Survey of Antilipidemic Agents Prescription in Non-national Drug List 2008 : Case Study at a Medical School Hospital

Abstract

Background and objective: The trend of medical budget in Non-Essential drug (NED) of National of essential Medicines 2008 in medical school hospitals has been increased every year. On 1^st December 2011, Pharmaceutical & Therapeutic Commeittee (PTC) announced policy to control budget of antilipedemic drugs.  This study was aimed to survey prescription after announcement of this policy.

Methods: We collected electronic data of prescription and cost of 3 antilipidemic agents; pravastatin (P), atorvastatin (A), and ezetimibe (E). Separatated data by health scheme of patient, during 6-month period before and after an announcement of this poicy (June 1^st, 2011 – May 31^th, 2012). Descriptive data analysis was run by SPSS.

Results: During 12 months of this study, there were 376 patients (1,330 visits). Majority of them were Civil Servant Medical Benefit Scheme, CSMBS (77.4%). Medicine usage report during before and after implement date of the policy were (1) a numbers of patients whom prescribed P/A/E before implement date were 53/121/97-108 persons, and a numbers of patients whom prescribed P/A/E after implement date were 57/176/108 persons (2) percentage of prescription which non-compliance to the policy of P/A/E were 49.1%/72.8%/80.9% (3) total medical budget due to prescribing with non-compliance to policy were  1,569,533.75 baht (4) CSMBS patients were majority group of prescription with non-compliance to indication indicated in the policy (5) Average of Proportion of Days Covered (PDC) before implement date were 0.99/1.04/0.97, and PDC after implement date were 1.03/1.05/1.02.

Conclusion: After the announcement of this policy we found increasing  prescription and medical budget with non-compliance to the policy. That might be reviewed distribution of this policy in hospital and appropriate communication of the announcement to physician.