Observational studyBMJ (Clinical research ed.)2018
Differences in rates of switchbacks after switching from branded to authorized generic and branded to generic drug products: cohort study.
Observational study in BMJ (Clinical research ed.), 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
12 citing papers in PubMed, 37 citations in OpenAlex.
- Generic Intravenous Amisulpride (QLG2069) for the Prevention of Postoperative Nausea and Vomiting in Adults: A Phase III, Multicenter, Randomized, Placebo-Controlled Study.Drug design, development and therapy · 2025Trial
- Factors influencing drug switching and changes in low-density lipoprotein-cholesterol levels with atorvastatin: a real-world observational study.Lipids in health and disease · 2023Observational
- Retrospective Database Analysis to Explore Patterns and Economic Burden of Switchback to Brand After Generic or Authorized Generic Utilization.ClinicoEconomics and outcomes research : CEOR · 2022Article
- Attitude and Purchase Intention to Generic Drugs.International journal of environmental research and public health · 2021Article
- Biosimilar medicines uptake: The role of the clinical pharmacist.Exploratory research in clinical and social pharmacy · 2021Article
- Quantification of Adverse Drug Reactions Related to Drug Switches in The Netherlands.Clinical and translational science · 2020Article
- The role of the Nocebo effect in the use of biosimilars in routine rheumatology clinical practice.Mediterranean journal of rheumatology · 2019Review
- Comparative effectiveness of generic and brand-name medication use: A database study of US health insurance claims.PLoS medicine · 2019Article
- Nocebos in rheumatology: emerging concepts and their implications for clinical practice.Nature reviews. Rheumatology · 2018Review
- Real World Evidence: Time for a Switch?Drug safety · 2018Article
- Evaluation of Switching Patterns in FDA's Sentinel System: A New Tool to Assess Generic Drugs.Drug safety · 2018Article
- Article
Corrections and comments
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Authors and funding
13 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesTo compare rates of switchbacks to branded drug products for patients switched from branded to authorized generic drug products, which have the same active ingredients, appearance, and excipients as the branded product, with patients switched from branded to generic drug products, which have the same active ingredients as the branded product but may differ in appearance and excipients.
designObservational cohort study.
settingPrivate (a large commercial health plan) and public (Medicaid) insurance programs in the US.
participantsBeneficiaries of a large US commercial health insurer between 2004 and 2013 (primary cohort) and Medicaid beneficiaries between 2000 and 2010 (replication cohort).
main outcome measuresPatients taking branded products for one of the study drugs (alendronate tablets, amlodipine tablets, amlodipine-benazepril capsules, calcitonin salmon nasal spray, escitalopram tablets, glipizide extended release tablets, quinapril tablets, and sertraline tablets) were identified when they switched to an authorized generic or a generic drug product after the date of market entry of generic drug products. These patients were followed for switchbacks to the branded drug product in the year after their switch to an authorized generic or a generic drug product. Cox proportional hazard models were used to estimate hazard ratios and 95% confidence intervals after adjusting for demographics, including age, sex, and calendar year. Inverse variance meta-analysis was used to pool adjusted hazard ratios across all drug products.
resultsA total of 94 909 patients switched from branded to authorized generic drug products and 116 017 patients switched from branded to generic drug products and contributed to the switchback analysis. Unadjusted incidence rates of switchback varied across drug products, ranging from a low of 3.8 per 100 person years (for alendronate tablets) to a high of 17.8 per 100 person years (for amlodipine-benazepril capsules), with an overall rate of 8.2 per 100 person years across all drug products. Adjusted switchback rates were consistently lower for patients who switched from branded to authorized generic drug products compared with branded to generic drug products in the primary cohort (pooled hazard ratio 0.72, 95% confidence interval 0.64 to 0.81). Similar results (0.75, 0.62 to 0.91) were observed in the replication cohort.
conclusionSwitching from branded to authorized generic drug products was associated with lower switchback rates compared with switching from branded to generic drug products.
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