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    An evaluation of prescribing trends and patterns of claims within the Preferred Drugs Initiative in Ireland (2011-2016): an interrupted time-series study.

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    Authors
    McDowell, Ronald
    Bennett, Kathleen
    Moriarty, Frank
    Clarke, Sarah
    Barry, Michael
    Fahey, Tom
    Issue Date
    2018-04-20
    Keywords
    PRESCRIBING
    PRESCRIPTIONS
    Local subject classification
    MEDICINES
    COST
    
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    Citation
    An evaluation of prescribing trends and patterns of claims within the Preferred Drugs Initiative in Ireland (2011-2016): an interrupted time-series study. 2018, 8 (4):e019315 BMJ Open
    Journal
    BMJ open
    URI
    http://hdl.handle.net/10147/622978
    DOI
    10.1136/bmjopen-2017-019315
    PubMed ID
    29678966
    Additional Links
    http://bmjopen.bmj.com/content/bmjopen/8/4/e019315.full.pdf
    Abstract
    To examine the impact of the Preferred Drugs Initiative (PDI), an Irish health policy aimed at enhancing evidence-based cost-effective prescribing, on prescribing trends and the cost of prescription medicines across seven medication classes.
    Retrospective repeated cross-sectional study spanning the years 2011-2016.
    Health Service Executive Primary Care Reimbursement Service pharmacy claims data for General Medical Services (GMS) patients, approximately 40% of the Irish population.
    Adults aged ≥18 years between 2011 and 2016 are eligible for the GMS scheme.
    The percentage of PDI medications within each drug class per calendar quarter. Linear regression was used to model prescribing of the preferred drug within each medication group and to assess the impact of PDI guidelines and other relevant changes in prescribing practice. Savings in drug expenditure were estimated.
    Between 2011 and 2016, around a quarter (23.59%) of all medications were for single-agent drugs licensed in the seven drug classes. There was a small increase in the percentage of PDI drugs, increasing from 4.64% of all medications in 2011 to 4.76% in 2016 (P<0.001). The percentage of preferred drugs within each drug class was significantly higher immediately following publication of the guidelines for all classes except urology, with the largest increases noted for lansoprazole (1.21%, 95% CI: 0.84% to 1.57%, P<0.001) and venlafaxine (0.71%, 95% CI: 0.15% to 1.27%, P=0.02). Trends in prescribing of the preferred drugs between PDI guidelines and the end of 2016 varied between drug classes. Total cost savings between 2013 and 2016 were estimated to be €2.7 million.
    There has been a small increase in prescribing of PDI drugs in response to prescribing guidelines, with inconsistent changes observed across therapeutic classes. These findings are relevant where health services are seeking to develop more active prescribing interventions aimed at changing prescribing practice.
    Item Type
    Article
    Language
    en
    ISSN
    2044-6055
    ae974a485f413a2113503eed53cd6c53
    10.1136/bmjopen-2017-019315
    Scopus Count
    Collections
    Royal College of Surgeons in Ireland (RCSI)

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