Hukins G, Boyce D
Department of Family Health, University of the Witwatersrand, Johannesburg.
S Afr Med J. 1990 Aug 4;78(3):152-4.
Despite a pre-existing cost-containment programme, expenditure on medicines was identified as a source of further cost savings in a medical benefit scheme faced with increasing divergence between income and benefit expenditure. Analysis of medicines utilisation trends showed that a relatively small number of pharmaceutical products accounted for a high percentage of total medicines expenditure, and that a small number of pharmacies were dispensing a very high proportion of prescriptions. On the basis of these findings, a revised cost-containment programme for medicines was implemented. It consisted of a recommended medicines list, designed to rationalise selection and utilisation of medicines, and a 'preferred provider pharmacy' network that allowed further savings to be achieved. In its first 12 months, the programme allowed for savings of R305,000, or 37% of anticipated expenditure on medicines for that year. This represents a decrease over 1988 expenditure notwithstanding an increase in membership and medicine prices over the same period. There are therefore significant savings to be obtained by medical schemes through implementation of cost-containment programmes for medicines.
尽管已有一项成本控制计划，但在一个收入与福利支出差距日益扩大的医疗福利计划中，药品支出仍被视为进一步节省成本的来源。对药品使用趋势的分析表明，相对少数的药品占药品总支出的比例很高，而且少数药店配发了很高比例的处方。基于这些发现，实施了一项修订后的药品成本控制计划。该计划包括一份推荐药品清单，旨在使药品的选择和使用合理化，以及一个“首选供应商药店”网络，从而实现进一步的成本节约。在该计划实施的头12个月里，节省了30.5万兰特，占该年度预期药品支出的37%。尽管同期会员人数增加且药品价格上涨，但这仍比1988年的支出有所减少。因此，医疗计划通过实施药品成本控制计划可实现显著的成本节约。
