Pattern of statins' utilization at Ramathobodi Hospital, 2005 to 2007

The use of statins at Ramathibodi, a teaching hospital, has been rising rapidly

Determine how price, volume, and drug mix (use of five brands and one generic) affect expenditure.

Dispensing records of the six statins were retrieved from database and analyzed for factors contributing to increased drug expense.

Overall, statins' expenditure rose 35.6% and 6.4% in 2006 and 2007 respectively, mainly from civil servant outpatients who are more likely to be prescribed with brand drugs, even among new patients. In all schemes, volume effect was positive, more people use statins, and each one used a larger quantity of drug in 2007 than in 2005. The price effect was negative. Drug mix effect indicated that there was a shift from higher to lower priced drugs in capitation scheme and from lower to higher priced original drugs in a fee-for-service scheme.

There is a trend of more statins utilization but with a different pattern of drug prescribed between health schemes and possible drug over-prescribed in some patients. However indication for statin use was not studied, which needs to be considered. With high use of original drugs, effective policy initiative to promote generic drug use should be implemented in order to efficiently use the limited health care resources.