What’s in a Name? Use of Brand versus Generic Drug Names in United States Outpatient Practice
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The use of brand rather than generic names for medications can increase health care costs. However, little is known at a national level about how often physicians refer to drugs using their brand or generic names.
To evaluate how often physicians refer to drugs using brand or generic terminology.
Design and Participants
We used data from the 2003 National Ambulatory Medical Care Survey (NAMCS), a nationally representative survey of 25,288 community-based outpatient visits in the United States. After each visit, patient medications were recorded on a survey encounter form by the treating physician or transcribed from office notes.
Our main outcome measure was the frequency with which medications were recorded on the encounter form using their brand or generic names.
For 20 commonly used drugs, the median frequency of brand name use was 98% (interquartile range, 81–100%). Among 12 medications with no generic competition at the time of the survey, the median frequency of brand name use was 100% (range 92–100%). Among 8 medications with generic competition at the time of the survey (“multisource” drugs), the median frequency of brand name use was 79% (range 0–98%; P < .001 for difference between drugs with and without generic competition).
Physicians refer to most medications by their brand names, including drugs with generic formulations. This may lead to higher health care costs by promoting the use of brand-name products when generic alternatives are available.
- Haas JS, Phillips KA, Gerstenberger EP, Seger AC. Potential savings from substituting generic drugs for brand-name drugs: medical expenditure panel survey, 1997–2000. Ann Intern Med. 2005;142:891–7.
- Banahan BF, 3rd, Kolassa EM. A physician survey on generic drugs and substitution of critical dose medications. Arch Intern Med. 1997;157:2080–8. CrossRef
- Mott DA, Cline RR. Exploring generic drug use behavior: the role of prescribers and pharmacists in the opportunity for generic drug use and generic substitution. Med Care. 2002;40:662–74. CrossRef
- Suh DC. Trends of generic substitution in community pharmacies. Pharm World Sci. 1999;21:260–5. CrossRef
- National Center for Health Statistics. Public use micro-data file documentation, National Ambulatory Medical Care Survey, 2003. Hyattsville, MD: National Technical Information Service; 2005. Available at http://www.cdc.gov/nchs/about/major/ahcd/ahcd1.htm.
- National Center for Health Statistics. Using ultimate cluster models with NAMCS and NHAMCS public use files. Available at: http://www.cdc.gov/nchs/data/ahcd/ultimatecluster.pdf. Accessed 19 May, 2005.
- Mathews AW. When a drug maker creates a new pill, Uncle Sam vets name. FDA tries to avoid mix-ups, similar monikers, dupes; Bonviva becomes Boniva. Wall Street J. March 17, 2006:1.
- Hemminki E, Enlund H, Hellevuo K, Laurila R, Turakka H. Trade names and generic names. Problems for prescribing physicians. Scand J Prim Health Care. 1984;2:84–7.
- Bower AD, Burkett GL. Family physicians and generic drugs: a study of recognition, information sources, prescribing attitudes, and practices. J Fam Pract. 1987;24:612–6.
- Berberich FR. Cephalosporin trade names. Pediatr Infect Dis J. 2003;22:388–9. CrossRef
- Caves R, Hurwitz M. Persuasion or information: promotion and the shares of brand name and generic pharmaceuticals. J Law Econ. 1988;31:299–320. CrossRef
- Meredith P. Bioequivalence and other unresolved issues in generic drug substitution. Clin Ther. 2003;25:2875–90. CrossRef
- Nightingale SL, Morrison JC. Generic drugs and the prescribing physician. JAMA. 1987;258:1200–4. CrossRef
- Fischer MA, Avorn J. Potential savings from increased use of generic drugs in the elderly: what the experience of Medicaid and other insurance programs means for a Medicare drug benefit. Pharmacoepidemiol Drug Saf. 2004;13:207–14. CrossRef
- Fischer MA, Avorn J. Economic consequences of underuse of generic drugs: evidence from Medicaid and implications for prescription drug benefit plans. Health Serv Res. 2003;38:1051–63. CrossRef
- Testimony of the Generic Pharmaceutical Association (GPhA) Before the Subcommittee on Health, House Committee of Energy and Commerce, May 18, 2005. Available at: http://energycommerce.house.gov/108/Hearings/05182005hearing1526/Jaeger.pdf#search=%22generic%20substitution%20utilization%22. Accessed 23 October, 2006.
- Congressional Budget Office. How Increased Competition from Generic Drugs Has Affected Prices and Returns in the Pharmaceutical Industry. Available at: http://www.cbo.gov/ftpdocs/6xx/doc655/pharm.pdf. Accessed 13 July, 2006.
- Anton C, Cox AR, Ferner RE. Using trade names: sometimes it helps. Arch Intern Med. 2002;162:2636. CrossRef
- Schwab M, Oetzel C, Morike K, Jagle C, Gleiter CH, Eichelbaum M. Using trade names: a risk factor for accidental drug overdose. Arch Intern Med. 2002;162:1065–6. CrossRef
- Accreditation Council for Continuing Medical Education. Standards for Commercial Support. Available at: http://www.accme.org/dir_docs/doc_upload/68b2902a-fb73-44d1-8725-80a1504e520c_uploaddocument.pdf. Accessed 13 July, 2006.
- What’s in a Name? Use of Brand versus Generic Drug Names in United States Outpatient Practice
Journal of General Internal Medicine
Volume 22, Issue 5 , pp 645-648
- Cover Date
- Print ISSN
- Online ISSN
- Additional Links
- drug labeling
- drug industry
- prescriptions, drug
- drugs, generic
- prescription fees
- ambulatory care
- Industry Sectors
- Author Affiliations
- 1. Division of Geriatrics, San Francisco VA Medical Center and the University of California, San Francisco, CA, USA
- 2. Department of Dermatology, San Francisco VA Medical Center and the University of California, San Francisco, CA, 94121, USA