'No-Frills Prils': GPs' views on drug costs and therapeutic interchange of angiotensin-converting enzyme inhibitors: a qualitative study.

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...

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Publicado en:Australian Journal of Primary Health Vol. 27; no. 2; pp. 152 - 158
Autores principales: Lim, Hok, Sanci, Lena, Webster, Susan, Wilson, Alyce N., Lau, Phyllis
Formato: research tables/charts Journal Article
Publicado: CSIRO Publishing 2021
Acceso en línea:Ver este registro en EBSCOhost
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        atl: 'No-Frills Prils': GPs' views on drug costs and therapeutic interchange of angiotensin-converting enzyme inhibitors: a qualitative study.
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        au:
          Lim, Hok
          Sanci, Lena
          Webster, Susan
          Wilson, Alyce N.
          Lau, Phyllis
        affil: Department of General Practice, Melbourne Medical School, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Level 3, 780 Elizabeth Street, Melbourne, Vic. 3010, Australia.
      sug:
        subj:
          Angiotensin-Converting Enzyme Inhibitors Economics
          Physicians, Family Australia
          Physician Attitudes
          Drug Substitution
          Health Care Costs
          Human
          Primary Health Care
          Family Practice
          Qualitative Studies
          Australia
          Thematic Analysis
          Prescribing Patterns
          Cost Control
          Semi-Structured Interview
          Purposive Sample
          Snowball Sample
          Data Analysis Software
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          Middle Age
          Aged
          Male
          Female
          Funding Source
          Adult: 19-44 years
          Middle Aged: 45-64 years
          Aged: 65+ years
          Male
          Female
      ab: 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.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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