Physicians' opinions and experiences of the Pharmaceutical Benefits Reform

Abstract

Aim: To investigate opinions on and experiences of the new Pharmaceutical Benefits Reform (PBR) among physicians working in the Swedish county council of Region Västra Götaland. Methods: Questionnaires were sent to all private practitioners who had contracts with the county council of Region Västra Götaland (n=320) and a random sample of 25% of the doctors employed by the same county council (n=1,068). The questionnaire comprised questions on how the physicians had received information on the PBR and sought opinions on the introduction of generic substitution in pharmacies, workplace codes, individual prescriber codes, and the Pharmaceutical Benefits Board. Analyses were performed with logistic regression. Results: The response rate was 65%. The majority of doctors had received sufficient information about the reform, most often from their employer, followed by the Drug and Therapeutics Committees. More than half of the respondents were positive about the introduction of generic substitution, which was associated with the respondent's age, experiences, and employer. Most of the doctors thought that generic substitution could reduce the health system's pharmaceutical expenditure, which was associated with the employer. One-third reported that generic substitution had caused problems for their patients in the past month. The probability of being mainly positive towards the newly created Pharmaceutical Benefits Board, which decides on reimbursement, increased with increasing age. Conclusions: Most participating doctors had received sufficient information about the reform and thought that generic substitution could save money for society. Age, employer, and experiences appeared to influence opinions on several issues.

Keywords

Pharmaceutical Benefits Reform healthcare reform physicians opinions experiences generic substitution

References

Ess SM , Schneeweiss S. , Szucs TD European healthcare policies for controlling drug expenditure. Pharmacoeconomics 2003;21:89—103.

Hoffmann M. Drug reform in Sweden: Major changes for patients, doctors and healthcare managers. Hospital—the Official Journal of the European Association of Hospital Managers 2004.

Act (2002:160) on Pharmaceutical Benefits, etc. SFS 2002: 160. 2002.

Ordinance (2002:687) on Pharmaceutical Benefits, etc. SFS 2002:687. 2002.

Lewis JM , Marjoribanks T. The impact of financial constraints and incentives on professional autonomy . Int J Health Plann Manage 2003;18:49—61.

Marjoribanks T. , Lewis JM Reform and autonomy: Perceptions of the Australian general practice community. Soc Sci Med 2003 ;56:2229—39.

Whynes DK , Baines DL Primary care physicians' attitudes to health care reform in England. Health Policy 2002;60: 111—32.

Wilf—Miron R. , Rotstein Z. , Noy S. , Turjeman A. , et al. Newly implemented health system reform in Israel: Physicians' attitudes. Health Policy 1999;49:137—47.

Hanning M. , Spangberg UW Maximum waiting time — a threat to clinical freedom? Implementation of a policy to reduce waiting times. Health Policy 2000;52:15—32.

10.

Hunter DJ , Shortt SE , Walker PM , Godwin M. Family physician views about primary care reform in Ontario: A postal questionnaire. BMC Fam Pract 2004;5:2.

11.

Rubak SL , Andersen ML , Mainz J. , Olesgaard P. , et al. [How do practitioners evaluate the newly introduced system of substituting prescriptions?]. Ugeskr Laeger 2000;162:6070—3.

12.

Tilyard MW , Dovey SM , Rosenstreich D. General practitioners' views on generic medication and substitution. N Z Med J 1990;103:318—20.

13.

Krueger RA , Casey MA Focus groups: A practical guide for applied research. 3rd ed. Thousand Oaks, CA: Sage Publications ; 2000.

14.

MacPherson I. , Bisset A. Not another questionnaire!: Eliciting the views of general practitioners. Fam Pract 1995;12:335—8.

15.

Brust M. , Hawkins CF , Grayson D. Physicians' attitudes toward generic drug substitution by pharmacists. Tex Med 1990;86:45—9.

16.

Andersson K. , Sonesson C. , Petzold M. , Carlsten A. , et al. What are the obstacles to generic substitution? An assessment of the behaviour of prescribers, patients and pharmacies during the first year of generic substitution in Sweden. Pharmacoepidemiol Drug Saf 2005;14:341—8.