6 INTERNATIONAL RESEARCH & OPINION

Prescribing-improvement programme successful in Germany

Using pharmacotherapeutic circles (PTC) is an effective way to optimise the quality of drug prescribing and reduce drug costs, say researchers in Germany.

The PTe concept is a prescribing-improvement programme that is based on physician-level feedback of prescribing patterns by means of small peer-review discussion groups.

The researchers' 18-month study involved 79 general practitioners and targeted 3 areas of suboptimal drug prescribing: • drugs that lack evidence-based efficacy (e.g. peripheral

vasodilators for dementia, or topical applications for varicose veins and rheumatic disorders)

• presumptive prescribing of effective drugs (e.g. benzodiaze­pines and NSAIDs)

• underprescribing of new, effective therapies (such as drugs for the management of pain and agents used for Helicobacter pylori eradication).

Prescribing improved, costs reduced 18 months after the implementation of the

prescribing-improvement programme, significant decreases in the prescription rates for drugs without evidence-based efficacy were recorded for varicose vein medications, peripheral vasodilators and topical antirheumatics. Furthermore, significant prescribing reductions occurred for drugs that are often prescribed presumptively, such as benzodiazepine derivatives and NSAIDs. The changes in prescribing patterns resulted in significant decreases in prescription costs for drugs without evidence-based efficacy and for agents often prescribed presumptively. The cost reductions were most pronounced among high prescribers. The researchers estimated that a 2% decrease in prescription costs occurred over a 2-year period for PTC participants, whereas prescription costs for all physicians in the area increased by 10% during the same time period. von Ferber L, Bausch J, Koster I, Schubert I, Ihle P. Pharmacotherapeutic circles: results of an 18-month peer-review prescribing-improvement programme for general practitioners. PharmacoEconomics 16: 273-283, Sep 1999 ,oom""

PharmacoEconomics & Ou/comes News 6 Nov 1999 No. 237 1173-5503199/0237-0006/$01.00° Adlalnternational Limited 1999. All right. ,nerved