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.

DESIGN AND PARTICIPANTS

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.

MEASUREMENTS

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.