Physicians prescribe less brand name drugs when EHR default settings show generics first
Findings point to simple strategy to cut drug costs, reduce unnecessary health care spending
2014-11-18
(Press-News.org) PHILADELPHIA - Programming electronic health records to make generic drugs the default choice when physicians write prescriptions may offer one way to reduce unnecessary spending and improve health care value in the face of spiraling U.S. health expenditures, according to a new study from researchers in the Perelman School of Medicine, The Wharton School and the Center for Health Incentives and Behavioral Economics (CHIBE) at the University of Pennsylvania, and the Philadelphia VA Medical Center. The study is published in a special issue of Annals of Internal Medicine featuring research from Robert Wood Johnson Foundation (RWJF) clinical scholars on innovative high-quality and high-value health care initiatives.
"Prescribing brand-name medications that have a generic equivalent is a prime example of unnecessary health care spending because in most cases, generic medications are less expensive, similar in quality and may actually lead to better outcomes than brand names because of higher rates of patient adherence to generics," said lead study author Mitesh S. Patel, MD, MBA, MS, assistant professor of Medicine and Health Care Management at Penn who is a graduate of the RWJF Clinical Scholars Program. "The results of this study demonstrate that leveraging default options can be very effective way to change behavior."
The study included four ambulatory clinics (two internal medicine and two family medicine) in the University of Pennsylvania Health System between June 2011 and September 2012 and evaluated the difference in prescribing behavior for three commonly prescribed classes of medications--beta-blockers, statins and proton-pump inhibitors--between family medicine and internal medicine physicians. The study looked at a total of 8,934 prescriptions in the pre-intervention period (6,698 from internal medicine and 2,336 from family medicine), and a total of 12,443 prescriptions during the intervention period (9,012 from internal medicine and 3,431 from family medicine). During the intervention phase of the study, the family medicine physicians (17 attendings and 34 residents) continued to be shown both brand name and generic medication options within the EHR medication prescriber portal, but internal medicine physicians (38 attendings and 166 residents) were shown a different display of only the generic medication options, with the ability to opt out. When compared to family medicine physicians that did not receive the intervention, internal medicine physicians had a significant increase in generic prescribing rates of 5.4 percentage points for all medications, 10.5 percentage points for beta-blockers, and 4.0 percentage points for statins.
"Not only was changing the default options within the EHR medication prescriber effective at increasing generic medication prescribing, this simple intervention was cost-free and required no additional effort on the part of the physician," added Patel. "The lessons from this study can be applied to other clinical decision efforts to reduce unnecessary health care spending and improve value for patients."
INFORMATION:
The other study authors, all of whom are from Penn, include Susan Day, MD, MPH, Dylan S. Small, PhD, John Howell, III, MD, Gillian L. Lautenbach, MD, Eliot H. Nierman, MD, and Kevin G. Volpp, MD, PhD. Patel's work on this study was supported by the Department of Veteran Affairs and the Robert Wood Johnson Foundation.
Penn Medicine is one of the world's leading academic medical centers, dedicated to the related missions of medical education, biomedical research, and excellence in patient care. Penn Medicine consists of the Raymond and Ruth Perelman School of Medicine at the University of Pennsylvania (founded in 1765 as the nation's first medical school) and the University of Pennsylvania Health System, which together form a $4.3 billion enterprise.
The Perelman School of Medicine has been ranked among the top five medical schools in the United States for the past 17 years, according to U.S. News & World Report's survey of research-oriented medical schools. The School is consistently among the nation's top recipients of funding from the National Institutes of Health, with $392 million awarded in the 2013 fiscal year.
The University of Pennsylvania Health System's patient care facilities include: The Hospital of the University of Pennsylvania -- recognized as one of the nation's top "Honor Roll" hospitals by U.S. News & World Report; Penn Presbyterian Medical Center; Chester County Hospital; Penn Wissahickon Hospice; and Pennsylvania Hospital -- the nation's first hospital, founded in 1751. Additional affiliated inpatient care facilities and services throughout the Philadelphia region include Chestnut Hill Hospital and Good Shepherd Penn Partners, a partnership between Good Shepherd Rehabilitation Network and Penn Medicine.
Penn Medicine is committed to improving lives and health through a variety of community-based programs and activities. In fiscal year 2013, Penn Medicine provided $814 million to benefit our community.
ELSE PRESS RELEASES FROM THIS DATE:
2014-11-18
This news release is available in French.
Montreal, November 17, 2014 - Resistance to antibiotics is an important health concern that affects both the spread of infections, like Clostridium difficile, and the medication budget. Researchers at the McGill University Health Centre (MUHC) examined the effectiveness of adopting an antibiotic "time-out" during treatment, which involves regularly re-evaluating the treatment strategy as the clinical situation evolves. The study, published in this month's issue of the Annals of Internal Medicine, showed that structured time-outs, ...
