Physicians’ prescription practices and knowledge about brand-name versus generic drugs in Yerevan, Armenia: An analytical cross-sectional study

Abstract

Literature review/background information. Health care expenditures have continuously grown during the past decades. One way to reduce healthcare expenditures for families, a heavy economic burden for some, is for physicians to shift to prescribing less expensive bioequivalent generic drugs instead of more expensive brand-name drugs. The use of less expensive generic bioequivalent drugs instead of brand-name can reduce prescription drug expenditures and make healthcare for families more affordable. The aim of the study was to measure the magnitude of the problem among general practitioners working in Yerevan polyclinics and assess and characterize their knowledge about generic vs. brand-name drugs, perceptions and prescribing practices, for the purpose of finding effective ways to increase generic drug prescription proportions over that of brand-name drugs. Methods. The study design was an analytical cross-sectional survey. The Institutional Review Board of the American University of Armenia reviewed and approved the research protocol. The study population included general practitioners working in polyclinics in Yerevan. The study conducted a stratified cluster sampling of 124 eligible GPs from twelve communities of Yerevan. Basic descriptive statistics were used for describing demographic characteristics. Simple and multivariate linear regression analyses were performed to test the associations between independent variables (demographic characteristics, generic drug knowledge score, generic drug perception score and dependent variables (practice score). Results and Discussion. All surveyed GPs were female, the mean age was 50.7 years old, the mean work experience was 24.8 years, and on average they wrote 11 prescriptions per day. Most of the respondents (82%) prescribed generics less than half the time for the five most prescribed drugs when given a choice, 79% of participants indicated that they would prefer to use brand-name drugs for themselves and for their family members, and 90% were concerned about the effectiveness and safety of generic drugs. Findings showed that higher generic drug knowledge score was associated with higher proportions of generic drugs prescribed, indicating that the negative beliefs towards generic drugs were associated with reduced confidence in generic drugs and reduced prescribing of generic drugs over equivalent brandname drugs. Conclusion and recommendations. The current study found a positive association between generic drug knowledge score and generic drug prescription practices, indicating that correct and positive knowledge towards generics could lead to increased prescription rates of generic drugs. It is recommended that knowledge among GPs and other physicians should be raised about the safety and effectiveness of generic drugs, leading to an increase of generic drug prescription rates and reducing the burden of drug expenditures on families.