Wolzt Michael, Ohrenberger Gerald, Reichardt Berthold
Universitätsklinik für Klinische Pharmakologie, Allgemeines Krankenhaus Wien.
Wien Klin Wochenschr. 2003 Jan 31;115(1-2):23-8. doi: 10.1007/BF03040268.
Increasing drug costs are an economic burden for the health insurance system.
The regional drug prescription pattern for ACE inhibitors in the Austrian county Burgenland was compared for patients discharged from hospital and those in primary care. Furthermore, the potential cost reduction by voluntary prescription of cheaper generic drugs was estimated in the project "Bessere Therapie zum besseren Preis".
Following consensual analysis of the regional cross-sectional study, a cheaper generic of the most cost-intensive class of ACE-inhibitor drugs should be prescribed at internal medicine wards and in primary care. The number of prescriptions for patients from the largest health insurance company BGKK was studied and the costs were calculated.
Of the 1347 patients discharged during October 1999 from internal medicine departments of four different hospitals 879 patients received a total of 1440 cardiovascular drugs. The regional prescription pattern at hospitals matched that of physicians in primary care. Between the second quarter of 2000 and 2001, the prescription of ACE inhibitor drugs increased by project advertising from 23,627 packages by 13.1%, and drug costs in this group were reduced by [symbol: see text] 29,778 in this quarter (7.3% of costs). The number of Enalapril prescriptions increased by 33.4% with a percentual portion of generic Enalapril of 57.3%, and in the rest of Austria by 16.9% with 45.0% generics.
Consensus based projects are appropriate pharmacoeconomic interventions to change prescription patterns, increase the use of drugs and reduce the increasing cost requirements.
药品成本不断增加给医疗保险系统带来经济负担。
比较奥地利布尔根兰州出院患者和初级保健患者中ACE抑制剂的区域用药处方模式。此外,在“以更优价格获得更好治疗”项目中,估计了通过自愿处方使用更便宜的仿制药可能实现的成本降低。
在对区域横断面研究进行共识分析后,应在内科病房和初级保健中开具最昂贵的ACE抑制剂药物类别中更便宜的仿制药。研究了最大的健康保险公司BGKK的患者处方数量并计算了成本。
1999年10月,四家不同医院的内科共出院1347名患者,其中879名患者共接受了1440种心血管药物。医院的区域处方模式与初级保健医生的模式相匹配。在2000年第二季度至2001年期间,通过项目宣传,ACE抑制剂药物的处方量从23,627包增加了13.1%,该季度该组药物成本降低了29,778欧元(占成本的7.3%)。依那普利的处方量增加了33.4%,其中通用型依那普利的比例为57.3%,在奥地利其他地区增加了16.9%,通用型比例为45.0%。
基于共识的项目是合适的药物经济学干预措施,可改变处方模式、增加药物使用并降低不断增加的成本需求。