The American College of Physicians recommends the use of generic medications when possible in a new clinical guideline published in the Annals of Internal Medicine. In the guideline, the authors sought to answer five questions:
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How commonly are brand-name medications used when a generic version is available?
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How does the use of generic medications influence adherence?
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What is the evidence that brand name and generic medications have similar clinical effects?
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What are the barriers to increasing use of generic medications?
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What strategies can be used to promote cost savings through greater generic medication use?
In the guideline, they systematically answer these questions and find brand-name medications show no superiority in effectiveness compared with molecularly identical generic medications. Using generic medication reduces out-of-pocket costs for patients and encourages better adherence to therapy, especially chronic diseases. A major barrier is physician perception about the safety and efficacy of generic medications, along with patient expectations and preferences. The authors recommended using electronic health records to notify prescribers about formulary status and medication costs, including out-of-pocket costs. Further, they recommended tiered formulary copayment systems and perhaps even a prior authorization for brand-name drugs when a generic drug is available. Additionally, they recommended patient and physician education, along with physician performance measurements. (Ann Intern Med 2015 Nov 24. doi: 10.7326/M14-2427. [Epub ahead of print].)
