Increasing Generic Medication Usage

Introduction A generic drug is a drug defined as a drug product that is comparable to brand listed drug product in dosage form, strength, route of administration, quality and performance characteristics, and intended use. A generic drug must contain the same active ingredients as the original formulation. Generic drugs are usually sold for significantly lower prices than their branded equivalent. Thus, use of generics by clinicians can result in significantly reduced healthcare costs. Insurance companies are motivated to increase use of generics since it improves their bottom line, and patient compliance has been shown to increase when the cost burden of drugs is minimized. Thus, we sought to increase the percentage of generic utilization one standard deviation by all three internal medicine physicians in our practice. Methods 1. Physician education the pharmacologic landscape is complicated and constantly changing, and therefore the physicians of the practice were educated on various nuances of generic prescribing and precisely how these rates are calculated (example: the denominator is the number of Rxs filled, not number of pills dispensed, therefore a three month supply filled at once counts for a single prescription, whereas a 30 day supply filled 3 times counts as three prescriptions). 2. Our organization compiles a monthly Top 50 Drugs report, which was reviewed monthly with a pharmacist, and specific recommendations were made based on each physicians unique prescribing profile. 3. A generics favorites tab was created in our EHR, with the goal of simplifying generic prescribing 4. Copies of each issue of The Medical Letter was printed out by the office manager given to each physician biweekly. Q110 77.51 64.52 86.89 Q210 78.42 68.28 80.92 Q310 81.41 70.79 67.90 Q410 83.33 72.54 76.92 Q111 85.11 75.02 73.81 Q211 85.36 72.83 74.58

MD #1 MD #2 MD #3

Discussion Frequent re-measurement and presentation of data to physicians was integral to moving generic rates higher. Engagement of an expert (pharmD) to give personalized guidance to the physicians was also essential, since physician prescribing habits are unique to each clinician. We found that each physician had distinct opportunities for improvement based on the cadre of medications they typically prescribe. The generics favorite tab was not widely used, as physicians failed to incorporate this into their current computer workflow. Future efforts to improve generic prescribing should focus on physician education and targeting prescribing habits that are unique to each physician. Monthly review of data with a pharmD, for a period of 6 consecutive months, is sufficient to move generic rates significantly higher. After the initial 6-month period, less frequent meetings (quarterly) may be needed, to continue positive trends in generic prescribing. The Medical Letter, a peerreviewed and unbiased biweekly publication proved useful in keeping physicians up to date on new medications, possibly counterbalancing the constant activity of pharmaceutical representatives in the office. Our patients derived the ultimate benefit from generic prescribing in terms of decreased out-of-pocket costs and increased compliance to their medical regimens.