Impacts of Esomeprazole Injection Control Policy on Utilization and Expenditure in Mahasarakham Hospital
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Abstract
Introduction: Esomeprazole is a non-essential drug which is expensive. In Mahasarakham hospital, utilization of and expenditure for esomeprazole injection are increasing. Therefore, in December 2012, the hospital introduced a policy to control use of esomeprazole injection. The objective of this study is to assess the impact of the policy. Methods: Data on esomeprazole utilization and expenditure in in-patient department during October 2011 to September 2013 were obtained. Utilization and expenditure were defined as vial and baht per gastrointestinal (GI) patient, respectively. Changes in level and trend were examined by segmented regression of interrupted time series (ITS) analysis. Results: esomepraozole utilization and expenditure declined from 6.2 to 4.1 vial/GI patient/month (33.9% reduction) and from 2,198 to 1,462 baht/GI patient/month (33.5% reduction), respectively, but omeprazole and pantoprazole utilization and expenditure increased. From ITS analysis, the policy statistically associated with changes in level and trend of esomeprazole use (utilization: level change -1.79 vial/GI patient/month (95%CI: -3.06 to -0.51) and trend change -0.21 vial/GI patient/month (95%CI: -0.40 to -0.03) and expenditure: level change -630.65 baht/GI patient/month (95%CI: -1,080.52 to -180.78) and trend change -75.64 baht/GI patient/month (95%CI: -140.69 to -10.60)). Conclusion: The drug control policy has significantly impacted both utilization of and expenditure for the study drugs. To efficiently control health expenditure, expensive substitute drugs should be considered and also controlled.
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