What's in a name? Use of brand versus generic drug names in United States outpatient practice.
BACKGROUND
The use of brand rather than generic names for medications can increase health care costs. However, little is known at a national level about how often physicians refer to drugs using their brand or generic names.


OBJECTIVE
To evaluate how often physicians refer to drugs using brand or generic terminology.


METHODS
We used data from the 2003 National Ambulatory Medical Care Survey (NAMCS), a nationally representative survey of 25,288 community-based outpatient visits in the United States. After each visit, patient medications were recorded on a survey encounter form by the treating physician or transcribed from office notes.


METHODS
Our main outcome measure was the frequency with which medications were recorded on the encounter form using their brand or generic names.


RESULTS
For 20 commonly used drugs, the median frequency of brand name use was 98% (interquartile range, 81-100%). Among 12 medications with no generic competition at the time of the survey, the median frequency of brand name use was 100% (range 92-100%). Among 8 medications with generic competition at the time of the survey ("multisource" drugs), the median frequency of brand name use was 79% (range 0-98%; P < .001 for difference between drugs with and without generic competition).


CONCLUSIONS
Physicians refer to most medications by their brand names, including drugs with generic formulations. This may lead to higher health care costs by promoting the use of brand-name products when generic alternatives are available.
Steinman
Michael A
MA
Division of Geriatrics, San Francisco VA Medical Center and the University of California, San Francisco, CA 94121, USA. mike.steinman@ucsf.edu
Chren
Mary-Margaret
MM
Landefeld
C Seth
CS
D000554:Ambulatory Care Facilities; D016527:Drug Costs / Q000145:classification; D016568:Drugs, Generic / Q000145:classification* / Q000191:economics*; D006801:Humans; D011306:Prescription Fees / Q000145:classification; D009626:Terminology as Topic; D013810:Therapeutic Equivalency; D014481:United States
D016568:Drugs, Generic