Implementation of Drug Cost Containment Measures for 5 Selected Non-essential drugs: Case Study of 7 General Hospitals

Abstract

Introduction: Prescribing of Non-Essential Drug(NED) is important problem in Thailand. This descriptive study aims to explore situation of an implementation of drug cost containment measures of five selected non-essential drugs (NEDs) used for hypertension, dyslipidemia, osteoporosis, peptic ulcer/variceal bleeding, and inflammatory and osteoarthritisin Civil Servant Medical Benefit Scheme (CSMBS) out-patient during 1 October 2011 to 30 September 2014 Methods: Study samples were voluntary hospitals in the Northeastern. Drug cost containment measures in all processes were studied including drug selection, drug procurement, drug prescribing, and drug reimbursement. Data collection was used data collection form,semi-structure questionnaire, and in-depth interview to obtain drug cost containment measures. Results: There were seven hospitals voluntary to participate in this study including three tertiary care hospitals (A, B and C), four general hospitals (D, E, F, and G). Total drug expenditure of these seven hospitals increased every year while expenditure of the five selected NEDs in these hospitals decreased.In 2014,top three hospitals with highest of the five selectedNEDs expenditures were hospital C (29.0%), hospital G (19.7%) and hospitalE (14.8%). Hospital B hadproportion of the five selected NEDs 9.3% which was the hospital with the highest intensity of cost containment measures implemented the rule to limit number of drugs in hospital drug formulary by including no more than two drug items for the same indicationsfor five selected drugs, delaying inclusion of original drug in the formulary, and increasing proportion of prescribing generic products for two targeted drugs. Hospital C had a cost containment measuresimplemented the rule to limit number of drugs in hospital drug formulary by including no more than two drug items for the same indicationsfor one selected drugs.Discussion: All hospitals implemented cost containment measures but in different degrees of intensity and different drug items.In hospital had several cost containment measures concomitantly were the effective.