Generic-to-branded drug switch-back patterns: exploratory analysis and insights from the statin class

Chressanthis, George A.; Khedkar, Pratap; Jain, Nitin; Poddar, Prashant; Seiders, Michael G.

doi:10.1111/j.1759-8893.2011.00064.x

Cited by 4 publications

(14 citation statements)

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“…Overall, in our cohort we observed generic‐to‐brand switchbacks in 4.8% of the population taking one of the study drugs. These results are relatively consistent with those seen in previous studies including a 3.4% generic‐to‐brand switchback for levetiracetam and a 7.1% generic‐to‐brand switchback for statin users . The statin study also found that the likelihood of generic‐to‐brand switchback increased with dose (16.1% for the highest simvastatin dose), patient age, and comorbidities, concluding that older and sicker patients may be more sensitive to adverse effects and efficacy considerations.…”

Section: Discussionsupporting

confidence: 87%

Comparison of Generic-to-Brand Switchback Rates Between Generic and Authorized Generic Drugs

et al. 2017

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Background While generic drugs are therapeutically equivalent to brand drugs, some patients and healthcare providers remain uncertain about whether they produce identical outcomes. Authorized generics, which are identical in formulation to corresponding brand drugs but marketed as a generic, provide a unique post-marketing opportunity to study whether utilization patterns are influenced by perceptions of generic drugs. Objectives To compare generic-to-brand switchback rates between generics and authorized generics. Methods A retrospective cohort study was conducted using claims and electronic health records data from a regional U.S. healthcare system. Ten drugs with authorized generics and generics marketed between 1999 and 2014 were evaluated. Eligible adult patients received a brand drug during the 6 months preceding generic entry, and then switched to a generic or authorized generic. Patients in this cohort were followed for up to 30 months from the index switch date to evaluate occurrence of generic-to-brand switchbacks. Switchback rates were compared between patients on authorized generics versus generics using Kaplan-Meier curves and Cox proportional hazards models, controlling for individual drug effects, age, sex, Charlson comorbidity score, pre-index drug use characteristics, and pre-index healthcare utilization. Results Among 5,542 unique patients that switched from brand-to-generic or brand-to-authorized generic, 264 (4.8%) switched back to the brand drug. Overall switchback rates were similar for authorized generics compared with generics (HR=0.86; 95% CI 0.65-1.15). The likelihood of switchback was higher for alendronate (HR=1.64; 95% CI 1.20-2.23) and simvastatin (HR=1.81; 95% CI 1.30-2.54) and lower for amlodipine (HR=0.27; 95% CI 0.17-0.42) compared with other drugs in the cohort. Conclusions Overall switchback rates were similar between authorized generic and generic drug users, indirectly supporting similar efficacy and tolerability profiles for brand and generic drugs. Reasons for differences in switchback rates among specific products need to be further explored.

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Section: Discussionsupporting

confidence: 87%

Comparison of Generic-to-Brand Switchback Rates Between Generic and Authorized Generic Drugs

et al. 2017

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“…With respect to patient characteristics, influential factors are less clear. Some studies found no gender differences in switching[17,19] while others[20] found switching more likely among women. Switching has been found more prevalent among older patients in one study[17] and among younger patients in others [19,20]…”

Section: Introductionmentioning

confidence: 99%

“…Factors examined in this research have included cost differentials, physician characteristics, prescribing pharmacy and patient characteristics, including knowledge about both insurance coverage and generic drug options. Only one recent paper examines switch‐back patterns (generic to branded) within the statin class of drugs, providing what its authors deem ‘initial exploratory’ evidence [17]. Using IMS Health data for a 2‐year period from July 2006 to June 2008, these authors found that 7.1% of patients on a generic statin switched to a branded drug during the 2‐year period of observation [17].…”

