Observational studyBMJ open2025
Breaking brand: an observational study on pharmacy-hospital-patient relationships and generic drug utilisation in Japan.
Observational study in BMJ open, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Authors and funding
5 authors.
Funding
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Abstract
objectivesTo examine how relationships between physicians, pharmacists and patients associate with generic drug (GE) utilisation in Japan's healthcare system.
designObservational study using longitudinal medical claims from April 2015 to March 2021.
settingPharmacies across Japan serving beneficiaries of the National Health Insurance Association.
participants69 395 pharmacies, resulting in 322 097 pharmacy-year observations.
main outcome measuresQuantity share of GEs dispensed by pharmacies.
resultsHigher hospital prescription concentration was consistently associated with increased GE usage (1.1-2.3 percentage points higher for moderate to very high concentrations compared with low). The relationship between patient prescription concentration and GE usage varied, showing a positive association (0.3-0.6 percentage points higher) overall, but negative in settings with low hospital concentration. Smaller pharmacies exhibited a stronger positive association between hospital concentration and GE usage, while larger pharmacies and those in less urbanised areas showed a stronger positive association between patient concentration and GE usage.
conclusionsThis study reveals that pharmacy-stakeholder relationships significantly influence GE utilisation in Japan's healthcare system. Our findings demonstrate that hospital-pharmacy relationships consistently drive generic usage, while patient-pharmacy relationships show contextual effectiveness. By measuring these relationships through concentration rates, we provide evidence that stakeholder interactions may affect medication dispensing decisions. These findings suggest that policies promoting GEs may benefit from considering the specific characteristics of pharmacies and their existing relationships with hospitals and patients. These insights can inform more effective policy design for GE promotion across different healthcare contexts.
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