{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,29]],"date-time":"2025-10-29T09:35:05Z","timestamp":1761730505231,"version":"build-2065373602"},"reference-count":24,"publisher":"CSIRO Publishing","issue":"2","license":[{"start":{"date-parts":[[2025,8,16]],"date-time":"2025-08-16T00:00:00Z","timestamp":1755302400000},"content-version":"vor","delay-in-days":1621,"URL":"https:\/\/doi.org\/10.1071\/journalslicense"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,4,20]]},"abstract":"<jats:p>Medications form a significant portion of spending in primary health care. Angiotensin-converting enzyme inhibitors (ACE-Is) are among the most prescribed blood pressure medications in general practice. Medications within this class are considered therapeutically equivalent, but the cost of each ACE-I varies. Our aim was to explore cost and other factors that influence general practitioners (GPs) to prescribe a specific ACE-I and understand their views on therapeutic interchange within this drug class. We conducted a qualitative study of Australian GPs using thematic analysis. We found that GPs were aware of therapeutic equivalency within the ACE-I class, but unaware of the cost differences. Although GPs tended to adopt a prescribing preference, they were open to fewer prescribing options if there was a decreased cost to patients and the PBS, or potential to minimise prescribing error. Our findings have immediate relevance for national prescribing policies and the Pharmaceutical Benefits Scheme (PBS). The wide selection of ACE-Is that are available results in diverse prescribing patterns and may not be cost-effective for patients or the PBS. Restricting the number of drug options within the ACE-I class in primary care appears to be an acceptable drug cost-containment strategy according to our sample of GPs.<\/jats:p>","DOI":"10.1071\/py20208","type":"journal-article","created":{"date-parts":[[2021,3,8]],"date-time":"2021-03-08T20:28:06Z","timestamp":1615235286000},"page":"152-157","source":"Crossref","is-referenced-by-count":0,"title":["\u2018No-Frills Prils\u2019: GPs\u2019 views on drug costs and therapeutic interchange of angiotensin-converting enzyme inhibitors: a qualitative study"],"prefix":"10.1071","volume":"27","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2851-9915","authenticated-orcid":true,"given":"Hok","family":"Lim","sequence":"first","affiliation":[{"name":"ADepartment of General Practice, Melbourne Medical School, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Level 3, 780 Elizabeth Street, Melbourne, Vic. 3010, Australia."},{"name":"CCorresponding author. Email: hokl@unimelb.edu.au"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lena","family":"Sanci","sequence":"additional","affiliation":[{"name":"ADepartment of General Practice, Melbourne Medical School, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Level 3, 780 Elizabeth Street, Melbourne, Vic. 3010, Australia."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Susan","family":"Webster","sequence":"additional","affiliation":[{"name":"ADepartment of General Practice, Melbourne Medical School, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Level 3, 780 Elizabeth Street, Melbourne, Vic. 3010, Australia."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alyce N.","family":"Wilson","sequence":"additional","affiliation":[{"name":"BInternational Development, Burnet Institute, 85 Commercial Road, Prahran, Vic. 3181, Australia."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0665-6348","authenticated-orcid":true,"given":"Phyllis","family":"Lau","sequence":"additional","affiliation":[{"name":"ADepartment of General Practice, Melbourne Medical School, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Level 3, 780 Elizabeth Street, Melbourne, Vic. 3010, Australia."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"67","published-online":{"date-parts":[[2021,3,9]]},"reference":[{"key":"2025102822181909200_R1"},{"key":"2025102822181909200_R2","doi-asserted-by":"publisher","first-page":"194","DOI":"10.18773\/austprescr.2018.067","article-title":"Top 10 drugs 2017\u201318.","volume":"41","author":"Australian Prescriber","year":"2018","journal-title":"Australian Prescriber"},{"key":"2025102822181909200_R3","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD009868.pub3","article-title":"Fixed-dose combination therapy for the prevention of atherosclerotic cardiovascular diseases.","author":"Bahiru","year":"2017","journal-title":"Cochrane Database of Systematic Reviews"},{"key":"2025102822181909200_R4","doi-asserted-by":"publisher","first-page":"537","DOI":"10.1093\/ajhp\/56.6.537","article-title":"Therapeutic interchange of conjugated and esterified estrogens in a managed care organization.","volume":"56","author":"Baluch","year":"1999","journal-title":"American Journal of Health-System Pharmacy"},{"key":"2025102822181909200_R5","doi-asserted-by":"publisher","first-page":"77","DOI":"10.1191\/1478088706qp063oa","article-title":"Using thematic analysis in psychology.","volume":"3","author":"Braun","year":"2006","journal-title":"Qualitative Research in Psychology"},{"key":"2025102822181909200_R6"},{"key":"2025102822181909200_R7","doi-asserted-by":"crossref","first-page":"c2441","DOI":"10.1136\/bmj.c2441","article-title":"How New Zealand has contained expenditure on drugs.","volume":"340","author":"Cumming","year":"2010","journal-title":"BMJ (Clinical Research Ed.)"},{"key":"2025102822181909200_R8","unstructured":"Department of Health (2019) Pharmaceutical Benefits Scheme (Report on the Collection of Under Co-payment Data 2017\u201318). 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