title: Reforms and initiatives in Scotland in recent years to encourage the prescribing of generic drugs, their influence and implications for other countries.
abstract: Scotland has introduced a number of initiatives to enhance the prescribing of low-cost generic drugs versus originators and patent products in a class where these are seen as similar. The objective of this review is to appraise the influence of the various measures on subsequent utilization patterns and expenditure in high-volume classes to provide guidance. This review is principally a narrative review of published studies. The authors' found supply-side measures resulted in generic prices as low as 3% of pre-patent loss prices. Multiple demand-side measures resulted in high international non-proprietary name prescribing, and a considerable increase in prescribing efficiency for the proton pump inhibitors, statins, renin-angiotensin inhibitor drugs and selective serotonin reuptake inhibitors. There were no specific activities encouraging the prescription of losartan versus other angiotensin receptor blockers or risperidone versus other atypical antipsychotic drugs following generics and no change in their utilization patterns post generics. The authors can conclude multiple measures are needed to change physician prescribing habits. Authorities cannot rely on any 'spillover' effects to affect future prescribing, even in closely related classes.
authors: Strathclyde Institute of Pharmacy and Biomedical Sciences, University of Strathclyde, Glasgow, Scotland, UK. brian.godman@strath.ac.uk
authors: Brian
authors: B
authors: Godman
authors: Iain
authors: I
authors: Bishop
authors: Alexander E
authors: AE
authors: Finlayson
authors: Stephen
authors: S
authors: Campbell
authors: Hye-Young
authors: HY
authors: Kwon
authors: Marion
authors: M
authors: Bennie
mesh_terms: D001291:Attitude of Health Personnel; D017046:Cost Savings; D003362:Cost-Benefit Analysis; D016527:Drug Costs; D011307:Drug Prescriptions; D016568:Drugs, Generic / Q000145:classification / Q000191:economics / Q000627:therapeutic use*; D019983:Guideline Adherence; D018166:Health Care Reform / Q000191:economics; D005102:Health Expenditures; D007722:Health Knowledge, Attitudes, Practice; D006291:Health Policy / Q000191:economics; D006801:Humans; D010816:Physician Incentive Plans; D011050:Policy Making; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians' / Q000191:economics; D012606:Scotland
chemical_list: D016568:Drugs, Generic