Prescription medication can get pricey, and it’s a big contribution to the rise of healthcare costs in this country. There are several ways a hospital can make an impact regarding the rising costs of medication, including encouraging providers to write more scripts for generic medications.
A study conducted by the Perelman School of Medicine at the University of Pennsylvania looked into the role hospitals play in influencing the types of drugs patients receive from the pharmacy. Its results were published in a recent issue of JAMA Internal Medicine.
According to a news release, Penn researchers changed a setting in the hospital’s electronic health records (EHR) system. Traditionally, EHR systems will default to ordering the brand name of a drug, leaving it up to a pharmacist to substitute a generic form of the medication. However, Penn changed its system to default to the generic medication for patients.
If doctors wanted to give a patient a brand-name version of the drug, they would have to specifically “opt out” of using the generic by clicking a checkbox in the EHR to indicate the drug should be dispensed as written.
Impact of system change
Once the EHR change was made, the researchers looked at oral medications prescribed for 10 common conditions: diabetes, hyperlipidemia, acid reflux, anxiety/insomnia, hypothyroid, seizures, bacterial infection, depression, pain and hypertension/congestive heart failure. Any medications for these conditions that didn’t have a generic equivalent were excluded.
Before updating the EHR, doctors would prescribe a generic medication for these conditions 75% of the time. These rates jumped to 98% after the update was implemented.
The only exception was for certain hypothyroid patients. Due to differences in hormone levels between the generic and the brand-name medication, doctors were more likely to opt for the brand-name drug.
Benefits of generics
Past research has shown that just listing the most common generics for brand-name medications in an EHR increases the chance that providers will select them for patients. Taking it a step further and using an opt-out system could increase their use even more.
Not only does widespread use of generics cut healthcare costs, it’s also beneficial for patients, particularly those who may have trouble affording a medication. A cheaper option is better for their budgets, and that could make it more likely for them to take their medication as prescribed.
In addition, patients who take their required medications have better outcomes post-discharge, which could lead to decreased readmissions and better population health overall – two important factors for hospitals in an age of value-based payments.
So automatically defaulting to generic prescriptions in your hospital’s EHR would be a wise move for many reasons. It’s a relatively simple, low-cost change that could save millions. With that in mind, you may want to talk to your EHR vendor and see if there are any settings you can change in your system to “nudge” providers in the direction of prescribing generics.
