Effect of Peer Comparison Feedback and Professional Norms on Vitamin D Testing and Generic Medication Prescribing.
NEJM EvidAug 25, 2026 (epub)
Clinical ResearchInternal Medicine (General)
Tobias Müller, Michael Gerfin, Raf Van Gestel
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In 30 seconds
This randomized controlled trial evaluated the impact of peer comparison feedback on vitamin D testing and generic medication prescribing among primary care physicians in Switzerland. The intervention significantly reduced vitamin D testing by 3.66 tests per 100 patients (95% CI, -5.42 to -1.89; P<0.001), but did not increase generic prescribing rates.
Key findings
- Vitamin D testing decreased by 3.66 tests per 100 patients (95% CI, -5.42 to -1.89; P<0.001).
- Generic medication prescribing showed no significant change, with a mean difference of +0.57 percentage points (P=0.37).
- Reductions in vitamin D testing varied among physician subgroups, ranging from one to seven tests per 100 patients.
- Higher baseline generic prescribing rates correlated with increased generic substitution post-intervention.
Why it matters
Reducing unnecessary vitamin D testing can help decrease healthcare costs and improve the quality of care. Understanding the effectiveness of peer comparison feedback may inform future strategies to address low-value care in clinical practice.