Doctors Who Consult Online Drug Database Quicker to Prescribe New Generics

A new study has found that clinicians who used an electronic drug reference database at the point of care tended to prescribe a more varied range of medications and started to prescribe new generic drugs faster than other doctors.

The paper, which was published by the National Bureau of Economic Research, discussed the use of an electronic drug reference database that provided physicians with not only clinical data about a medication, but also information like retail pricing, formulary status, and off-label use guidelines.

To evaluate differences between physicians who used this resource and those who did not, researchers analyzed prescribing data from over 57,000 clinicians who had adopted the tool by December 2010 and around 70,000 who had not. They found that those who had graduated from a top-ranked medical school in the United States or had graduated recently were more likely to be “early adopters,” as were male doctors. Physicians practicing in the southern region of the US and those in the field of obstetrics and gynecology tended to be slower in adopting the database.

The researchers examined physicians’ prescribing patterns of new and existing drugs for cholesterol and lipid control and found that, on average, a database user wrote the first prescription for a newly approved drug 1.2 months (5.96%) sooner than non-users. After further statistical analysis, the researchers found that physicians using the database were faster to start prescribing new generics, but began prescribing new branded drugs at the same speed as their counterparts.

The physicians using the database were significantly more likely to prescribe generic drugs in general, regardless of the time since the product’s approval. The study also found that prescribing diversity increased when a physician gained access to the database.

The researchers suggested that the database users’ propensity for prescribing generics was in response to the increased availability of non-clinical information like formulary status and pricing that led them to prescribe generics in an effort to lower the costs to patients. They emphasized that the finding of increased diversity in prescriptions indicated that the clinicians were not uniformly prescribing less costly drugs “at the expense of careful medical decision-making.” Instead, the additional information “may lead to a closer match between patient characteristics and available therapies.”

The study authors acknowledged that they could not establish a causal relationship between database use and changes in prescribing patterns, but nevertheless considered the results “suggestive of the idea that database use could reduce disparities in care.” Although the changes at the prescriber level were small, they could cumulatively lead to significant reductions in drug spending nationwide. They calculated that use of the database was associated with an estimated $35 million per year in cost savings.

Overall, these findings indicate that information technology tools can be an important resource in efforts to decrease medical spending and improve the quality of care, the authors concluded.

“Our estimates suggest that uneven access to information may contribute to heterogeneity in US healthcare provision and prescription drug costs, particularly along the branded-generic margin, and that connecting physicians to electronic information resources has the potential to reduce disparities in care,” they wrote.