{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,14]],"date-time":"2026-02-14T15:14:25Z","timestamp":1771082065579,"version":"3.50.1"},"reference-count":26,"publisher":"Oxford University Press (OUP)","issue":"1179","license":[{"start":{"date-parts":[[2023,10,12]],"date-time":"2023-10-12T00:00:00Z","timestamp":1697068800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,12,21]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>We aimed to examine the cost-related prescribing performance of primary care physicians who had a higher versus lower tendency of arbitrary prescribing.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>In this cross-sectional study, we evaluated the prescriptions of primary care physicians in Istanbul, collected with 3:1 systematic sampling. We determined higher versus lower arbitrary prescribing by the physician\u2019s degree of writing the solo diagnosis of \u201cZ00- General examination without diagnosis\/complaint\u201d: those for whom such prescriptions constituted &amp;gt;5% were classified as Group A and those with them at &amp;lt;0.5% as Group B. We compared these two groups by the total and disease-specific drug costs per prescription they produced for 10 frequently encountered indications.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>The median cost of disease-specific medication for all diagnoses in Group A and Group B, except anemia, was equal. In upper respiratory tract infections (URTIs), hypertension, anemia, diabetes, and conjunctivitis, the mean prescription costs of Group A were significantly higher than those of Group B (P\u2009&amp;lt;\u2009.001, P\u2009&amp;lt;\u2009.001, P\u2009=\u2009.009, P\u2009=\u2009.007, and P\u2009&amp;lt;\u2009.001, respectively), whereas disease-specific drug costs per prescription were similar (P\u2009&amp;gt;\u2009.05 in all diagnoses). In myalgia, Group A had lower cost per prescription (P\u2009&amp;lt;\u2009.001) and higher analgesic costs per prescription (P\u2009&amp;lt;\u2009.001) compared to those in Group B. We found significantly higher disease-specific drug cost share in Group B for URTIs (antibiotic), gastroesophageal reflux disease (gastric acid\u2013suppressant), hypertension (antihypertensive), anemia (iron preparations), diabetes (antidiabetic), depression (antidepressant), and conjunctivitis (corticosteroid) than those in Group A (P\u2009&amp;lt;\u2009.001 for each).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Our study showed that physicians who had a higher tendency of prescribing for no clear indication are also more likely to produce costly prescriptions.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/postmj\/qgad092","type":"journal-article","created":{"date-parts":[[2023,10,13]],"date-time":"2023-10-13T00:28:57Z","timestamp":1697156937000},"page":"36-41","source":"Crossref","is-referenced-by-count":1,"title":["Association of arbitrary prescribing behavior to costly drug expenditures: a pharmacoeconomic study in primary care"],"prefix":"10.1093","volume":"100","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8294-0802","authenticated-orcid":false,"given":"N Ipek","family":"Kirmizi Sonmez","sequence":"first","affiliation":[{"name":"Department of Pharmacology , School of Pharmacy, , Istanbul 34353 , Turkey"},{"name":"Bahcesehir University , School of Pharmacy, , Istanbul 34353 , Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8511-6349","authenticated-orcid":false,"given":"Volkan","family":"Aydin","sequence":"additional","affiliation":[{"name":"Department of Medical Pharmacology , International School of Medicine, , Istanbul 34815 , Turkey"},{"name":"Istanbul Medipol University , International School of Medicine, , Istanbul 34815 , Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2137-7352","authenticated-orcid":false,"given":"Omer","family":"Atac","sequence":"additional","affiliation":[{"name":"Department of Public Health , International School of Medicine, , Istanbul 34815 , Turkey"},{"name":"Istanbul Medipol University , International School of Medicine, , Istanbul 34815 , Turkey"},{"name":"Department of Health Management and Policy , College of Public Health, , Lexington, KY 40506 , United States"},{"name":"University of Kentucky , College of Public Health, , Lexington, KY 40506 , United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8593-0818","authenticated-orcid":false,"given":"Ahmet","family":"Akici","sequence":"additional","affiliation":[{"name":"Department of Medical Pharmacology , School of Medicine, , Istanbul 34854 , Turkey"},{"name":"Marmara University , School of Medicine, , Istanbul 34854 , Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2023,10,12]]},"reference":[{"key":"2023122205042917000_ref1","doi-asserted-by":"crossref","first-page":"704","DOI":"10.1377\/hlthaff.2020.00094","article-title":"National health expenditure projections, 2019\u201328: expected rebound in prices drives rising spending growth","volume":"39","author":"Keehan","year":"2020","journal-title":"Health Aff"},{"key":"2023122205042917000_ref2","doi-asserted-by":"crossref","first-page":"317","DOI":"10.1111\/j.1365-2125.2010.03708.x","article-title":"From NCE to NICE: the role of pharmacoeconomics","volume":"70","author":"Hughes","year":"2010","journal-title":"Br J Clin Pharmacol"},{"key":"2023122205042917000_ref3","doi-asserted-by":"crossref","first-page":"482","DOI":"10.2146\/ajhp130767","article-title":"National trends in prescription drug expenditures and projections for 2014","volume":"71","author":"Schumock","year":"2014","journal-title":"Am J Health Syst Pharm"},{"key":"2023122205042917000_ref4","volume-title":"Prescribing Costs in Hospitals and the Community","author":"NHSBSA Statistics and Data Science"},{"key":"2023122205042917000_ref5","volume-title":"Guide to Good Prescribing. 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