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Swedish physicians’ views on responsibility of prescribing costs related to dispensed prescriptions.

Conference paper
Authors Karolina Andersson
Anders Carlsten
Tove Hedenrud
Published in 23rd International Conference on Pharmacoepidemiology & Therapeutic Risk Management, Quebec, augusti 2007.
Publication year 2007
Published at Institute of Medicine, School of Public Health and Community Medicine
Language en
Subject categories Social and Clinical Pharmacy

Abstract

Background. Discrepancies between what physician’s reports on cost awareness in prescribing and actual prescribing has been reported. Objectives. To investigate how physicians’ opinions on budget responsibility for prescribed drugs relates to economizing goals of prescribing and how prescribing develops over time. Methods. Data on physicians’ opinions in Region Västra Götaland, RVG, was retrieved from a questionnaire about a pharmaceutical benefit reform, undertaken in April 2003. Associations between views and employer, type of workplace, age and gender were analysed with logistic regression. Data on dispensed prescriptions on workplace level for RVG for the year 2003 and 2006 was obtained from Apoteket AB. Workplaces were categorized according to ownership. Five prescribing indicators reflecting the county council’s goals for cost containing prescribing were calculated. Differences in level of the indicators between private practitioners and prescribers employed by the county councils and changes over time were analyzed with student’s t-tests considered as statistically significant if p<0.05. Results. Private practitioners reported to a lower degree that the economical responsibility for prescribed drugs had increased after the introduction of workplace codes compared to publicly employed physicians. In 2003, physicians working at public workplaces had a more appropriate prescribing for two of the prescribing indicators compared to private practitioners. In 2006 two prescribing indicators differed between private and public workplaces. One indicator was significantly higher for private than public workplaces which were an undesirable outcome for that indicator. Three of the prescribing indicators of dispensed prescriptions changed significantly between 2003 and 2006 for both private practitioners and physicians working at public workplaces. The changes were considerable for all indicators and changed in the preferred direction both for private practitioners and public workplaces. Conclusion. Adherence to most of the prescribing indicators increased over time irrespective of employer or type of workplace. Public workplaces had a higher adherence to the prescribing indicators than private workplaces which is in accordance with the views on economic responsibility for prescribed drugs.

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