Physicians’ generic drug prescribing behavior in district hospitals: a case of Phitsanulok, Thailand

  • Pinyupa Plianbangchang
  • Kanchalee Jetiyanon
  • Charawee Suttaloung
  • Lalida Khumchuen
Keywords: Drugs, Generic, Drug Prescriptions, Thailand


Generic prescribing is a sound approach to contain health care costs. However, little is known about physicians’ prescribing patterns in the Thai context.

Objective: To explore physicians’ generic prescription patterns in district hospitals.

Methods: Data was collected from three of the eight district hospitals between January and December 2008 (final response rate 37.5%). All participating hospitals were between 30 and 60-bed capacity. The researchers reviewed 10% of total outpatient prescriptions in each hospital.

Results: A total of 14,500 prescriptions were evaluated. The majority of patients were under universal health coverage (4,367; 30.1%), followed by senior citizens’ health insurance (2,734; 18.9%), and civil servant medical benefit schemes (2,419; 16.7%). Ten thousand six hundred and seventy-one prescriptions (73.6% of total prescriptions) had at least one medication. Among these, each prescription contained 2.85 (SD=1.69) items. The majority of prescriptions (7,886; 73.9%) were prescribed by generic name only.  Drugs prescribed by brand names varied in their pharmacological actions. They represented both innovator and branded-generic items. Interestingly, a large number of them were fixed-dose combination drugs. All brand name prescriptions were off patented. In addition, none of the brand-name drugs prescribed were categorized as narrow therapeutic range or any other drug that had been reported to have had problems with generic substitution.

Conclusion: The majority of prescriptions in this sample were written by generic names. There is room for improvement in brand name prescribing patterns.


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1. Faramnuayphol P, Ekachampaka P, Taverat R, Wattanamano N. Health Services Systems in Thailand. In: Wibulpolprasert S, editor. Thailand Health Profile 2005-2007. Bangkok, Thailand: Veterans Organization of Thailand; 2007. p. 257-348.

2. Tangcharoensathien V, Harnvoravongchai P, Pittayaransarit S, Kasemsup V. Health impacts of rapid economic changes in Thailand. Soc Sci Med. 2000;51:789-807.

3. Tantivess S, Jierapong S, Jitraknatee A, Chakajnarodom S. Generic entry and drug expenditures of hospitals: case study of drugs approved by means of the new drug registration regulations. J Health Sci. 2002;11:167-176.

4. Fischer MA, Avron J. Economic consequences of underuse of generic drugs: evidence from Medicaid and implications for prescription drug benefit plan. Health Serv Res. 2003;38:1051-1063.

5. Tantivess S. Generic substitution in public and private hospitals in Thailand. J Health Sci. 2002;11:32-43.

6. Burapadaja S, Kawasaki N, Kittipongpatana O, Ogata F. Study on variation in price of prescription medicines in Thailand. Yakuga Zasshi. 2007;127:515-526.

7. Heikkila R, Mäntyselkä P, Hartikainen-Herranen K, Ahonen R. Customers’ and physicians’ opinions of and experiences with generic substitution during the first year in Finland. Health Policy. 2007;82:366-374.

8. Alghasham AA. Generic drug prescribing in central Saudi Arabia: perceptions and attitudes of physicians. Ann Saudi Med. 2009;29:24-29.

9. Al-Gedadi NA, Hassali MA, Shafie AA. A pilot survey on perceptions and knowledge of generic medicines among consumers in Penang, Malaysia. Pharm Pract (Internet). 2008;6(2):93-97.

10. Ministry of Public Health, Food and Drug Administration, Department of Drug Control. National Drug Policy B.E. 2536 (1993). Nonthaburi, Thailand: Ministry of Public Health; 1994. 50 p. [Transcript in Thai language]

11. Adair RF, Holmgren LR. 2005. Do drug samples influence resident prescribing behavior? A randomized trial. Am J Med. 2005;118:881-884.

12. General information regarding drug products [Internet]. Nonthaburi, Thailand: Ministry of Public Health, Food and Drug Administration, Drug Control Department; c2009 [cited 2009 Nov 28]. Available from:

13. Compilation of the Ministry Orders Regarding Pharmaceutical Formula Evocation [Internet]. Nonthaburi, Thailand: Ministry of Public Health, Food and Drug Administration, Drug Control Department; c2009. [cited 2009 Nov 28]. Available from: [Transcript in Thai language]

14. Pope ND. Generic substitution of narrow therapeutic index drugs. US Pharmacist. 2009;34 (Generic Drug Review supplement): 12-19.

15. Rokstad K, Straand J, Fugelli P. General practitioners’ drug prescribing practice and diagnosis for prescribing: the Møre & Romsdal Prescription Study. J Clin Epidemiol. 1997;50:485-494.

16. Hider P, Lay-Yee R, Davis P. Practitioners, patients, and their visits: a description of accident and medical (A&M) clinics in New Zealand 2001/2. New Zeal Med J. 2007;120:U2538.

17. Abraham J, Lewis G. Harmonising and competing for medicines regulation: how healthy are the European Union’s systems of drug approval? Soc Sci Med. 1999;48:1655-1667.

18. Hill S, Johnson K. Emerging challenges and opportunities in drug registration and regulation in developing countries. London: DFIC Health Systems Resource Center. 47 p.

19. Assavakijsiri V. 2009. The development of systematic review of drug registers in Thailand. Report presented at: The development of drug register review system; 2009 Nov 25; Bangkok, Thailand. [Transcript in Thai language]

20. Carrin G. Drug prescribing: A discussion of its variability and (ir)rationality. Health Policy. 1987;7:73-94.

21. Lambert BL, Salmon JW, Stubbings J, Gilomen-Study G, Valuck RJ, Kezlarian K. Factors associated with antibiotic prescribing in a managed care setting: an exploratory investigation. Soc Sci Med. 1997;45:1767-1779.

22. Steinman MA, Landefeld C, Gonzales R. Predictors of broad-spectrum antibiotic prescribing for acute respiratory tract infections in adult primary care. JAMA. 2003;289:719-725.

23. Stevenson FA, Greenfield SM, Jones M, Nayak A, Bradley C. GP’s perceptions of patient influence on prescribing. Fam Pract. 1999;16:255-261.
How to Cite
Plianbangchang P, Jetiyanon K, Suttaloung C, Khumchuen L. Physicians’ generic drug prescribing behavior in district hospitals: a case of Phitsanulok, Thailand. Pharm Pract (Granada) [Internet]. 2010Sep.3 [cited 2019Jul.23];8(3):167-72. Available from:
Original Research