Prescribing, prescription costs and adherence to formulary committee recommendations: long-term differences between physicians in public and private care.
BACKGROUND
In southern Sweden, many general practitioners (GPs) participate in an extensive postgraduate drug education programme, and many health centres are also fed back crude local drug statistics from pharmacists in the area. Private physicians and hospital physicians have not participated in these programmes.


OBJECTIVE
The drug prescribing habits and costs of GPs, hospital physicians and private physicians were compared.


METHODS
Each March, from 1990 to 1997, all prescriptions dispensed at the eight pharmacies in Växjö, a city and municipality in southern Sweden, were registered, specifying drug(s) prescribed, price, patient's age, sex and area of residence, and prescriber's place of work and category.


RESULTS
Overall, the costs of prescribed drugs increased with time, even in 1997 when the prescribing volume was reduced due to changes in the reimbursement system. The cost increase was caused by increased prescribing of newer, more expensive drug alternatives. However, within each of the eleven major drug groups, the drugs prescribed by GPs were less expensive than those prescribed by hospital physicians and, particularly, private physicians. Moreover, even though GPs prescribed more and a wider range of drugs, they also had a higher degree of adherence to the recommendations by the formulary committee.


CONCLUSIONS
GPs prescribed less expensive drugs and had a higher degree of adherence to the recommendations by the formulary committee than other categories of physicians. One reason for these differences may be that the GPs participated in regional and local educational activities aimed at the rationalisation of drug prescribing.
Håkansson
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Department of Community Medicine, Malmö University Hospital, S-20502 Malmö, Sweden. anders.hakansson@smi.mass.lu.se
Andersson
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Cars
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Melander
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D011307:Drug Prescriptions / Q000191:economics / Q000706:statistics & numerical data*; D019983:Guideline Adherence / Q000191:economics / Q000706:statistics & numerical data*; D006801:Humans; D008505:Medical Staff, Hospital / Q000191:economics / Q000706:statistics & numerical data; D010821:Physicians, Family / Q000191:economics / Q000193:education / Q000706:statistics & numerical data*; D011306:Prescription Fees / Q000706:statistics & numerical data*; D011331:Private Practice / Q000191:economics / Q000706:statistics & numerical data*; D013548:Sweden