European Journal of Clinical Pharmacology

, Volume 75, Issue 2, pp 275–283 | Cite as

INN or brand name drug prescriptions: a multilevel, cross-sectional study in general practice

  • Florent De Bruyne
  • Arnaud Ponçon
  • Joris Giai
  • Xavier Dode
  • David Darmon
  • Cyrille Colin
  • François Gueyffier
  • Laurent LetrilliartEmail author
Pharmacoepidemiology and Prescription



The prescription in International Nonproprietary Names (INN) is a legal obligation for all physicians in France since January 2015. The objective of this study was to analyze the frequency and main factors of INN drug prescribing in general practice.


Multicenter cross-sectional study conducted with 11 interns acting as observers of 23 GP trainers between November 2015 and January 2016. Two evaluators analyzed all GPs’ drug prescriptions to identify INN or brand name prescriptions.


The database included 4957 drugs prescribed during 1647 visits. Of these, 1462 (29.5% [95% CI 28.2–30.8%]) were prescribed only in INN. According to the multivariate analyses, the factors favoring INN prescribing were as follows: at the drug level, its initial prescribing (OR = 1.4), a nonspecific prescribing objective (OR = 1.6), its listing in the generic drug index with (OR = 7.7) or without (OR = 2.9) efficiency objective included in the payment for public health objectives (PPHO) program, and the oral route of administration (OR from 0.4 for the percutaneous route to 0.2 for the pulmonary route); at the patient level, the male gender (OR = 1.3), the age of 15 years or more (OR = 1.9), and the absence of a long-term condition (OR = 1.3); at the physician level, the reception of a public healthcare insurance representative (OR = 4.1), the nonreception of pharmaceutical sales representatives (OR = 3.0), and the urban practice environment (OR = 2.8).


In 2015, less than one third of drugs were prescribed in INN only in general practice. The use of various incentives and regulatory measures is likely to favor the prescription of INNs by practitioners.


International Nonproprietary Name (INN) Brand name Drug prescription General practice 



We would like to thank Louis Bernard who supervised the data collection, and the interns who collected the data: Morgane Aillet, Sofien Amraoui, François Drogou, Florent Debruyne, Aurélie Fleurentin, Laura Laperriere, Thomas Lecocq, Lucile Moracchini, Allison Netboute, Arnaud Ponçon, and Manon Ubéra. We also thank their 23 GP trainers. We are indebted to Philippe Ameline, who developed the server for data entry and storage. We are grateful to Natane Reynaud for the English editing of the manuscript.

Authors’ contributions

LL conceived the study, and he designed it along with FB and AP. XD helped to use the Thériaque drug database. FB and AP managed the database, with the support of LL. JG performed the statistical analyses. XD, DD, CC, and FG contributed to the interpretation of the findings. FB, AP, and LL drafted the manuscript. All authors reviewed and approved the final version of the article.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

The Hospices Civils de Lyon ethics committee has approved the OPREM study. A patient information poster was displayed in the offices of participating physicians. Data storage was covered by a statement made to the French Commission on Information Technology and Liberties (CNIL, No. 1549782).

Supplementary material

228_2018_2580_MOESM1_ESM.pdf (59 kb)
ESM 1 (PDF 58.5 kb)


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Collège universitaire de médecine généraleUniv. Lyon, Université Claude Bernard Lyon 1, Université Saint-EtienneSaint-EtienneFrance
  2. 2.Université Lyon 1VilleurbanneFrance
  3. 3.Laboratoire de Biométrie et Biologie ÉvolutiveCNRS, UMR5558VilleurbanneFrance
  4. 4.Service de BiostatistiqueHospices Civils de LyonLyonFrance
  5. 5.Département de PharmacieHospices Civils de LyonLyonFrance
  6. 6.Département d’Enseignement et de Recherche en Médecine GénéraleUniversité de Nice Sophia-AntipolisNiceFrance
  7. 7.UMR 912 Sesstim InsermMarseilleFrance
  8. 8.Health Services and Performance Research, HESPER EA 7425Lyon Cedex 3France
  9. 9.Pôle IMER des Hospices Civils de LyonLyonFrance
  10. 10.Service de Pharmaco-ToxicologieHospices Civils de LyonLyonFrance
  11. 11.UMR 5558, CNRS & Université Claude Bernard Lyon 1LyonFrance

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