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[The requirement to use the cheapest synonymous preparation--does it work as intended?]
E Horgen1, R Kristensen, O Smiseth
1Senter for helseadministrasjon Rikshospitalet, Oslo.
Summary
Government regulations promoting cheaper antihypertensive drugs had minimal impact. Doctors increasingly prescribed expensive alternatives lacking proven cardiovascular benefits.
Area of Science:
- Pharmacoeconomics
- Cardiovascular medicine
- Health policy
Context:
- Retrospective analysis of antihypertensive drug prescriptions in 1992.
- Pharmacy data from a practice serving 20 general practitioners and 17 temporary doctors.
- Analysis covered two 3-month periods with a 5-month interval.
Purpose:
- To evaluate the impact of governmental regulations on antihypertensive drug prescribing.
- To assess trends in the cost and efficacy of prescribed antihypertensive medications.
- To identify patterns in the selection of expensive drug alternatives.
Summary:
- Governmental "cheapest synonymous drug" policies showed little effect on prescribing habits.
- An increasing proportion of expensive antihypertensive alternatives were prescribed.
- These more costly drugs lacked documented evidence of reducing cardiovascular morbidity or mortality.
Impact:
- Highlights potential disconnect between cost-saving policies and clinical prescribing practices.
- Suggests a need for improved physician education on cost-effective, evidence-based antihypertensive therapy.
- Raises concerns about the economic efficiency of cardiovascular drug prescribing and its impact on patient outcomes.