Strategies to Improve Drug Use

1
Strategies to Improve Drug Use
Educational to inform or persuade
Managerial to structure or guide decisions
Regulatory to restrict or limit decisions
2
Managerial Strategies 1GOAL to structure or
guide decisions

• Changes in Selection, Procurement, Distribution
• essential drugs lists
• morbidity-based quantification
• kit system distribution
• Changes Aimed at Prescribers
• utilization review (audit) and feedback
• diagnostic and treatment guidelines
• structured drug order forms
• peer group monitoring

3
Managerial Strategies 2GOAL to structure or
guide decisions

• Changes Aimed at Dispensers
• allowing generic substitution
• improved labeling
• course of therapy packaging
• Changes in Economic Incentives
• patient cost-sharing
• revolving drug funds
• cost controls

4
Standard Treatment Guidelines

• STGs lead prescribers to most cost-effective
  treatments
• Particularly useful for low level workers
• Can be used for training, examinations and audit
• Used for procurement

5
Prescribing Audits plus "Feedback" to Prescriber
6
Regulatory OptionsGOAL To Restrict Decisions

• Market Controls
• Limiting Drug Registration
• Banning Previously Registered Drugs
• Rx - only to OTC
• Controlling Content in Drug Advertising
• Prescribing and Dispensing Controls
• Limiting Drugs Supplied in Public Sector
• Restricting Specific Drugs to Higher Levels of
  Care
• Required Generic Prescribing
• Allowing Generic Substitution
• Limits on Number or Quantity of Drugs per Patient