Physicians prescribed less-costly drugs when their electronic health record systems were set to default to generic medications, according to a study published in the Annals of Internal Medicine, Health Data Management reports.

Details of Study

The study was conducted by researchers from the University of Pennsylvania's Center for Health Incentives and Behavioral Economics, Perelman School of Medicine and Wharton School, as well as the Philadelphia Veterans Affairs Medical Center.

The study included four of the University of Pennsylvania Health System's ambulatory clinics. Two of the clinics specialize in internal medicine, and the other two specialize in family medicine.

The clinics were observed from June 2011 to September 2012 and evaluated for changes in physicians' prescribing behaviors for three commonly prescribed medication classes:

• Beta-blockers;
• Proton-pump inhibitors; and
• Statins.

Overall, researchers examined 8,934 prescriptions during the pre-intervention period and 12,443 prescriptions during the intervention period.

Throughout the study's intervention phase, family medicine physicians were shown both generic and brand-name prescription possibilities through their EHR prescribing. Meanwhile, the internal medicine physicians were shown only generic medication possibilities and had the option to opt out of the display and select a different drug.

Findings

The study found that internal medicine physicians prescribed significantly more generic medications during the intervention period when compared with family medicine physicians who were shown both generic and brand-name options.

Overall, internal medicine physicians increased their generic prescribing rates by 5.4 percentage points for all medications. Specifically, they increased generic prescribing rates by:

• 10.5 percentage points for beta blockers; and
• 4 percentage point for statins (Goth, Health Data Management, 11/19).

Implications

Lead study author Mitesh Patel wrote that the findings show "that leveraging default options can be a very effective way to change behavior" (Penn Medicine study, 11/16).

Patel added, "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" (Bresnick, EHR Intelligence, 11/18).