Prescribing patterns and drug costs: Effects of formulary recommendations and community pharmacists' information campaigns

Publisher Website
Google Scholar
Abstract
In the health care districts of Lund and Orup (Lund-Orup) in southern Sweden, prescription recommendations for both primary and secondary health care are made by one local formulary committee. A revised formulary was introduced in 1989, and information on the most important changes was distributed to all prescribing physicians in the area with the new formulary. In an information campaign aimed only at district physicians (general practitioners) in Lund-Orup, community pharmacists initiated and maintained verbal discussions on the changed recommendations, particularly those concerning low-price brands of erythromycin, doxycycline, naproxen and combined amiloride/hydrochlorothiazide. One year and two years later they supplied feedback on compliance with the recommendations. Other prescribers in Lund-Orup received written information on the formulary changes but no verbal information. Prescription surveys during that time indicated that the district physicians had rapidly accepted the new guidelines; compared with the other physicians they showed greater increases in prescription volume of the recommended low-price brands and higher compliance rates with the recommendations. The overall cost reduction for the four preparations during 1989–91 was approximately SEK3m,* of which almost 25 per cent (SEK700,000) was attributable to the extra savings due to the higher compliance rates among district physicians. Not only do these figures exceed the costs of the information campaign; there was a return in reduced costs of several times the investment. It appears that a verbal information campaign providing district physicians with data on formulary recommendations and savings is a realistic means of reducing drug expenditure.