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A systematic review of the literature comparing the practices of dispensing and non-dispensing doctors

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  • Lim, David
  • Emery, Jon
  • Lewis, Janice
  • Sunderland, V Bruce

Abstract

Objectives Some doctors perform the dual roles of prescribing and dispensing pharmaceuticals. The dispensing doctors (DDs) role may give rise to prescribing behaviours that vary from those of non-DDs. The aim of this review was to systematically and comparatively appraise the research evidence related to the practices of DDs.Methods A systematic search of bibliographic databases and reference lists from selected papers were the sources of the data. Inclusion criteria were papers published in English, between 1970 and 2008 that provided quantitative data comparing the practices of DDs and non-DDs. At least two of the authors abstracted data from all eligible papers using a purpose-made data extraction form.Results Twenty-one papers were included in this review. Evidence indicated that DDs prescribed more pharmaceutical items and less often generically than non-DDs. There was limited evidence to suggest that DDs prescribed less judiciously and were associated with poor dispensing standards. Patient convenience and access to pharmaceuticals were main reasons for doctors to dispense.Conclusion DDs can fill an important gap in the provision of pharmaceuticals for their patients especially where health workforce shortages exist. There was evidence the dispensing role influenced prescribing. Patient convenience should be balanced against scarce medical resources, being utilised for dispensing.

Suggested Citation

  • Lim, David & Emery, Jon & Lewis, Janice & Sunderland, V Bruce, 2009. "A systematic review of the literature comparing the practices of dispensing and non-dispensing doctors," Health Policy, Elsevier, vol. 92(1), pages 1-9, September.
    • Handle: RePEc:eee:hepoli:v:92:y:2009:i:1:p:1-9
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    References listed on IDEAS

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    1. Nizami, S. Q. & Khan, I. A. & Bhutta, Z. A., 1996. "Drug prescribing practices of general practitioners and paediatricians for childhood diarrhoea in Karachi, Pakistan," Social Science & Medicine, Elsevier, vol. 42(8), pages 1133-1139, April.
    2. Toshiaki Iizuka, 2007. "Experts' agency problems: evidence from the prescription drug market in Japan," RAND Journal of Economics, RAND Corporation, vol. 38(3), pages 844-862, September.
    3. Gilbert, Leah, 1998. "Dispensing doctors and prescribing pharmacists: A South African perspective," Social Science & Medicine, Elsevier, vol. 46(1), pages 83-95, January.
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    5. Kang, Hye-Young & Park, Chong Yon & Joong Kim, Han, 2002. "Public attitude and knowledge on a new health policy for pharmaceutical care in Korea," Health Policy, Elsevier, vol. 62(2), pages 195-209, November.
    6. Kwon, Soonman, 2003. "Pharmaceutical reform and physician strikes in Korea: separation of drug prescribing and dispensing," Social Science & Medicine, Elsevier, vol. 57(3), pages 529-538, August.
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    Cited by:

    1. Daniel Burkhard & Christian P. R. Schmid & Kaspar Wüthrich, 2019. "Financial incentives and physician prescription behavior: Evidence from dispensing regulations," Health Economics, John Wiley & Sons, Ltd., vol. 28(9), pages 1114-1129, September.
    2. Ben Greiner & Le Zhang & Chengxiang Tang, 2017. "Separation of prescription and treatment in health care markets: A laboratory experiment," Health Economics, John Wiley & Sons, Ltd., vol. 26(S3), pages 21-35, December.
    3. Olivia Bodnar & Hugh Gravelle & Nils Gutacker & Annika Herr, 2024. "Financial incentives and prescribing behavior in primary care," Health Economics, John Wiley & Sons, Ltd., vol. 33(4), pages 696-713, April.
    4. Boris Kaiser, Christian Schmid, 2013. "Does Physician Dispensing Increase Drug Expenditures?," Diskussionsschriften credresearchpaper02, Universitaet Bern, Departement Volkswirtschaft - CRED.
    5. Matthias Bannert & David Iselin, 2015. "Ask Your Doctor or Pharmacist! On the Effect of Self-Dispensing Physicians on Pharmaceutical Coverage," KOF Working papers 15-387, KOF Swiss Economic Institute, ETH Zurich.
    6. Boris Kaiser & Christian Schmid, 2016. "Does Physician Dispensing Increase Drug Expenditures? Empirical Evidence from Switzerland," Health Economics, John Wiley & Sons, Ltd., vol. 25(1), pages 71-90, January.
    7. Kaplan, Warren A. & Ritz, Lindsay Sarah & Vitello, Marie & Wirtz, Veronika J., 2012. "Policies to promote use of generic medicines in low and middle income countries: A review of published literature, 2000–2010," Health Policy, Elsevier, vol. 106(3), pages 211-224.

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