Department of Medical Pharmacology, Marmara University School of Medicine, Istanbul, Turkey.
Department of Medical Pharmacology, Dokuz Eylul University School of Medicine, Izmir, Turkey.
Int J Clin Pract. 2021 Aug;75(8):e14284. doi: 10.1111/ijcp.14284. Epub 2021 May 9.
Dissemination of generic drug (GD) use could provide significant savings on drug expenditures and contribute to the long-term sustainability of healthcare. We aimed to exhibit the nationwide trend of GD use in primary care and investigate potentially relevant drug and patient factors.
Prescriptions written by primary care physicians in Turkey between 2013 and 2016 were analysed using the National Prescribing Information System. We determined the ratio of GD prescriptions with all prescriptions in terms of quantity and cost. In addition, we analysed the use of GD in terms of demographic characteristics of the patients, the most frequently prescribed preparations and frequent indications.
In the 4-year period, we identified 518,335,821 prescriptions, those with at least one GD constituted 54.0% (n = 786,972,813) with a total cost-share of 36.9%-37.8%. GD use was the highest in 2016 (54.4%) and lowest in 2014 (53.6%). GD prescribing was higher in women than men every year (P < .001 for each), with the highest difference in 2016 as 54.7% vs 54.0%. GD utilisation decreased as the age group increased, which was 64.0%-64.5% in <18-year-old group and 46.0%-47.1% in ≥75-year-old group. Among the top ten encountered indications, the highest and lowest GD prescribing was detected in acute tonsillitis (68.1%) and hypertension (33.9%). Metformin had the highest percentage of GD prescribing (96.1%-97.7%), whereas esomeprazole showed the lowest GD prescribing (4.5%-14.8%) among the most frequently used preparations in primary care.
This study shows a modest upward trend of GD utilisation in primary care, though its share appears to be lower than expected. GD use revealed a consistent reduction towards older age groups. GDs were more likely to be prescribed for acute conditions, particularly infectious diseases.
推广使用仿制药（GD）可以在药品支出方面节省大量资金，并有助于医疗保健的长期可持续性。我们旨在展示初级保健中 GD 使用的全国趋势，并调查潜在相关的药物和患者因素。
使用国家处方信息系统分析 2013 年至 2016 年期间土耳其初级保健医生开具的处方。我们根据数量和成本确定 GD 处方与所有处方的比例。此外，我们根据患者的人口统计学特征、最常开的制剂和常见适应证分析 GD 的使用情况。
在 4 年期间，我们确定了 518335821 张处方，其中至少有一种 GD 的处方占 54.0%（n=786972813），总费用份额为 36.9%-37.8%。GD 使用在 2016 年最高（54.4%），在 2014 年最低（53.6%）。每年女性的 GD 处方都高于男性（每年 P<.001），2016 年的差异最大，为 54.7%比 54.0%。随着年龄组的增加，GD 的使用减少，<18 岁年龄组为 64.0%-64.5%，≥75 岁年龄组为 46.0%-47.1%。在遇到的十大适应证中，急性扁桃体炎（68.1%）和高血压（33.9%）的 GD 处方率最高和最低。二甲双胍的 GD 处方率最高（96.1%-97.7%），而埃索美拉唑在初级保健中最常用的制剂中 GD 处方率最低（4.5%-14.8%）。
这项研究表明，初级保健中 GD 的使用呈温和上升趋势，尽管其份额似乎低于预期。GD 的使用向老年人群持续减少。GD 更有可能用于急性疾病，特别是传染病。
