Physicians’ generic drug prescribing behavior in district hospitals: a case of Phitsanulok, Thailand

Generic prescribing is a sound approach to contain health care costs. However, little is known about physicians’ prescribing patterns in the Thai context. OBJECTIVE: To explore physicians’ generic prescription patterns in district hospitals. METHODS: Data was collected from three of the eight district hospitals between January and December 2008 (final response rate 37.5%). All participating hospitals were between 30 and 60-bed capacity. The researchers reviewed 10% of total outpatient prescriptions in each hospital. RESULTS: A total of 14,500 prescriptions were evaluated. The majority of patients were under universal health coverage (4,367; 30.1%), followed by senior citizens’ health insurance (2,734; 18.9%), and civil servant medical benefit schemes (2,419; 16.7%). Ten thousand six hundred and seventy-one prescriptions (73.6% of total prescriptions) had at least one medication. Among these, each prescription contained 2.85 (SD=1.69) items. The majority of prescriptions (7,886; 73.9%) were prescribed by generic name only. Drugs prescribed by brand names varied in their pharmacological actions. They represented both innovator and branded-generic items. Interestingly, a large number of them were fixed-dose combination drugs. All brand name prescriptions were off patented. In addition, none of the brand-name drugs prescribed were categorized as narrow therapeutic range or any other drug that had been reported to have had problems with generic substitution. CONCLUSION: The majority of prescriptions in this sample were written by generic names. There is room for improvement in brand name prescribing patterns.