Impact of limiting prescription of low therapeutic value drugs

Abstract

Background During the last decade healthcare systems have developed different strategies for containing drug costs. Among others, in Spain the Ministry of Health together with regional Health Departments, have published guidelines for drugs considered to have low therapeutic value (LTVDs), through evidence-based studies and drug assessment data, and they encourage healthcare practitioners to avoid prescribing them. Purpose Our aim was to estimate the cost saving obtained by limiting the use of LTVDs in our hospital. Materials and methods The authors reviewed different guidelines published by Healthcare Authorities and compiled those drugs listed as LTVDs. Data was obtained from three sources: ‘Therapeutic usefulness of medical drugs reimbursed by the National Health System’ Spanish Ministry of Health 2001, ‘List of medical drugs considered as Low Therapeutic Value’ Canary Islands Health Department 2011, and ‘Medical drugs with Non-High Intrinsic Value’ Andalucia Health Department. The authors drew up a list of LTVDs and compared it with the formulary and non-formulary drugs purchased during the period August 2010–July 2011. Results A total of 110 drugs were listed as LTVDs, 59 formulary drugs and 51 non-formulary drugs. The potential cost saving obtained by restricting the use of LTVDs during the reviewed period was estimated at €88,142. By ATC classification, the most significant groups were Sensory organs (€36,118), Nervous system (€15,347), Respiratory system (€11,917) and Dermatologicals (€11,440). Conclusions Our drug formulary contains 59 LTVDs. Deleting them from the formulary as well as restricting the prescription of LTVDs through the Pharmacy and Therapeutic Committee would result in a potential saving of €88,142 per year. Furthermore, this approach encourages physicians to implement Healthcare Authorities recommendations and contributes to cost-effective and rational drug treatment.