Older physicians less likely to prescribe generic medications

WOONSOCKET, R.I. — While a majority of physicians are comfortable with generic medications, there is a small segment who still have negative perceptions about the effectiveness and quality of generic drugs, and that may lead to doctors prescribing unnecessarily expensive medications, according to a new study by researchers at Harvard University, Brigham and Women's Hospital and CVS Caremark.

In a study published in the Annals of Pharmacotherapy, the researchers stated, "Overall, we found that the majority of physicians are comfortable with the efficacy of generic medications and are comfortable using generics themselves. However, there is a meaningful proportion who express concerns about generics. These beliefs could represent an important barrier to greater generic use and could contribute to elevated prescription costs for patients, insurance providers and society."

According to the study, 23% of doctors have negative perceptions of the effectiveness and quality of generic medications.

"While there are many studies about how consumers and patients view generics, we thought it would be important to also look at the perception of generics by prescribers, because understanding the physician's perception can help us determine if there are other potential barriers to the greater use of generics," stated lead author of the study William Shrank of Brigham and Women's Hospital and Harvard. "We don't have clear insight as to what might influence a prescriber's behavior, and as we look to develop programs to encourage more cost-effective pharmacy care, this is an area industry and policy-makers should be reviewing. We know that if we help patients access less expensive medications, they are more likely to take them."

The researchers surveyed more than 2,700 physicians and received 506 responses from prescribers representing both specialists and general practitioners. More than 60% of the physicians surveyed were between ages 35 and 54 years, with physicians older than 55 years representing about 30% of the survey group; physicians ages 25 to 34 years made up 9% of the respondents. Physicians ages 55 years or older were 3.3 times more likely to have negative perceptions about generics than those between ages 25 and 34 years.

While the doctors said they were aware some patients struggle with the costs of medications, there was little relationship between the doctor's perception of cost burden and their perceptions of generics, according to researchers.

In addition, when asked how they were informed about the market entry of a generic medication, 75% said they received their information from the pharmaceutical representatives. Other sources of information included medical journals (42%), colleagues (40%) and pharmaceutical mailings and literature (38%).

The researchers also indicated that the study was limited by the sample that was surveyed. While the sample was drawn from a large source, the response rate was low; physicians who did respond may have differed from the overall population.

"Payers and policy-makers attempting to stimulate cost-effective medication use should consider educating physicians, particularly older ones, to improve their comfort with generics," the study concluded.

The study is a product of CVS Caremark's previously announced three-year collaboration with Harvard University and Brigham and Women's Hospital to research pharmacy claims data to better understand patient behavior, particularly around medication adherence.