Electronic alerts persuade clinicians to switch from costly drugs to generic brands
Simple computerized alerts can help curb the impulse to prescribe unnecessarily expensive, heavily marketed drugs. A study in the August issue of Journal of General Internal Medicine found that when clinicians received computerized alerts, which compared medication brands, they changed 23.3 percent of prescriptions for four heavily marketed sleep medications to comparable generic equivalents.
The alerts provided links to supplementary information, including supporting evidence for the recommendations, specific co-payment information and patient educational materials about sleep hygiene and insomnia. They were triggered when a new prescription for a heavily marketed drug appeared in the electronic health records system.
"Prescription drugs remain a key component of health care expenses, totaling more than $216 billion per year. If we can reduce unnecessary prescriptions for high-priced, heavily marketed drugs that are prescribed, we can directly lower some of the high costs associated with health care," said Robert J. Fortuna, M.D., M.P.H., a senior instructor of Pediatrics and Internal Medicine at the University of Rochester Medical Center.
Some clinicians received computerized alerts while others received alerts accompanied with educational sessions and a third control group of clinicians received no alerts. The two groups of clinicians who received alerts were much less likely to start newly prescribed patients with name brand drugs. Fortuna said that once a patient has already been prescribed a medication, it can be difficult to persuade the patient to change to a new medication, which explains why a steady rate of name brand prescriptions still persisted among the groups who received interventions. Overall, the alerts were well received by clinicians and many reported that it prompted discussion regarding costs and alternative therapies with patients.