1Laboratorio per la Salute Materno-Infantile, Dipartimento di Salute Pubblica, Istituto di Ricerche Farmacologiche, “Mario Negri”, IRCCS, Milano; 2UO Governo dei Servizi sanitari territoriali e Politiche di appropriatezza e controllo, Regione Lombardia, Milano
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Key words: Generic drugs, Anti-bacterial agent, Child, Primary care physicians, Drug prescriptions
Aims - To evaluate the prescription profile of generic antibiotics in paediatric outpatient population in the Lombardy region.
Methods - All reimbursed prescriptions (class A) dispensed to children < 14 years old in 2008 resident in 15 Local Health Units (LHUs) of the Lombardy region were considered. Drugs were identified according to the Anatomical Therapeutic Chemical (ATC) classification system. An antibiotic was defined as any drug belonging to the J01 subgroup of the ATC classification. Antibiotics reported in the so-called “transparency list” of the Italian Medicines Agency (AIFA) were defined as off-patent. Drugs marketed under the active substance name were identified as “generic”.
Results - Overall 590,940 children (46% of residents) received at least an antibiotic prescription in 2008. About 79% of prescribed drugs were off-patent antibiotics and 29% were generic antibiotics. The amount of generic drugs prescribed varied among different active substances, ranging from 6% (clarithromycin) to 72% (amoxicillin). Wide differences were observed among LHUs, ranging from 12 to 48%. The average percentage of generic antibiotics prescribed by each paediatrician was 38.5 (median 37.7). Paediatricians classified as high prescribers prescribed slightly less generic antibiotics in comparison with their colleagues classified as low prescribers (median: 32.0 vs 40.6%; p=0.02). Generic drugs covered about 15% of the overall expenditure for antibiotics.
Conclusions - Generic drug prescription rate in paediatric outpatients is low. The differences observed between settings and prescribers call for targeted educational interventions on the generic drug use addressed to physicians and patients.
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