2014-11-17
Minneapolis, MN - November 17, 2014 - At the 2014 American Heart Association Scientific Sessions in Chicago, Ill., Minneapolis Heart Institute Foundation Research Cardiologist Dr. Michael Miedema gave a presentation entitled "The Implications of the Recent American College of Cardiology/American Heart Association Guidelines for the Treatment of Blood Cholesterol on a Rural Community: The Heart of New Ulm Project."
"The recently released cholesterol guidelines appear to have significantly increased the number of middle-aged adults who qualify for a cholesterol-lowering ...
2014-11-17
MAYWOOD, Ill. - Obesity is a known risk factor for atrial fibrillation, the most common heart rhythm disorder.
Obesity is commonly measured as a person's body mass index (BMI). But a Loyola University Medical Center study has found that the layer of fat around the outside of the heart is more closely associated with atrial fibrillation than BMI.
"Many people who would not be considered obese by their BMI nevertheless have high volumes of fat around their hearts, which could put them at risk for atrial fibrillation. Simple measures such as BMI may fail to completely ...
2014-11-17
CHICAGO - Most patients with implantable cardioverter defibrillators (ICDs)--small devices placed in a person's chest to help treat irregular heartbeats with electrical pulses, or shocks--haven't thought about device deactivation if they were to develop a serious illness from which they were not expected to recover. But given changes in healthcare, there may be a new reason to do so. A new study led by researchers in the Perelman School of Medicine at the University of Pennsylvania, which was presented today at the 2014 Scientific Sessions of the American Heart Association, ...
2014-11-17
We like to think of evolution as a fine-tuning process, one that whittles away genetic redundancies. The only problem is, we are not fine-tuned machines. Our bodies are chock-full of parts that either don't work anymore or are so buggy that our biology has Macgyvered a way to make it work.
Take our DNA. No, seriously, take our DNA. It's mostly garbage anyways. Fifty percent of our genome is comprised of genetic parasites, called transposable elements or transposons, that usually lie dormant. When they are allowed to move around the genome, they can wreak havoc on our ...
2014-11-17
African Americans, Hispanics, and those who receive care at a community hospital are all significantly less likely than other patients to receive treatment for early stage non-small cell lung cancer, according to a report in the Journal of Thoracic Oncology.
"We found significant disparities for treatment of a curable cancer based on race, insurance status, and whether or not treatment was at an academic or community hospital," said Dr. Matthew Koshy, a physician in the department of radiation oncology at the University of Illinois at Chicago College of Medicine, and ...
2014-11-17
ANN ARBOR--In recent years, scientists have linked chemicals known as phthalates with complications of pregnancy and fetal development.
Now, a study led by researchers at the University of Michigan School of Public Health sheds light on the mechanism that may be to blame.
Phthalates are chemicals used to make plastic materials more flexible and can also be found in personal care products such as perfumes, deodorants and lotions. They can enter the human body by being ingested, inhaled or through the skin. Most often phthalates are metabolized and excreted quickly, but ...
2014-11-17
Increasing the amount of omega-3s in your diet, whether from fish or flax, will likely decrease your risk of getting heart disease, according to Penn State nutritionists.
A substantial amount of evidence exists supporting the heart-health benefits of eicosapentaenoic acid and docosahexaenoic acid (EPA and DHA), marine-derived omega-3 fatty acids. However, much less evidence exists to demonstrate the positive effects of alpha-linolenic acid (ALA), a plant-based omega-3 fatty acid.
"The benefits reported for EPA and DHA are stronger because supplements of EPA and DHA ...
2014-11-17
VIDEO:
An ultra-high-resolution NASA computer model has given scientists a stunning new look at how carbon dioxide in the atmosphere travels around the globe. Plumes of carbon dioxide in the simulation...
Click here for more information.
An ultra-high-resolution NASA computer model has given scientists a stunning new look at how carbon dioxide in the atmosphere travels around the globe.
Plumes of carbon dioxide in the simulation swirl and shift as winds disperse the greenhouse ...
2014-11-17
A team of 14 scientists led by David Williams of Arizona State University's School of Earth and Space Exploration has completed the first global geologic and tectonic map of the asteroid Vesta. The work reveals that Vesta's history has been dominated by impacts from large meteorites.
The mapping was carried out using images from NASA's Dawn spacecraft, which orbited Vesta between June 2011 and September 2012. The images let scientists create high-resolution geological maps, revealing the variety of Vesta's surface features in unprecedented detail.
"The geologic mapping ...
LAST 30 PRESS RELEASES:
[Press-News.org] Physicians prescribe less brand name drugs when EHR default settings show generics first
Findings point to simple strategy to cut drug costs, reduce unnecessary health care spending
