目的： 藥廠研發新藥在專利保護期過後， 其他藥廠可以通過生體相等性(bioequivalence, BE) 試驗後製造同成分的學名藥 (generic drug)。因過專利期，藥品價格自然調降。同成分及含量的學名藥，不論是研發廠藥 (brand name drug) 或非研發廠生產之學名藥，在醫療經營者可選擇其中一種或二種並存來供醫師開方選擇。
方法：本研究以卡方檢定來分析某醫學中心使用降血壓及血脂藥品比例最高的心臟內科、心臟外科及最具相關性之腎臟科醫師在藥品使用量於研發廠藥與一般學名藥間的選擇行為。
結果：醫師傾向選擇研發廠藥 (p < 0.001)。心臟內科醫師在大部分之高血壓藥物，包括鈣離子阻斷劑 (calcium channel blocker)、乙型阻斷劑 (beta-blocker) 及血管收縮素受體阻斷劑 (angiotensin receptor blocker) 選擇上等較其他科別更傾向研發廠藥 (p < 0.001)。腎臟科醫師在使用與腎功能有關之降血脂藥物pitavastatin 時更傾向使用研發廠藥 (p < 0.001)。本研究所分析之所有一般學名藥物中，進口藥使用量多於臺灣廠製造的一般學名藥 (p < 0.001)。
結論：醫師的專科專業與藥物特性之關連性越高，選擇研發廠藥的比例也較高，其動機可能為醫療品質之維持及對原研發廠之品牌信任。欲提升學名藥之可信賴度與使用率，未來應鼓勵人員妥善利用藥物品管及藥品不良反應通報系統，以利衛生主管機關監控藥品品質，進而減少醫師在學名藥處方上之選擇差異。
Objective: Patent protection for an original drug expires after the protection period. After expiration, generic drugs having the same drug components can be produced and marketed if bioequivalence has been demonstrated. The drug price can be reduced through market competition, and hospital managers can either choose a generic drug produced by the original company (DO) or by an alternative company (DA) or choose both.
Methods: In this study, chi-square test was used to analyze the prescription choices between DO and DA in a medical center for antihypertensive and hyperlipidemia drugs. The prescription behaviors made by cardiologists, ephrologists, and cardiac surgeons were analyzed.
Results: The physicians tended to prescribe DO over DA. Cardiologists tended to prescribe DO for most antihypertensive medications (p < 0.001), including beta blockers, calcium channel blockers, and angiotensin receptor blockers, whereas nephrologists tended to prescribe DO for pitavastatin (p < 0.001), a drug that is specifically related to renal functions. DOs made by foreign companies were more often prescribed than were DOs made by Taiwanese companies (p < 0.001).Conclusions: Physicians tended to select a DA if it was highly related to the physician’s specialty category. The strong preference for DA observed in this study could be accounted for by the intention to ensure high quality of care and by trust in the original company. In the future, to enhance the credibility of generic drugs, pharmacologists should perform quality control by recording adverse drug-related events to facilitate monitoring of the quality of medicines by the health authorities.
