Quantity and Expenditure of Non-Essential Drugs Use after the National Prescribing Restriction Policy in a Provincial Hospital
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Abstract
Introduction: Expenditure of Non-Essential Drugs (NEDs) in Civil Servant Medical Benefit Scheme (CSMBS) is rising. In 2011, the national prescribing restriction policy was announced to control drug expenditure due to use of expensive NEDs. This study aimed to determine quantity and expenditure of NEDs use after implementation of the policy in one provincial hospital. Methods: A retrospective study was conducted to analyze data on utilization and expenditure of 4 NEDs: HMG-CoA reductase inhibitors (Statins), Angiotensin II receptor blockers (ARBs), Proton Pump Inhibitors (PPIs) and COX-2 inhibitors (Cox2s) in CSMBS out-patients during 1 October 2009 to 30 September 2014 (fiscal year 2010-2014). Number of the patients, quantity and expenditure of NEDs use together with quality use of the medicines were extrapolated by medicine group and fiscal year. Results: During 2010-2014, number of the patients and quantity of NEDs used declined except for Statins. The expenditure of 4 NEDs decreased for 4.9 million baht (25.6%) where the highest reduction was found in Cox2s (54.3%). For quality use of medicine, the proportions of medical procession ratio over 1 in ARBs and Statins did not decrease but the proportion of Cox2s use over 30-day threshold declined. Furthermore, quantity and expenditure of essential drugs in the same categories of 4 NEDs increased. Conclusion: the national prescribing restriction policy has impact on quantity and expenditure of NED utilization. Future research should extensively assess impact of the policy on quality use of medicine.
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