Section: Introductionmentioning

confidence: 99%

“…While there is a growing literature focusing on determinants of generic drug substitution, far less attention has been paid to switching behaviour once a patient has used a generic drug. The one study looking specifically at switch‐backs identifies a few important factors: the number of co‐morbid conditions the patient has, higher dosage of the generic (particularly for those on high doses of simvastatin and presumably due to unpleasant side effects) and the type of physician prescribing the switch‐back [17]. While these results are suggestive, they are based solely on simple univariate and bivariate statistical analysis.…”

Section: Introductionmentioning

confidence: 99%

“…Only one recent paper examines switch-back patterns (generic to branded) within the statin class of drugs, providing what its authors deem 'initial exploratory' evidence. [17] Using IMS Health data for a 2-year period from July 2006 to June 2008, these authors found that 7.1% of patients on a generic statin switched to a branded drug during the 2-year period of observation. [17] Of these patients, approximately 13% switched back to the branded bioequivalent while the rest switched to another brand name statin.…”

Section: Introductionmentioning

confidence: 99%

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Influencing choice of branded or generic statins by older adults in the USA

Porterfield

Levin

Feigenbaum

2014

Journal of Pharmaceutical Health Services Research

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Objective This study examines whether information gained from face‐to‐face contact with health professionals has an influence on switching between branded and generic statins, a class of drugs primarily used by older adults. Methods Data from five panels of the Medical Expenditure Panel Study covering 2006–2011 are used to estimate multivariate logistic regression models examining whether statin switching is influenced by the patient‐centred medical home and type of pharmaceutical drug vendor. Key findings Provider consultation is important in consumer choice. Older adults who report their physician's office is ‘patient‐centred’ are more than twice as likely to make a generic to branded switch. Switching from branded to generic statins is 50% more likely when prescriptions are filled at a drugstore, 80% more likely when filling at another type of retail outlet and more than twice as likely when filling at a hospital‐based clinic (all places where it is possible to speak with a pharmacist in person) rather than filling through mail order or online. Free samples, dosage and type of insurance coverage also influence switching behaviour. Conclusions Communication between health providers and patients is an important part of the decision to switch between different statin formulations.

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The contribution of generic substitution to rationalizing pharmaceutical expenditure in Greek public hospitals under recent economic crisis

Kontodimopoulos

Kastanioti

Thireos³

et al. 2013

Journal of Pharmaceutical Health Services Research

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Objectives This paper focuses on practices and policies implemented by the Greek Ministry of Health to reduce pharmaceutical expenditure in public hospitals in light of the economic crisis, and presents cost savings resulting from brand-generic substitution. Methods All Greek national health service (GNHS) hospitals (n = 133) were included in the sample and data were collected from the monthly reports of a recently established web-based facility named ESY.net. Data were analysed by healthcare region, hospital type and size, and also by medicine type to determine if the generics policy had been more favourable for certain drugs. Key findings Expenditure gradually decreased from 2009 to 2011 but geographical variations in reductions were observed. In 2011, brand-generic substitution was 26%, implying that the 35% target for end-2012 was feasible. Psychiatric facilities and small hospitalhealth centres were more favourable in adopting generics (47.7% and 38.2% respectively), whereas specialized and children's hospitals (14.1% and 12.0%) performed more poorly in this respect. Smaller hospitals achieved better brand-generic substitution. By drug type, substitution was higher for antibiotics (51.9%), cardiologic drugs (38.2%) and antidepressants (48.2%). Conclusions The demanding effort to rationalize pharmaceutical expenditure in the GNHS appears to be on course, based on results being achieved in a stressful environment, caused by the Greek economic crisis. Data are continuously collected and processed, allowing for corrective actions and longitudinal (i.e. time-series) comparisons from which more valid conclusions will emerge in the following years.

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Generic-to-branded drug switch-back patterns: exploratory analysis and insights from the statin class

Cited by 4 publications

References 14 publications

Comparison of Generic-to-Brand Switchback Rates Between Generic and Authorized Generic Drugs

Comparison of Generic-to-Brand Switchback Rates Between Generic and Authorized Generic Drugs

Influencing choice of branded or generic statins by older adults in the USA

The contribution of generic substitution to rationalizing pharmaceutical expenditure in Greek public hospitals under recent economic crisis

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