[Which Proportion of Prescriptions in Germany is Evidence Based?]

The provision of healthcare has to take into consideration evidence-based results from valid and relevant studies; this principle is included in German social laws. The prescribing assessment scheme (PAS) of the German National Association of Statutory Health Insurance Physicians contains a systematic appraisal of the benefit of drugs on the basis of their clinical evidence, their safety, and indications for their prescription.

We analysed nationwide prescription data of physicians that have contractual relationships with statutory health insurance funds in 2014. The drugs have been classified on the basis of their clinical evidence as "standard", "reserve" or "third level" medication. We report proportions of prescriptions in the first and third priority levels of the PAS in primary care, cardiology, and neurology/psychiatry as their prescriptions have a high correspondence with the PAS.

The proportion in the first priority in primary care was more than two-thirds of the total prescriptions. The highest proportion in this category was observed in Bremen; the lowest proportions were found in the new federal states. In cardiology, the first priority was chosen in 54%, in neurology/psychiatry in about 41% of prescriptions (DDDs). The proportion of the third priority is with one-fifth highest in cardiology, with 16%, lowest in primary care; neurology/psychiatry takes a middle position with 17.7%.

Prescriptions predominantly conformed with the first priority of the PAS. There were variations across disciplines and regions (federal states). The PAS offers an opportunity to connect quality and indication in the prescription process.