The Effects of Managerial Intervention on Drug Prescribing Patterns

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(No Transcript)
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The Effects of Managerial Intervention on Drug
Prescribing Patterns at King Chulalongkorn
Memorial Hospital
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Background

• Thailand economic crisis in 1997
• cutting of public finance as well as the public
  health care budget Thai currency devaluation
• King Chulalongkorn memorial hospital new policy
  on 1st March 1998
• New hospital drug list
• Generic prescribing and dispensing policy

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The new hospital drug list of King Chulalongkorn
Memorial hospital
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Characteristics of prescription before and after
the implementation
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The cost of drugs in each class (1)
Antihis
GI
Bloodderiv
Blood coag
CVS
Respi
Neuromuscular
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The cost of drugs in each class (2)
Electrolyte
EENT
Skin
unclassified
Anti-infective
Antineo plastic
Hormone
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Baht
Peni cillins
Erythro mycins
Tetra cycline
Quino lones
Sulfo namides
Anti fungal
Antiviral
Cepha losporin
the cost of systemic anti-infective drugs
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The percentage of prescribed drugs after generic
prescribing policy

Generic name
Trade name
Combination drugs
Hospital formulary
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The percentage of prescribed and dispensed drugs
after the generic prescribing and dispensing
policy
Prescribed drugs
Dispensed drugs
90.43
84.27
71.84

60.72
39.28
28.16
15.72
9.57
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conclusion

• Key lessons from this work
• The short term productivity of the implementation
  not only reduced the drug expenditure but also
  facilitated better drug management.
• Implicatation of this work
• Specific studies in the future research

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conclusion

• Implicatation from this work
• Establish effective essential drug list
• containing suitable drug items that cover all the
  possible therapeutic conditions
• maintain the quality of treatment
• The generic prescribing and dispensing policy
• should be strictly implemented or maintained to
  all hospitals
• the quality of generic drugs under good
  manufacturing practice (GMP) and bioequivalence
  study is required
• Specific studies in the future research

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conclusion

• Specific studies in the future research
• long-term study (at least 6 months) of drug
  categories which caused high cost from
  prescriptions.
• cardiovascular drugs
• systemic anti-infective agents