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PharmacoEconomics

, Volume 5, Issue 4, pp 299–312 | Cite as

Drug Utilisation Studies as Tools in Health Economics

  • José A. Sacristén
  • Javier Soto
Review Article

Summary

Drug utilisation and many pharmacoeconomic studies use pharmacoepidemiological methods characterised by the study of drugs from a socioeconomic perspective. Drug utilisation studies may be defined as studies of the marketing, distribution, prescription and use of drugs in a society, with special emphasis on the resulting medical, social and economic consequences. Pharmacoeconomic studies are used to measure drug efficiency, through comparison of the costs and effects of alternative therapies.

Drug utilisation studies can provide highly valuable information, at a reasonable price, on the costs and effects (harmful and beneficial) of drugs. Such studies make available much useful information including indirect data on morbidity, the pharmaceutical component of the treatment cost of an illness, therapeutic compliance, the incidence of adverse reactions, the effectiveness of drug consumption and the choice of comparators. This information can k of great use in the subsequent elaboration of phamacoeconomic studies, or in the selection of problematic areas in which these studies may be applied.

Pharmacoeconomic studies, in turn, can be used to discover the economic repercussions of inappropriate prescribing and to quantify the cost effectiveness of various therapeutic interventions.

The use of drug utilisation studies in conjunction with pharmacoeconornic analysis can result in more cost effective utilisation of medicines and a better utilisation of pharmacoeconomic methods, both of which contribute to a more rational use of drugs.

Keywords

Drug Consumption Drug Utilisation Pharmacoeconomic Study Drug Utilisation Review Drug Utilisation Study 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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References

