Generic drug use is an important tool for controlling rising prescription drug costs in the U.S. However, use of more costly brand-name drugs persists even when equivalent generic drugs are available. Several factors contribute to brand-name drug use instead of a generic substitute. Some states require a patient’s consent prior to generic substitution by a pharmacist under certain conditions.
Johnson, K., Kiptanui, Z, Qian, J., & Hansen, R. (2019). Addressing generic drug information needs among patients and families, prescribers, pharmacists, formulary managers, and policymakers. Poster Presentation at AcademyHealth's National Health Policy Conference, Washington, DC.
Generic drug use is an important tool for controlling rising prescription drug costs in the U.S. However, use of more costly brand-name drugs persists even when equivalent generic drugs are available. Several factors contribute to brand-name drug use instead of a generic substitute. Some states require a patient’s consent prior to generic substitution by a pharmacist under certain conditions. In addition, physicians can mark prescriptions for brand-name drugs “dispense as written.” Patients’ and prescribers’ concerns about generic drug substitution may thus limit the potential for greater cost savings.
Maximizing generic drug use requires understanding information needs about generic drugs by key stakeholders, including patients and family caregivers, prescribers, pharmacists, formulary managers, health plans, and policymakers. Addressing knowledge gaps regarding generic drug safety, efficacy, and equivalency may help promote appropriate generic drug use and mitigate rising drug costs.
Implications and new insights for federal, state, and/or local health policy: To inform future policymaking around appropriate generic drug use, IMPAQ performed forty-eight semi-structured interviews in fall 2016 among physicians, pharmacists, patients/families, large purchasers, policymakers, and formulary managers. Interviews were transcribed and coded to identify key themes, which include the participants’ drug prescribing, dispensing or utilization background, roles in generic drug use, beliefs about safety and effectiveness of generic drugs, and informational needs related to generic drugs.
Roles in Generic Drug Use: Policymakers indicated that physicians and pharmacists have the most influence on generic drug utilization, while other groups emphasized formularies as the driver.
Beliefs about Safety and Effectiveness: Policymakers consistently agreed that generic drugs are as safe and effective as brand-name drugs. For most drugs, pharmacists saw generic drug safety and effectiveness equivalent to brand-name drugs. The other groups varied in their assessment of the equivalency in safety and effectiveness.
Generic Drug Information Sources: Patients primarily relied on physicians and pharmacists for generic drug information, while the other groups typically accessed generic drug information in published literature and electronic sources.
Generic Drug Information Preferences: Policymakers, large purchasers, formulary managers, physicians, and pharmacists prefer generic drug information in electronic format. Patients prefer to receive this information through discussion with a physician or pharmacist together with a handout.
Policymakers, large purchasers, and formulary managers value additional drug information related to generic drug manufacturer, length of time and availability on the market, and equivalency information.
Patients wanted to know whether they were prescribed a brand or generic, as well as the side effects of the medication.
Pharmacists and physicians wanted information regarding a drug’s mechanism of action, efficacy, side effects, costs, and manufacturer in order to share comprehensive information with patients.
Description of how evidence and/or data was or could be used: The evidence generated in this study supported the development of tailored educational outreach materials to meet different stakeholders’ informational needs regarding generic drugs.
Potential impact of the presentation for health policy: The informational needs identified in this study can be used to support better targeted outreach materials to further increase generic drug use. Improved knowledge and information regarding generic drugs could enhance stakeholders’ decision making in increased use of generic drugs.