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Analyzing generic and branded substitution patterns in the Netherlands using prescription data
Petros Pechlivanoglou1, Willem Jan van der Veen, Jens H Bos
1Unit of PharmacoEpidemiology and PharmacoEconomics (PE2), Department of Pharmacy, University of Groningen, A, Deusinglaan 1, 9713 AV Groningen, The Netherlands. P.Pechlivanoglou@rug.nl
BMC Health Services Research
|April 29, 2011
Summary
Pharmacists are increasingly substituting generic drugs, especially for older patients and earlier after patent expiry. Pharmacy ownership and drug type also influence substitution patterns, offering insights for cost control strategies.
Area of Science:
- Pharmaceutical policy
- Health economics
- Pharmacy practice
Background:
- Rising pharmaceutical expenditures necessitate cost control measures.
- Increasing generic substitution by pharmacists is a potential cost-saving strategy.
- Understanding substitution patterns is crucial for optimizing pharmaceutical spending.
Purpose of the Study:
- To analyze the extent and nature of drug substitution in the Netherlands.
- To estimate the likelihood of generic or branded substitution based on various characteristics.
- To identify factors influencing pharmacist substitution decisions.
Main Methods:
- Utilized a linked prescription dataset from general practitioners and pharmacies in the northern Netherlands.
- Analyzed approximately 55,000 prescriptions across 15 drug classes.
- Employed a crossed generalized linear mixed model to assess influencing factors.
Main Results:
- Generic substitution occurred in 25% of branded prescriptions, influenced by timing post-patent expiry, patient age, and drug use experience.
- Individually owned pharmacies showed lower generic substitution rates compared to chain pharmacies.
- Branded substitution occurred in 10% of generic prescriptions, particularly for antidepressants and proton pump inhibitors (PPIs).
Conclusions:
- Pharmacist substitution is significantly related to patient experience, pharmacy type, and timing.
- Findings can inform strategies to enhance generic substitution and manage pharmaceutical costs.
- Further research can optimize generic substitution policies.
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