| Sumario: | Medications form a significant portion of spending in primary health care. Angiotensin-converting enzyme inhibitors (ACE-Is) are among the most prescribed blood pressure medications in general practice. Medications within this class are considered therapeutically equivalent, but the cost of each ACE-I varies. Our aim was to explore cost and other factors that influence general practitioners (GPs) to prescribe a specific ACE-I and understand their views on therapeutic interchange within this drug class. We conducted a qualitative study of Australian GPs using thematic analysis. We found that GPs were aware of therapeutic equivalency within the ACE-I class, but unaware of the cost differences. Although GPs tended to adopt a prescribing preference, they were open to fewer prescribing options if there was a decreased cost to patients and the PBS, or potential to minimise prescribing error. Our findings have immediate relevance for national prescribing policies and the Pharmaceutical Benefits Scheme (PBS). The wide selection of ACE-Is that are available results in diverse prescribing patterns and may not be cost-effective for patients or the PBS. Restricting the number of drug options within the ACE-I class in primary care appears to be an acceptable drug cost-containment strategy according to our sample of GPs. GPs prescribe a range of medications within the commonly used blood pressure medication class, angiotensin-converting enzyme inhibitors (ACE) inhibitors. Medications within this class are considered equivalent, but the cost of each ACE inhibitor varies. We found GPs were aware of equivalence within this drug class, but unaware of cost differences. GPs were open to fewer available prescribing options if there was a decreased cost to the health system. Restricted prescribing options in primary care may be an acceptable cost-containment strategy.
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