Background Little is known about the treatments physicians choose for themselves compared with how they treat their patients. We determine if physicians prescribe different treatments to patients than to themselves.
Methods Population-based cohort study from 2004 to 2012 examining prescription claims of all Danish primary care physicians (PCP; n=3088) and all other Danish adults (n=2 334 590) who received a first-time prescription from a PCP for a statin (n=455 586), calcium channel blocker (CCB, n=330 369), serotonin-norepinephrine/selective serotonin reuptake inhibitors (SN/SSRIs, n=423 740), proton pump inhibitor (PPI, n=671 965) or antihistamine (n=456 018). The main outcome is the brand-name or generic status of the first prescribed drug. A logistic regression model compared outcomes, unadjusted and adjusted for sociodemographic characteristics and coverage information.
Results For drugs that require chronic treatment (statins, CCBs, SN/SSRIs), the relative risk (RR) for PCPs (PCP patients) being treated with a brand drug was 3.86 (95% CI 3.33 to 4.47; p<0.001). This difference remained significant when adjusting for covariates (adjusted RR=2.51 (95% CI 2.16 to 2.92; p<0.001)). For non-chronic drugs (PPIs, antihistamines), the RR for PCP patients was (RR=1.13 (95% CI 1.08 to 1.20; p<0.001)), and this difference was explained by higher income. Physicians are not more likely than non-physicians, however, to be treated with brand-name versions of drugs that are available as generics.
Conclusion Physicians are more likely than non-physicians to be treated with brand-name drugs without generic equivalents in three chronic treatment drug classes but not in two acute treatment drug classes. Guidelines can lead to lower brand-name drug use than physicians prefer for themselves.
- primary care
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