Favaretti C, Visintin S, Pilati G; International Society of Technology Assessment in Health Care. Meeting.

Annu Meet Int Soc Technol Assess Health Care Int Soc Technol Assess Health Care Meet. 1998; 14: 93.

Regione del Veneto - Azienda ULSS n. 19 - Adria (RO) - Italy.

OBJECTIVE: In recent years we have seen an expanding of therapeutic tools and higher quality of life expectations by western patients; on the other hand there is a correspondent lower increasing of available resources. This is the matter why we managed to reduce drug expenditure in Local Health Unit n. 19 of Adria (LHU n. 19 - Veneto Region - Italy), taking best care to avoid detrimental impact on health outcomes. METHOD: We choose to stimulate general practitioners to elaborate local guidelines for drug utilization in primary health care. First we identified critical areas and diseases for intervention, by a pharmacoepidemiological and pharmacoeconomic research; then we started informing physicians about their own prescription patterns, with oral communication being more effective than printed reports, and induced them to cooperate to the elaboration of local guidelines. These initial guidelines regard antibacterial and anti-ulcer drugs and are based on international literature and local specific needs. RESULTS: Even if overall acceptance and application of these recommendations will take a long time, we have been noting a decreasing of inappropriate therapies and a progression towards correct drug utilization. We recorded a switching from newer and more expensive third generation injective cefalosporins (ceftriaxone and ceftazidime) to cheaper second generation ones or other oral antibacterials (cefuroxime, cefaclor, amoxicillin/clavulanate, macrolides). Anti-ulcer drugs have declined as a result of more adequate Helicobacter pylori infection eradications with a consequent reduction in peptic ulcer relapse rate and maintenance therapies. Interventions were associated with a $US 10,500/1000 inhabitants money saving in 1997, this is an annual cost-containment of around $US 800,000 or 9% of LHU n. 19 total drug expenditure ($US 9,482,000). CONCLUSION: Activity of LHU n. 19 proves that pharmacoepidemiology, an effective method of informing physicians about their own prescriptions and local guidelines are appropriate measures to improve health care delivery within available resources.

Publication Types:

• Meeting Abstracts

Keywords:

• Amoxicillin
• Anti-Ulcer Agents
• Cost Control
• Drug Utilization
• Health Expenditures
• Helicobacter Infections
• Humans
• Italy
• Peptic Ulcer
• Pharmacoepidemiology
• Physicians, Family
• Prescriptions, Drug
• Primary Health Care
• Substance-Related Disorders
• economics
• hsrmtgs

Other ID:

• HTX/99600406

UI: 102237084

From Meeting Abstracts