MONNET DL, SORENSEN TL, JOHANSEN HL, LOPEZ LOZANO JM; Interscience Conference on Antimicrobial Agents and Chemotherapy.

Abstr Intersci Conf Antimicrob Agents Chemother Intersci Conf Antimicrob Agents Chemother. 1999 Sep 26-29; 39: 733 (abstract no. 180).

Danish Integrated Antimicrobial Resistance Monitoring and Res. Programme (DANMAP), Statens Serum Inst., Copenhagen, DENMARK

BACKGROUND: In Denmark before 1/1/1996, 75% reimbursement was provided for all antimicrobials with the exception of tetracyclines (50%), and cephalosporins, aminoglycosides, chloramphenicol and trimethoprim-sulfonamide combinations (not reimbursed). Starting 1/1/ 1996, tetracyclines were not reimbursed and only 50% reimbursement was provided for all other subsidized antimicrobials. We conducted the present study to evaluate the impact of this intervention on antimicrobial prescriptions in the primary health care sector.METHODS: Monthly data on redeemed antimicrobial prescriptions were obtained from the Register of Medicinal Product Statistics for the period 1994-98. ARIMA modeling and intervention analysis were performed by using SPSS for Windows.RESULTS: From 1994-95 to 1996-98, we observed a decrease from 46.7 to 44.3 antimicrobial prescriptions per 1,000 inh. with large differences among ATC classes: beta-lactamase-sensitive penicillins (J01CE), 19.4 to 19.3; extended-spectrum penicillins (J01CA), 9.9 to 8.5; macrolides (J01FA), 6.8 to 7.3; tetracyclines (J01A), 3.3 to 1.9; other antimicrobials, 7.3 and 7.3. Examination of the tetracycline prescription series revealed a seasonal component (more prescriptions in winter), a decreasing trend in 1994-95, a sharp decrease in the first months of 1996, and stability at a lower level since this date. By using intervention analysis, we were able to model the tetracycline series and demonstrated the effect of the change in reimbursement policy on tetracycline prescriptions. Intervention analysis also showed an effect of the reimbursement change on extended-spectrum penicillin prescriptions, but no effect on other groups of antimicrobials.CONCLUSION: Changes in reimbursement policy may have a strong impact on antimicrobial prescriptions by general practitioners. The impact of such changes can be evaluated by using appropriate methods such as intervention analysis.

Publication Types:

• Meeting Abstracts

Keywords:

• Anti-Bacterial Agents
• Anti-Infective Agents
• Denmark
• Health Care Sector
• Physicians, Family
• Prescriptions, Drug
• Research
• Tetracycline
• Tetracyclines
• beta-Lactamases
• economics
• methods

Other ID:

• GWAIDS0009029

UI: 102246526

From Meeting Abstracts