Zunker R J, Carlson D L
Prime Therapeutics, Inc., St. Paul, MN 55164-0812, USA.
Am J Health Syst Pharm. 2000 Apr 15;57(8):753-5. doi: 10.1093/ajhp/57.8.753.
An educational program designed to help physicians control the overall cost of drugs and total health care is described, along with its effectiveness at one managed health care plan. Prime Therapeutics, Inc., developed and manages an ongoing physician education program designed to help primary care physicians control drug and total health care costs. Physician education initiatives in the program are developed by using peer-reviewed literature; selections of preferred drugs are based on evidence of their safety, efficacy, uniqueness, and cost-effectiveness. For a typical educational initiative, a pharmacist meets with the physicians identified as being among the top 20% of prescribers of high-cost drugs addressed by the initiative and delivers a 20-minute presentation. One-on-one meetings with the physicians are then held quarterly to review their prescribing. Each physician is shown comparisons with the prescribing patterns of other physicians in the organization. The clinic chooses to present the clinicwide data as either blinded or nonblinded data. The program was evaluated by comparing per member per month (PMPM) total health care and drug costs for 1996 and 1997 at 12 general medicine clinics in a managed health care plan. Five clinics received no interventions, three clinics allowed the initial presentation and the quarterly face-to-face meetings, and four clinics allowed only the presentation and barred ongoing meetings. In general, the clinics with more interaction between pharmacists and physicians had lower PMPM costs for total health care and drugs than the clinics with less interaction. Pharmacists acting as advisers to primary care physicians in general medicine clinics helped lower PMPM costs for drugs and total health care.
本文描述了一个旨在帮助医生控制药品总体成本和整体医疗保健成本的教育项目，以及该项目在一个管理式医疗保健计划中的成效。Prime Therapeutics公司开发并管理了一个持续开展的医生教育项目，旨在帮助初级保健医生控制药品和整体医疗保健成本。该项目中的医生教育举措是通过使用经过同行评审的文献制定的；首选药物的选择基于其安全性、有效性、独特性和成本效益的证据。对于一个典型的教育举措，一名药剂师会与被确定为该举措所涉及的高成本药物处方量排名前20%的医生会面，并进行20分钟的陈述。然后每季度与这些医生举行一对一会议，以审查他们的处方情况。会向每位医生展示与该机构其他医生处方模式的对比。该诊所选择以匿名或非匿名数据的形式呈现全诊所的数据。通过比较1996年和1997年在一个管理式医疗保健计划中的12家普通内科诊所的人均每月（PMPM）整体医疗保健和药品成本，对该项目进行了评估。五家诊所未接受任何干预，三家诊所允许进行初始陈述和季度面对面会议，四家诊所只允许进行陈述并禁止持续会议。总体而言，药剂师与医生之间互动较多的诊所，其人均每月的整体医疗保健和药品成本低于互动较少的诊所。在普通内科诊所中，药剂师作为初级保健医生的顾问有助于降低人均每月的药品和整体医疗保健成本。
