Ongoing measures to enhance the efficiency of prescribing of proton pump inhibitors and statins in The Netherlands: influence and future implications.
BACKGROUND
Multiple reforms have recently been introduced in The Netherlands to improve prescribing efficiency. These include preference pricing policies for multiple sourced products, guidelines, and quality and efficiency targets, as well as regular pharmacotherapy meetings.


OBJECTIVE
Assess the influence of these multiple measures on prescribing efficiency.


METHODS
Retrospective observational study of all reimbursed prescriptions for proton pump inhibitors and statins between 2000 and 2010 using the Genees-en hulpmiddelen Informatie Project (Health Insurance) database. Utilization measured in defined daily doses. Narrative review of reforms.


RESULTS
Reimbursed expenditure for the proton pump inhibitors fell by 58% in 2010 versus 2000 despite a threefold increase in utilization, helped by increasing utilization of generic omeprazole at only 2% of the prepatent loss price in 2010. Similarly, reimbursed expenditure for the statins fell by 14% in 2010 versus 2000 despite a 3.8-fold increase in utilization. Again, this was helped by increasing utilization of generic simvastatin at only 2% of the prepatent loss originator price.


CONCLUSIONS
Multiple supply and demand measures, including the preference pricing policy, appear to have appreciably enhanced proton pump inhibitor and statin prescribing efficiency, providing examples to other countries.
Dutch Institute for Rational Use of Medicines, Churchillaan 11, 3527 GV Utrecht, The Netherlands.
Menno van
Mv
Woerkom
Hans
H
Piepenbrink
Brian
B
Godman
Joost de
Jd
Metz
Stephen
S
Campbell
Marion
M
Bennie
Marietta
M
Eimers
Lars L
LL
Gustafsson
D000553:Ambulatory Care / Q000191:economics; D017723:Drug Utilization Review; D016568:Drugs, Generic / Q000191:economics / Q000600:supply & distribution / Q000627:therapeutic use; D005102:Health Expenditures; D006291:Health Policy; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000191:economics / Q000600:supply & distribution / Q000627:therapeutic use*; D009426:Netherlands; D010818:Practice Patterns, Physicians' / Q000592:standards*; D054328:Proton Pump Inhibitors / Q000191:economics / Q000600:supply & distribution / Q000627:therapeutic use*; D012051:Reimbursement Mechanisms; D012189:Retrospective Studies; D013272:Stomach Diseases / Q000188:drug therapy
D016568:Drugs, Generic; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D054328:Proton Pump Inhibitors