Effects of pharmaceutical cost containment policies on doctors' prescribing behavior: Focus on antibiotics

Euna Han; Su Mi Chae; Nam Soon Kim; Sylvia Park

doi:10.1016/j.healthpol.2015.05.005

Effects of pharmaceutical cost containment policies on doctors' prescribing behavior: Focus on antibiotics

Euna Han, Su Mi Chae, Nam Soon Kim, Sylvia Park

Department of Pharmacy

Research output: Contribution to journal › Article › peer-review

19 Citations (Scopus)

Abstract

Objectives: We analyzed the effect of the outpatient prescription incentive program and price cuts of listed medicines in South Korea on prescription drug expenditures and prescription behaviors, focusing on antibiotics for the most common infectious diseases. Methods: We used the National Health Insurance claims data from January 1, 2009 through December 31, 2012. For 1625 primary clinics randomly sampled, we included all claims with principal diagnoses of acute upper respiratory tract infections (URTIs, J00-J06), acute lower respiratory tract infections (LRTIs, J20-J22), or otitis media (H65, H66). An interrupted time-series analysis was conducted. Results: Pharmaceutical spending per claim dropped immediately after the outpatient prescription incentive program only for otitis media (adults), but the secular trend shifted downward after the incentive program for all target diseases. The incentive program lowered the trend of antibiotic prescribing rate in otitis media (adults). The program was associated with an increase of the number of antibiotics prescribed in URTI (adults) and LRTI (children) and decrease in otitis media (adults). The broad markdown of drug prices reduced pharmaceutical expenditures immediately for all diseases, but without lasting effect. Conclusion: The direct financial incentives to physicians to reduce in prescription spending had the intended effect over time and can be an important tool to improve pharmaceutical spending management.

Original language	English
Pages (from-to)	1245-1254
Number of pages	10
Journal	Health Policy
Volume	119
Issue number	9
DOIs	https://doi.org/10.1016/j.healthpol.2015.05.005
Publication status	Published - 2015 Sept 1

Bibliographical note

Funding Information:
We acknowledge research support from Korea Institute for Health and Social Affairs. The first author also acknowledges research support from the Korea National Research Foundation ( NRF-2014049984 ). The funding source had no involvement in study design, the collection, analysis and interpretation of data, in the writing of the report, and in the decision to submit the article for publication.

Publisher Copyright:
© 2015 Elsevier Ireland Ltd.

All Science Journal Classification (ASJC) codes

Health Policy

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1016/j.healthpol.2015.05.005

Cite this

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abstract = "Objectives: We analyzed the effect of the outpatient prescription incentive program and price cuts of listed medicines in South Korea on prescription drug expenditures and prescription behaviors, focusing on antibiotics for the most common infectious diseases. Methods: We used the National Health Insurance claims data from January 1, 2009 through December 31, 2012. For 1625 primary clinics randomly sampled, we included all claims with principal diagnoses of acute upper respiratory tract infections (URTIs, J00-J06), acute lower respiratory tract infections (LRTIs, J20-J22), or otitis media (H65, H66). An interrupted time-series analysis was conducted. Results: Pharmaceutical spending per claim dropped immediately after the outpatient prescription incentive program only for otitis media (adults), but the secular trend shifted downward after the incentive program for all target diseases. The incentive program lowered the trend of antibiotic prescribing rate in otitis media (adults). The program was associated with an increase of the number of antibiotics prescribed in URTI (adults) and LRTI (children) and decrease in otitis media (adults). The broad markdown of drug prices reduced pharmaceutical expenditures immediately for all diseases, but without lasting effect. Conclusion: The direct financial incentives to physicians to reduce in prescription spending had the intended effect over time and can be an important tool to improve pharmaceutical spending management.",

author = "Euna Han and Chae, {Su Mi} and Kim, {Nam Soon} and Sylvia Park",

note = "Funding Information: We acknowledge research support from Korea Institute for Health and Social Affairs. The first author also acknowledges research support from the Korea National Research Foundation ( NRF-2014049984 ). The funding source had no involvement in study design, the collection, analysis and interpretation of data, in the writing of the report, and in the decision to submit the article for publication. Publisher Copyright: {\textcopyright} 2015 Elsevier Ireland Ltd.",

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AU - Han, Euna

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AU - Kim, Nam Soon

AU - Park, Sylvia

N1 - Funding Information: We acknowledge research support from Korea Institute for Health and Social Affairs. The first author also acknowledges research support from the Korea National Research Foundation ( NRF-2014049984 ). The funding source had no involvement in study design, the collection, analysis and interpretation of data, in the writing of the report, and in the decision to submit the article for publication. Publisher Copyright: © 2015 Elsevier Ireland Ltd.

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N2 - Objectives: We analyzed the effect of the outpatient prescription incentive program and price cuts of listed medicines in South Korea on prescription drug expenditures and prescription behaviors, focusing on antibiotics for the most common infectious diseases. Methods: We used the National Health Insurance claims data from January 1, 2009 through December 31, 2012. For 1625 primary clinics randomly sampled, we included all claims with principal diagnoses of acute upper respiratory tract infections (URTIs, J00-J06), acute lower respiratory tract infections (LRTIs, J20-J22), or otitis media (H65, H66). An interrupted time-series analysis was conducted. Results: Pharmaceutical spending per claim dropped immediately after the outpatient prescription incentive program only for otitis media (adults), but the secular trend shifted downward after the incentive program for all target diseases. The incentive program lowered the trend of antibiotic prescribing rate in otitis media (adults). The program was associated with an increase of the number of antibiotics prescribed in URTI (adults) and LRTI (children) and decrease in otitis media (adults). The broad markdown of drug prices reduced pharmaceutical expenditures immediately for all diseases, but without lasting effect. Conclusion: The direct financial incentives to physicians to reduce in prescription spending had the intended effect over time and can be an important tool to improve pharmaceutical spending management.

AB - Objectives: We analyzed the effect of the outpatient prescription incentive program and price cuts of listed medicines in South Korea on prescription drug expenditures and prescription behaviors, focusing on antibiotics for the most common infectious diseases. Methods: We used the National Health Insurance claims data from January 1, 2009 through December 31, 2012. For 1625 primary clinics randomly sampled, we included all claims with principal diagnoses of acute upper respiratory tract infections (URTIs, J00-J06), acute lower respiratory tract infections (LRTIs, J20-J22), or otitis media (H65, H66). An interrupted time-series analysis was conducted. Results: Pharmaceutical spending per claim dropped immediately after the outpatient prescription incentive program only for otitis media (adults), but the secular trend shifted downward after the incentive program for all target diseases. The incentive program lowered the trend of antibiotic prescribing rate in otitis media (adults). The program was associated with an increase of the number of antibiotics prescribed in URTI (adults) and LRTI (children) and decrease in otitis media (adults). The broad markdown of drug prices reduced pharmaceutical expenditures immediately for all diseases, but without lasting effect. Conclusion: The direct financial incentives to physicians to reduce in prescription spending had the intended effect over time and can be an important tool to improve pharmaceutical spending management.

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Effects of pharmaceutical cost containment policies on doctors' prescribing behavior: Focus on antibiotics

Abstract

Bibliographical note

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UN SDGs

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