The simple act of listing generic drugs first in a physician's electronic health record can substantially increase generic prescribing and lower the cost of healthcare, according to a new study in the Annals of Internal Medicine.
The researchers, from the University of Pennsylvania and the Philadelphia VA Medical Center, evaluated two family medicine ambulatory clinics and two internal medicine ambulatory clinics between June 2011 and September 2012, reviewing 8,934 prescriptions pre-intervention and 12,443 during the intervention period for beta blockers, statins and proton-pump inhibiters.
In the intervention period, the family medicine physician's EHR listed both brand name and generic drugs in the prescription portal. However, the internal medicine's EHRs were configured so that only generic drugs were listed, although the physicians had the opportunity to opt out.
The change impacted the physicians' prescribing behavior. The internal medicine physicians had a "significant" increase in generic prescribing of 5.4 percent for all three types of drugs. The increase in generic prescribing for beta blockers was 10.5 percent.
"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," lead study author Mitesh Patel, an assistant professor of Medicine and Health Care Management at Penn, said in a statement. "The results of this study demonstrate that leveraging default options can be very effective way to change behavior."
The researchers also pointed out that the change in default settings in the EHR cost nothing to implement and created no additional burdens on the physicians.
Other studies have shown that EHRs can directly reduce costs, such as through avoiding duplicative unnecessary tests. They also decrease costs--and improve patient care--by preventing illness and reducing medical errors.