Little is known about the treatments physicians choose for themselves compared with how they treat their patients. We determine if physicians prescribe different treatments to patients than to themselves.Methods
Population-based cohort study from 2004 to 2012 examining prescription claims of all Danish primary care physicians (PCP; n=3088) and all other Danish adults (n=2 334 590) who received a first-time prescription from a PCP for a statin (n=455 586), calcium channel blocker (CCB, n=330 369), serotonin-norepinephrine/selective serotonin reuptake inhibitors (SN/SSRIs, n=423 740), proton pump inhibitor (PPI, n=671 965) or antihistamine (n=456 018). The main outcome is the brand-name or generic status of the first prescribed drug. A logistic regression model compared outcomes, unadjusted and adjusted for sociodemographic characteristics and coverage information.Results
For drugs that require chronic treatment (statins, CCBs, SN/SSRIs), the relative risk (RR) for PCPs (PCP patients) being treated with a brand drug was 3.86 (95% CI 3.33 to 4.47; p<0.001). This difference remained significant when adjusting for covariates (adjusted RR=2.51 (95% CI 2.16 to 2.92; p<0.001)). For non-chronic drugs (PPIs, antihistamines), the RR for PCP patients was (RR=1.13 (95% CI 1.08 to 1.20; p<0.001)), and this difference was explained by higher income. Physicians are not more likely than non-physicians, however, to be treated with brand-name versions of drugs that are available as generics.Conclusion
Physicians are more likely than non-physicians to be treated with brand-name drugs without generic equivalents in three chronic treatment drug classes but not in two acute treatment drug classes. Guidelines can lead to lower brand-name drug use than physicians prefer for themselves.