Healthcare expenditures are a common cause of household bankruptcy and pharmaceutical costs contribute largely to the said expenses. Use of generic drugs has been shown to have a significant cost minimisation effect. In spite of this, the benefits of generic drug substitution are yet to be quantified or even fully explored in Kenya. This study sought to explore the patterns of generic drug use and factors that influence of generic drug use among the prescribers and dispensers in two high volume hospitals in Nakuru County, Kenya. The study focused on selected tracer drugs for cardiovascular Non-Communicable diseases. The study was in the form of case surveys using semistructured questionnaires and interviews. These were conducted over two weeks in two high volume hospitals: Rift Valley Provincial Hospital, and Evans Sunrise Medical Centre, Nakuru. A sample of 50 providers was selected with responses from Forty three providers (43) including thirty three (33) prescribers and ten (10) dispensers across the two institutions. By the end of the 2 weeks of the study, 43 out of the 50 providers contacted participated in the study. Analysis was done to elicit any associations existent in the generic drug use patterns amongst the providers. The study revealed that the factors that influenced the providers’ prescribing and dispensing habits in hospitals were the cost of the drugs, quality of the drugs, fear of counterfeits, prescriber preference of the drug, availability of the drugs and influence from pharmaceutical firms. The study also found that majority of the respondents (90% Dispensers and 87.6% Prescribers) support generic drug use, generic drug prescription (80% Dispensers and 60.6% Prescribers), and generic drug substitution (70% Dispensers and 33.3% Prescribers) as means of lowering the cost of health care. 90.6% of Prescribers were unaware of legal provisions governing generic drug use while 88.9% of Dispensers were aware of the provisions. Further, the study found that there were patterns of association between providers’ prescribing and dispensing habits and provider and institutional factors. The key provider factors were level of training and awareness of legal provisions governing generic drug use. The key institutional factors were presence of institutional policies governing the use of generic drugs as well as availability of generic drugs. There is great potential in cost containment through quality generic drug use, thus the need for awareness, promotion and enforcement of generic drug use policies among the providers by health institutions and the Government as the providers play a key role in determining the use of generic drug use.