[Medication in a physicians network: modern treatment with no increase in costs?]

Practice networks are intended to improve drug treatment and render it more economical. To check whether these aims can be realized, two groups of physicians were observed over a period of two years. The first group stemmed from the Practice Network Nuremberg North (PNN), the other comprised a group of physicians in Augsburg similarly structured in terms of prescriptions, specialties and patients. A comparison was made of the application and costs of drugs for the following four different indications: bronchial asthma, diabetes mellitus, hypertension and osteoporosis. Within the practice network a mild increase in costswas observed forall four indications. This was in part explained by the increased used of modern, more expensive drugs, although savings were also achieved by a more liberal use of more economical, patent-free medications. No improvement in treatment outcome was seen, since prescription in accordance with recommended guidelines would have required the use of other drugs. Evaluation of treatment qualitywas not an aim of this study. Overall, the potentials in terms of improved and simultaneously more economical chemotherapy expected from the establishment of a practice network were not fully utilized. Perhaps the conclusion of a modified agreement Quality and Efficiency (QaE, 2003) might result in improved prescribing through evidence-based medicine, and greater savings.