| This survey research aimed to determine reasons for prescribing original brand name drugs and opinion of physicians on strategies to reduce prescribing of the drugs. Subjects were physicians working for medical department of general and regional hospitals of the ministry of public health in Thailand. Five self-developed questionnaires were sent to heads of medical department of every hospital and asked them to distribute to other physicians in the department. Of 470 sent questionnaires, 95 (20.21%) were returned.
The study found that the top 3 reasons for prescribing the original brand name drugs were more confidence in treatment outcomes (3.94±0.97; maximum scale of 5), patients’ ability to pay for the cost of the drugs (3.65±0.98), and the drugs have narrow therapeutic index (3.62±1.09). The first 3 strategies to reduce prescribing of the drugs that most of the physicians agreed with were the development of generic drugs that have good quality (4.32±0.82; maximum scale of 5), the ministry of public health should have database of quality control of both the original brand name drugs and generic drugs that could be used by physicians countrywide (4.21±0.75), and pharmacists should have database regarding comparability between original brand name drugs and generic drugs that easy to access (4.18±0.86).
Results also indicated that physicians working for the regional hospitals were more likely than physicians working for general hospitals to agree with the strategy to reduce prescribing of original brand name drugs regarding there should have a nationwide guideline on prescribing original brand name drugs; especially on the drugs that had high prescription volume (p-value 0.02). In addition, physicians who had more than 10 years experience were more likely than physicians who had less than 10 years experience to agree with these strategies – availability of a standard criteria that accepted by physicians regarding brand name drug prescribing conditions (p-value 0.03), limited numbers of medications per prescription (p-value 0.003), and a system to inform physicians regarding cost of brand name drugs that they had prescribed (p-value 0.04). Physicians who had also worked part-time in another hospital or private clinic were more likely than physicians who did not work part-time in another hospital or private clinic to agree with the strategy that the Pharmaceutical and Therapeutic Committee should have a strict criteria in including a brand name drug in the hospital formulary (p-value 0.02).
In conclusion, results of this study showed that physicians in medical department belief that brand name drugs had better efficacy that generic drugs. They also belief that effective strategies to reduce brand name prescribing would be the developing quality of generic drugs as good as brand name drugs and the availability of easy accessibility of a trusted information source regarding comparability of generic drugs and brand name drugs.
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