Survey: Docs Are Surrendering To Generics

Pharma Blog | Ed Silverman 

As the arrival of a generic version of the best-selling Lipitor pill neared last fall, a group of physicians - mostly, family medicine docs and internists - were asked about their views on prescribing lower-cost copycat meds, in general. Not surprisingly, 64 percent reported they were somewhat likely to switch to a generic within six months of availability. And 82 percent would do so within the first nine months.

At the same time, though, 65 percent reported that they have experienced a failure with a generic equivalent where the brand-name drug was successful. And 94 percent reported that their own patients had indicated a generic did not work as well as the branded drug they were taking previously, according to DoctorDirectory, a firm that specializes in brand-name marketing.

 And even though other brand-name products may be available in the same therapeutic category, 76 percent indicated they will still prescribe a generic. Moreover, 70 percent responded that they often do not specify ‘dispense as written’ on prescriptions, and 4 percent never do. Yet only 16 percent were able to correctly identify the bioequivalence range needed for generics.

We should note the survey queried 153 physicians, which is a small sample size and, therefore, the results should only be interpreted as a glimpse into prescribing behavior, not a definitive statement. Nonetheless, the responses do offer some insights and suggest that physicians are more than willing to prescribe generics, even when they may be reason for pause. 

What might this mean? “In some cases, I think physicians have lost prescribing authority or control,” says Tom St. Peter, a marketing vice president at DoctorDirectory. “Even though they may write for a given brand, it gets changed at the pharmacy. I think some feel that it doesn’t make much difference what they write anymore because it’s being determined by somebody else.

“And I think a lot of physicians say they switch (to prescribing generics) because they’re forced to switch, and to do so quickly. That’s because either the patient will demand it or it happens at the pharmacy and managed care level. They’ve given up the fight. I think some must say to themselves that they won’t even write ‘dispense as prescribed,’ because it’s not worth the phone calls.”

However, there may be one way to convince doctors to prescribe another brand-name drug, even when a generic is launched for a category leader. The answer? Give them samples and coupons - 37 percent of the doctors reported that they have switched to other brand-name meds to continue receiving these items. While not a majority, it suggests many docs are open to suggestion.