Prescribing generic drugs in place of their more expensive brand-name counterparts can improve medication adherence and clinical outcomes while reducing drug spending, a physician's group said in a new paper.

The paper, published Monday in Annals of Internal Medicine by the American College of Physicians, said brand-name drugs are frequently prescribed even when generics are available.

For example, the ACP pointed to a 2013 study of Medicare beneficiaries with diabetes in which the use of brand-name drugs with identical generic counterparts accounted for 23% to 45% of prescriptions, depending on the class.

According to that study, Medicare could save $1.4 billion for patients with diabetes by substituting generic drugs and therapeutic alternatives, or those drugs that are chemically different but therapeutically similar, the ACP said in a statement accompanying the paper.

The underuse of generic drugs is in part a result of patient and physician perceptions about the safety and efficacy of such drugs, as well as confusion about the difference in appearance between generics and their brand-name counterparts, the ACP said.

The ACP also said prescribing generic drugs could motivate better long-term adherence to drug therapies, as higher out-of-pocket costs are associated with lower rates of long-term medication adherence. In addition, brand-name drug prescriptions are almost twice as likely to be left at the pharmacy after being filled.

Furthermore, the majority of evidence shows that generic drugs are as effective as their brand-name counterparts, according to the paper.

Plan sponsors and other payers can implement strategies such as prior authorization, step therapy and financial penalties, like higher copayments, for using brand-name drugs in place of generics to increase generic usage and lower costs, the ACP said.

In addition, educating patients on the bioequivalence of generics and brand-name medications could encourage patients to make value-conscious decisions, according to the paper.

“While the use of generic drugs has increased over time, clinicians often prescribe more expensive brand-name drugs when equally effective, well-proven and less expensive generic versions are available,” ACP President Dr. Wayne J. Riley said in the statement. “The use of generic drugs is a high-value care way to improve health, avoid harms and eliminate wasteful practices.”