Impacts of Drug Use Control Measures on Utilization and Expenditure of Non-National Essential Statins in A Provincial Hospital
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Abstract
Introduction: Expenditures of non-national essential drug use in civil servant medical benefit scheme (CSMBS) outpatients increase every year and several drug use control measures have been introduced to control the use and expenditures of these drugs in hospital settings. The objectives of this study are to determine impacts of the measures on utilization and expenditures of statins in a provincial hospital. Methods: Data were retrospectively collected from electronic databases of CSMBS outpatients who were prescribed statins (either non-essential drugs (NED) or essential drugs (ED)) during fiscal year 2010-2014 in one provincial hospital. Utilization was measured as number of prescriptions and medication supply days, medication procession ratio (MPR) and patterns and ratios of ED and NED use, and expenditure as baht/month or baht/year. Segmented regression was applied for time-series analysis to estimate impacts of the measures on statins utilization and expenditures. Results: During 2010-2014, numbers of CSMBS outpatients using statins increased and ratios of the ED/NED statins used patients rose from 0.84 in 2010 to 2.87 in 2014. From 2010 to 2014, the total use of all statins increased but quantity of NED statins use declined (5.27 to 3.10 thousand prescriptions and 366 to 234 medication supply days, respectively). The expenditure of NED statins declined from 14.2 to 6.13 million baht and the total expenditure of all statins decreased from 16.78 to 9.79 million baht. Proportions of the MPR greater than 1 slightly increased from 45.0% to 46.9%. The regression analysis revealed that all measures implemented in the studied hospital were statistically associated with reduction in NED statins utilization and expenditure. Conclusion: The findings from the study provincial hospital illustrate that drug use control measures have significant impacts on statins utilization and reduce drug expenditure to the hospital.
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