Exploring medical scheme drug formulary influence on general practitioners prescribing decisions

Abstract

The purpose of the study was to explore the influence of drug formulary on General Practitioners (GPs) prescribing decisions. Based on the tri-focal theories namely; Agency, Implementation and Planned Behaviour, the study followed a qualitative methodology. A total of 12 GPs in private practice were purposively selected. Semi-structured face-to-face interviews were conducted over a month in Johannesburg North. Results of the study confirm that the top four category factors influence most of the GPs. These being; patient factors, external factors, environmental and drug factors. Patient factors included medical aid drug formulary, the drug cost, patients' pathology and affordability. External factors included national treatment guidelines, scientific talks, medical sales representatives and interactions with pharmaceutical companies. Environmental factors included characteristics of GPs such as familiarity and numbers of years in practice. Drug factors included drug efficacy, availability and particularly the drug levies referred to as drug co-payments. This study has business and policy implications in the way health authorities make economic over clinical decisions. The study proposes a decision-making model and further delineates future research in understanding how GPs prescribe. Academically, it adds to the body of knowledge in healthcare.