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Brand name or generic? What are the health professionals prescribed for treating diabetes? A longitudinal analysis of the National Health Insurance reimbursement database
Author(s) -
Liou WenShyong,
Hsieh ShuChing,
Chang WaiYuan,
Wu Grace HuiMin,
Huang HsuShan,
Lee Chuanfang
Publication year - 2013
Publication title -
pharmacoepidemiology and drug safety
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.023
H-Index - 96
eISSN - 1099-1557
pISSN - 1053-8569
DOI - 10.1002/pds.3445
Subject(s) - medicine , medical prescription , odds ratio , odds , reimbursement , family medicine , multivariate analysis , diabetes mellitus , pharmacoepidemiology , health care , logistic regression , nursing , endocrinology , economics , economic growth
Objective This study aimed to explore whether physicians prescribe more brand‐name oral hypoglycemic agents (OHA) for diabetic patients with medical training background (MP) than for general patients (GP). Research design and methods A longitudinal analysis of 1 000 000 National Health Insurance cohorts of 1998–2008 was conducted. Univariate and multivariate models were performed to assess the associations of the outcome (the ratio of brand‐name/generic odds in the MP group to that in the GP group) and the covariates, including patient medical training background, characteristics of patient, prescriber, and medical settings, and market competition. A generalized estimating equation method was used to control the dependency of longitudinal data. Results A total of 46 850 diabetic patients were prescribed with 2 703 149 OHA prescriptions during the study period. Compared with GP, MP had 1.37 times greater odds of being prescribed with brand‐name instead of generic OHA, among whom pharmacists and physicians had the highest odds ratios of 2.78 (95%CI, 1.05–7.36) and 1.68 (95%CI, 0.99–2.85), respectively. Patients' diabetes severity, prescribers' level of experience, medical settings that were publicly owned, had a higher accreditation level, and were located in a higher urbanized area, lower market competition, and earlier dates of prescription were positively associated with brand‐name prescription. Among all medical sub‐specialties, cardiologists were more likely to prescribe brand‐name OHA. Conclusions This study is the first to demonstrate how a patients' medical training background, in addition to the characteristics of patients, prescribers, and medical settings, and market competition might influence physicians' prescribing choice of brand‐name or generic OHA. Copyright © 2013 John Wiley & Sons, Ltd.