الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
International Nonproprietary Name (INN) prescribing is the use of the name of the active ingredient(s) instead of the trade name for prescribing. An INN identifies a pharmaceutical substance or active pharmaceutical ingredient by a unique name that is globally recognized and is a public property. A non-proprietary name is also known as a generic name.The generic drug has been defined as a term referring to any drug marketed under its chemical name without advertising. Generic medicines are clinically interchangeable with original brand medicines and have the same quality, efficacy and safety profiles. They are, nevertheless, much cheaper in price because there is no need to make investments in research and development as in the case of new drugs.
This study aims to:
1. Assess knowledge and perception of hospital physicians regarding INN (generic name) prescribing.
2. Investigate generic name prescribing practice by hospital physicians.
3. Estimate the potential cost savings that could be attained from generic name prescribing practice.
The study was conducted in a 280-bed specialized Ministry of Health Fever Hospital in Alexandria, Egypt. The hospital provides services for the management of infectious diseases for the population of Alexandria and Western Delta. The study sample consisted of 400 medical records selected from various hospital inpatient departments using proportional allocation method and the systematic random technique,andphysicians with the prescribing authority who are privileged to attend patients; they were 130 physicians.
As regards data collection, data was collected using;
- A sheet for abstracting the following data from the medical record; age, medical record number, department name, diagnosis, length of stay, prescribed drugs, amount, type of drug prescribing (INN or trade name), the available lowest-priced generic equivalent, price and total prices for the prescribed drugs and their lowest-priced generic equivalents.
- A self-administered questionnaire to physicians. The questionnaire included five main sections. The first section includes eight questions about socio-demographic and background characteristics of the participants. The second section includes 15 questions for assessing physicians’ knowledge about INNs and generic medicines. The third section includes 16 questions for assessing Physicians’ perception about INNs and generic medicines. The fourth section includes a question for assessing the frequency of using INNs in daily practice. The fifth section includes a semi closed question for assessing the barriers preventing physicians from using INNs in daily practice.
The study revealed the following findings:
1. INN prescribing was not widely adopted in the inpatient departments of Fever Hospital (percentage of drugs prescribed in INN was 52.61%).
2. Implementation of INN prescribing practice to the sampled prescriptions and the consequent dispensing of cheaper generic equivalentscould have resulted in 15,144 EGP savings to the health care payers.
3. Generally, the study physicians were knowledgeable about INNs, with a knowledge score meanof 15.01 ± 1.772 which ranged from 0 to 18. However, 60% of the study physicians wereunaware ofregulations mandating INN prescribing in the public sector.
4. Gaps in knowledge of generic medicines were identified among the study physicians, with a knowledge score mean of 18.90 ± 4.262 which ranged from 6 to 30, especially in terms of bioequivalence, safety and efficacy of generic medicines.
5. The differences in physicians’ mean knowledge scores in relation to age, years in medical practice and years in Fever Hospital are statistically significant(p=0.000, p=0.000 and p=0.002 respectively).
6. The differences in physicians’ use of INNs in daily practice in relation to their knowledge about generic medicines are statistically significant(p=0.044).
7. Generally, the study physicians had positive perceptions regarding INNs and generic medicines, with a perception score mean of 61.52 ± 5.366 which ranged from 16 to 80.However, 54% of the study physicians had concerns about the quality of generic medicines.
8. The differences in physicians’ use of INNs in daily practice in relation to their perception about INNs and generic medicines are statistically significant(p=0.049).
Based on the study findings, the following recommendations are suggested:
1. Activating the existing prescribing policies regarding INN prescribing, developing of training programs for physicians that clearly explain the new policies and their benefits, together with, the implementation of a national monitoring mechanism.
2. Developing trust for generic medicines in both MOHP firms and in the market.
3. Informing physicians about the quality, efficacy and safety of generic medicines through dissemination of evidence based information.
4. Developing an official guide on therapeutically substitutable medicines.
5. Implementing a standard guideline for both physicians and pharmacists on how and when to perform generic substitution.