Department of Medical Pharmacology, School of Medicine, Marmara University, Istanbul, Turkey.
Department of Medical Pharmacology, International School of Medicine, Istanbul Medipol University, Istanbul, Turkey.
Prim Health Care Res Dev. 2024 Sep 20;25:e40. doi: 10.1017/S1463423624000276.
The prevalence of depression is gradually increasing worldwide with an increasing utilization of antidepressants. Nevertheless, despite their lower costs, generic-brand antidepressants were reported to be less prescribed. We aimed to examine the costs of reference- versus generic-brand antidepressant prescriptions in primary care practice.
This cross-sectional study included electronic prescriptions for adult patients that contained antidepressants (World Health Organization's Anatomical Therapeutic Chemical (ATC) code: N06A), which were generated by a systematically selected sample of primary care doctors ( = 1431) in Istanbul in 2016. We examined the drug groups preferred, the reference- versus generic-brand status, and pharmacotherapy costs.
The majority of the prescriptions were prescribed for women (71.8%), and the average age of the patients was 53.6 ± 16.2 years. In prescriptions with a depression-related indication ( = 40 497), the mean number and cost of drugs were 1.5 ± 1.0 and 22.7 ± 26.4 United States Dollar ($) per prescription, respectively. In these prescriptions, the mean number and cost of antidepressants per encounter were 1.1 ± 0.2 and $17.0 ± 13.2, respectively. Reference-brand antidepressants were preferred in 58.2% of depression-related prescriptions, where the mean cost per prescription was $18.3 ± 12.4. The mean cost per prescription of the generics, which constituted 41.8% of the antidepressants in prescriptions, was $15.1 ± 11.4. We found that if the generic version with the lowest cost was prescribed instead of the reference-brand, the mean cost per prescription would be $12.9 ± 11.2.
Our study highlighted the substantial pharmacoeconomic impact of generic-brand antidepressant prescribing, whose preference over reference-brands could reduce the cost of antidepressant medication treatment by 17.5% in primary care, which could be approximately doubled if the cheapest generic antidepressant had been prescribed.
随着抗抑郁药的使用逐渐增多，全球范围内抑郁症的患病率也在逐渐上升。然而，尽管通用品牌抗抑郁药的成本较低，但据报道，它们的处方量却较少。我们旨在研究初级保健实践中参照品牌与通用品牌抗抑郁药处方的成本。
这项横断面研究包括 2016 年伊斯坦布尔一组经过系统选择的初级保健医生开具的包含抗抑郁药（世界卫生组织解剖治疗化学分类法代码：N06A）的成年患者电子处方（=1431）。我们检查了首选的药物组、参照品牌与通用品牌的状况以及药物治疗成本。
大多数处方是为女性开具的（71.8%），患者的平均年龄为 53.6±16.2 岁。在与抑郁症相关的处方（=40497）中，药物的平均数量和成本分别为 1.5±1.0 和 22.7±26.4 美元/处方。在这些处方中，每次就诊的抗抑郁药平均数量和成本分别为 1.1±0.2 和 17.0±13.2 美元。在与抑郁症相关的处方中，参照品牌抗抑郁药的使用率为 58.2%，处方的平均成本为 18.3±12.4 美元。在处方中占 41.8%的通用品牌抗抑郁药的平均处方成本为 15.1±11.4 美元。我们发现，如果使用成本最低的通用品牌替代参照品牌，平均处方成本将降至 12.9±11.2 美元。
我们的研究强调了通用品牌抗抑郁药处方的重要药物经济学影响，如果初级保健中优先使用通用品牌而非参照品牌，抗抑郁药治疗的处方成本可降低 17.5%，如果使用最便宜的通用抗抑郁药，这一比例可能增加一倍。
