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Lisa M Kalisch, Elizabeth E Roughead, Andrew L Gilbert, Pharmaceutical brand substitution in Australia: Identifying factors associated with having multiple brand substitutions, International Journal of Pharmacy Practice, Volume 17, Issue 6, December 2009, Pages 339–344, https://doi.org/10.1211/ijpp.17.06.0004
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Abstract
The aim was to determine the frequency with which people have multiple brand changes for more than one medicine and to identify factors associated with having multiple brand substitutions.
The setting was the Repatriation Pharmaceutical Benefits Scheme, a national subsidised scheme for medicines supply in Australia. We used a retrospective cohort design using prescription claims data for subsidised medicine dispensings from 1 June 2005 to 31 August 2006. Analysis was limited to patients with the opportunity for brand substitution of two or more medicines. ‘Switches’ were identified for each medicine if different brand or generic products were supplied at consecutive dispensings. Multivariate analysis was conducted to identify factors associated with patients who had multiple switches during follow-up.
A total of 84 040 people were included. On average, they received 11 prescription medicines. Forty-nine per cent of people received the same product throughout follow-up for each medicine and 34% had a single brand substitution. Seventeen per cent had multiple switches for one or more medicine; however, only 3% of all patients had multiple switches for more than one medicine. Independent factors associated with having multiple switches were increasing number of hospital admissions, prescription medicines, co-morbidities, prescribers, dispensing pharmacies and living in an aged-care facility or city.
Most patients do not have multiple brand substitutions of their medicine, even when all medicine use is considered. This is the first study to identify factors associated with having multiple brand substitutions. Quality use of medicines interventions targeting individuals with these risk factors could minimise the potential for patient confusion as a result of multiple brand changes.
