A major campaign to cut the debt of the regional health services will introduce three monthly inspections of patient histories and prescribing patterns at all local health centres, an obligation on medical staff to prescribe cheaper drugs and lays down strict “prescribing guidelines” for all GPs.
An existing economy drive within the regional health service, which also concentrates principally on the prescribing habits of GPs, aims to prevent the “indiscriminate prescribing of antibiotics.” In three years the regional prescribing of two of the most commonly employed antibiotics has fallen by 13 and 26% apparently due to “prescribing only when an antibiotic is indicated.”
The new protocol places an obligation on GPs and Dispensing Chemists to fill a prescription using the cheapest version of the drug available. This method of prescribing is called prescription for “principio activo” and basically means GPs must prescribe the active element of a drug not the brand name. This move is expected to save the Health service 800,000 euros monthly.
The quantity of drugs prescribed will also be cut to the “dosage required.” For example, patients with prescriptions for paracetamol or ibuprofeno may be dispensed less than a complete pack depending on the “treatment period” assessed by the GP.
All local health centres will have their patient lists inspected every three months and prescription patterns of individual patients presenting with cholesterol, hypertension or asthma or who require gastric protection or antibiotics will be monitored to ensure they comply with the new guidelines.
The new protocol will be obligatory in all local health centres when the computer technology has been installed and all the staff at the individual centre have undergone awareness training, said a Health Department spokesperson.
In 2010 some 40 health centres in the region took part in the voluntary revision of patients with multi prescriptions and discovered that some 40% of medications prescribed did not “conform to the new Therapeutic Guide for Primary Attention.” This Guide aims to increase the effectiveness of medicines while reducing the cost to the health service, according to the spokesperson, by setting down strict criteria for GPs writing prescriptions, which takes into account the cost effectiveness and safety of the drug and the adherence habits of the patient.
Three of the patent medicines affected by this protocol are: escitalopram (an antidepressant which costs the regional health service 516,000 euros monthly); venlafaxina (an antidepressant which costs 4.9 million euros annually); and atorvastatina (prescribed for cholesterol which costs the region 2 million euros monthly).
