utilisation of generic versus originator risperidone and the prices for generic risperidone.MethodsPrincipally, this was a segmented regression analysis of retrospective time-series data of the effect of the various initiatives in Belgium, Ireland, Scotland and Sweden following the introduction of generic risperidone. The study included patients prescribed at least one atypical antipsychotic drug up to 20 months before and up to 20 months after generic risperidone. In addition, retrospective observational studies were carried out in Austria and Spain (Catalonia) from 2005 to 2011 as well as one English primary care organisation (Bury Primary Care Trust (PCT)).ResultsThere was a consistent steady reduction in risperidone as a percentage of total selected atypical antipsychotic utilisation following generics. A similar pattern was seen in Austria and Spain, with stable utilisation in one English PCT. However, there was considerable variation in the utilisation of generic risperidone, ranging from 98% of total risperidone in Scotland to only 14% in Ireland. Similarly, the price of generic risperidone varied considerably. In Scotland, generic risperidone was only 16% of pre-patent loss prices versus 72% in Ireland.ConclusionConsistent findings of no increased prescribing of risperidone post generics with limited specific demand-side measures suggests no ‘spillover’ effect from one class to another encouraging the preferential prescribing of generic atypical antipsychotic drugs. This is exacerbated by the complexity of the disease area and differences in the side-effects between treatments. There appeared to be no clinical issues with generic risperidone, and prices inversely reflected measures to enhance their utilisation.

Behaviour change interventions to promote prescribing of generic drugs: a rapid evidence synthesis and systematic review

ObjectiveTo summarise evidence on the effectiveness of behaviour change interventions to encourage prescribing of generic forms of prescription drugs where clinically appropriate in the UK National Health Service (NHS) and...