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KMID : 1011320100030030119
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Journal of Pharmacoepidemiology and Risk Management
2010 Volume.3 No. 3 p.119 ~ p.127
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Switching Pattern between Original and Generic Medication among Korean Elderly Patients
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Shin Ju-Young
Choi Nam-Kyong
Jung Sun-Young
Park Byung-Joo
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Abstract
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Objective: To describe the switching pattern between original and generic medication and to know its determinants affecting switching in the elderly who received ambulatory care with the prescription of glimepiride in Korea.
Methods: Using claims data of Korea Health Insurance Review and Assessment Service, the patients who were prescribed at least twice of glimepiride between 1 January 2005 and 31 January 2005 were included. Study subjects were observed from their first prescription to the date of discontinuation or 31 December 2005, whichever was reached first. The main outcome measure was the number of switching and number of products per patient during the follow-up period. Based on this, patients were defined as no-switch, switch, switch-back. Switching status and proportion were calculated and compared between original initiator and generic initiator. We described dirverse switching pattern. Potential determinants of being switcher included age, gender, geographical location, the type of medical service, the number of providers, length of follow-up period, initiagting drug. Logistic regression analysis was performed to know the determinants of switching.
Results: Glimepiride treated 336,040 patients were analysed. Switching pattern was categorized into 20 types. Overall more than 70% of patients had not switched their medication. Switch group consisted of 17.7%, switch-back group was 10.6%. Original initiator showed higher proportion of ‘no switch’ than generic initiator, however, odds of being a switcher had no difference between original and generic initiator. The odds of being a switcher was associated with female (OR=1.1, 95% CL=1.1-1.2), lenth of follow-up period (OR=5.0, 95% CL=4.8-5.1), increasing number of prescribers (OR=89.8, 95% CL=79.1-101.9), use of medical institutions in urban areas (OR=1.6, 95% CL=1.6-1.7).
Conclusion: Most patients in this study did not switch their medication, and those who did were more likely to demonstrate switch than have switch-back. Factors affecting switching were the number of prescribers, lenth-of follow-up period, medical institutions in urban, female. Further study for investigating switching pattern on provider-based anlaysis should be performed.
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KEYWORD
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Generic, Original, Switch, Switch-back, Drug episode, Elderly
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