  1. Agenäs I, Andrew M. Sales statistics. In Nordic Statistics on Medicines 1981-1983: 1, NLN Publication number 13, Nordic Council on Medicines, Uppsala, 1983Google Scholar
  2. Avorn J, Soumerai SB. Improving drug-therapy decision through educational outreach: a randomized controlled trial of academically based ‘detailing’. New England Journal of Medicine 308: 1457–1463, 1983PubMedCrossRefGoogle Scholar
  3. Baksaas I. Patterns in drug utilization: national and international aspects - antihypertensive drugs. Acta Medica Scandinavica 683: 59–66, 1984PubMedGoogle Scholar
  4. Baksaas I, Ltinde PKM. Drug utilization: pharmacokinetics in the community. Trends in Pharmacological Sciences 2: 5–7, 1981Google Scholar
  5. Bergman U, Boman G, Wiholm BE. Epidemiology of adverse reactions to phenformin and metformin. British Medical journal 2: 464–466, 1978PubMedCrossRefGoogle Scholar
  6. Bergman U, Elmes P, Halse M, et al. The measurement of drug consumption: drugs for diabetes in Northern Ireland. Norway and Sweden. European Journal of Clinical Pharmacology 8: 33–89, 1975CrossRefGoogle Scholar
  7. Bergman U, Sjöqvist F. Measurement of drug utilization in Sweden: methodological and clinical implications. Acta Medica Scandinavica 683: 15–22, 1984PubMedGoogle Scholar
  8. Bergman U, Wessling A, Sjöqvist F. Validation of observed differences in the utilization of antihypertensive drugs and antidiabetic drugs in Northern Ireland, Norway, and Sweden. European Journal of Clinical Pharmacology 29: 1–8, 1985PubMedCrossRefGoogle Scholar
  9. Blackburn JL. Impact of drug usage review on drug utilisation. Pharmacoeconomics 3: 14–21, 1993PubMedCrossRefGoogle Scholar
  10. Boethius G. Approaches to assessing the rationality of drug usage in a developed country. Acta Medica Scandinavica 721: 21–26, 1988PubMedGoogle Scholar
  11. Bootman JL, Larson UN, McGhan WF, Townsend RJ. Pharmacoeconomic research and dinical trials. DICP: Annals of Pharmacotherapy 23: 693–697, 1989PubMedGoogle Scholar
  12. Bootman JL, Townsend RJ, McGhan Wf. Principles of pharmacoeconomics, pp. 3–17, Harvey Whitney, Cincinnati, 1991Google Scholar
  13. Brenner G. Methods to assess health economic aspects on drug utilization. Acta Medica Scandinavica 721: 31–35, 1988PubMedGoogle Scholar
  14. Bright RA, Avorn J, Everitt DE. Medicaid data as a resource for epidemiological studies: strengths and limitations. Journal of Clinical Epidemiology 42: 937–945, 1989PubMedCrossRefGoogle Scholar
  15. Brodie DC. Drug utilization review/planning. Hospitals 46: 103–112, 1972PubMedGoogle Scholar
  16. Brodie DC, Smith WE. Constructing a conceptual model of drug utilization review. Hospitals 50: 143–150, 1976PubMedGoogle Scholar
  17. Commonwealth of Australia. Guidelines for the pharmaceutical industry on preparation of submissions to the Pharmaceutical Benefits Advisory Committee: including submissions involving economic analysis, Department of Health and Community Services, Canberra, 1990Google Scholar
  18. Denig P, Haaijer-Ruskamp FM, Zijsling DH. Impact of a drug bulletin on the knowledge, perception of drug utility, and prescribing behavior of physicians. DICP: Annals of Pharmacotherapy 24: 87–93, 1990PubMedGoogle Scholar
  19. Drummond M. Cost-of-illness studies: A major headache? PharmacoEconomics 2: 1–4, 1992PubMedCrossRefGoogle Scholar
  20. Drummond M, Smith GT, Wells N. Economic evaluation in the development of medicines, pp. 28–29, Office of Health Economics, London, 1988Google Scholar
  21. Edlavitch SA. Postmarketing surveillance methodologies. Drug intelligence and Clinical Pharmacy 22: 68–78, 1988PubMedGoogle Scholar
  22. Eisenbcrg JM. Clinical economics: a guide to the economic analysis of clinical practices. Journal of the American Medical Association 262: 2879–2886, 1989CrossRefGoogle Scholar
  23. Erwin WG. The definition of drug utilization review: statement of issues. Clinical Pharmacology and Therapeutics 50: 596–599, 1991PubMedCrossRefGoogle Scholar
  24. Erill S. Clinical pharmacology in Spain. Clinical Pharmacology and Therapeutics 16: 597–604, 1974PubMedGoogle Scholar
  25. Feinstein AR. Para-analysis, faute de mieux. and the perils of riding on a data barge. Journal of Clinical Epidemiology 42: 929–935, 1989PubMedCrossRefGoogle Scholar
  26. Fendler KJ, Gumbhir AK, Sail K. The impact of drug bulletins on physician prescribing habits in a health maintenance organization. Drug Intelligence and Clinical Pharmacy 18: 627–631, 1984PubMedGoogle Scholar
  27. Fish CA, Kirking DM, Martin JB. Information systems for evaluating the quality of prescribing. DICP: Annals of Pharmacotherapy 26: 392–398, 1992Google Scholar
  28. Freund DA, Dittus RS. Principles of pharmacoeconomic analysis of drug therapy. PharmacoEconomics 1: 20–31, 1992PubMedCrossRefGoogle Scholar
  29. Garratini S, Tognoni G. Drug utilisation review and pharmacoeconomics: interaction after parallel development? PharmacoEconomics 4: 162–172, 1993CrossRefGoogle Scholar
  30. Gross FH. Drug utilization data in risk/benefit analyses of drugs: benefit analysis. Acta Medica Scandinavica 683: 141–147, 1984PubMedGoogle Scholar
  31. Guyatt G, Drurmmond M, Fenny D, Tugwell P, Stoddait G, et al. Guidelines for the clinical and economic evaluation of health care technologies. Social Science and Medicine 22: 393–408, 1986PubMedCrossRefGoogle Scholar
  32. Hemminki E. Review of literature on the factors affecting drug prescribing. Social Science and Medicine 9: 111–115, 1975CrossRefGoogle Scholar
  33. Henry D. Economic analysis as an aid to subsidisation: the development of Australian guidelines for pharmaceuticals. PharmacoEconomics 1: 54–67, 1992PubMedCrossRefGoogle Scholar
  34. Hjort P, Holmen J, Waaler HT. Relation between drug utilization and morbidity pattern: antihypertensive drugs. Acta Medica Scandinavica 683: 89–93, 1984PubMedGoogle Scholar
  35. Hull FM, Westerman RF, Jonkers R. Comparison of prescribing habits of general practitioners in The Netherlands versus England and Wales. Pharmacoeconomics 2: 77–86, 1992PubMedCrossRefGoogle Scholar
  36. Inman WHW. Prescription-event monitoring: a preliminal study of benoxaprofen and fenbufen. Acta Medica Scandinavica 683: 119–126, 1984PubMedGoogle Scholar
  37. Ioannides-Demos LL, Eckert GM, McLean AJ. Pharmacoeconomic consequences of measurement and modification of hospital drug use. Pharmacoeconomics 2: 15–33, 1992PubMedCrossRefGoogle Scholar
  38. Jakovljevic V, Slanulovic M. Extremes in drug utilization patterns. Acta Medica Scandinavica 683: 67–69, 1984PubMedGoogle Scholar
  39. Jones K, Van der Carr SW, Rosa F, Morse L, LeRoy A. Medicaid drug-event data: an emerging tool for evaluation of drug risk. Acta Medica Scandinavica 683: 127–134, 1984PubMedGoogle Scholar
  40. Knapp DA. Development of criteria for drug utilization review. Clin Pharmacology and Therapeutics 50: 600–602, 1991CrossRefGoogle Scholar
  41. Kotzan L, Carroll NV, Kotzan JA. Influence of age, sex, and race om prescription drug use among Georgia Medicaid recipients. American Journal of Hospital Pharmacy 46: 287–290, 1989PubMedGoogle Scholar
  42. Kreling DH, Mott DA. The cost effectiveness of drug utilisation review in an outpatient setting. PharmacoEconomics 4: 414–436, 1993PubMedCrossRefGoogle Scholar
  43. Laporte JR, Porta M, Capella. Drug utilization studies: a tool for determining the effectiveness of drug use. British Journal of Clinical Pharmacology 16: 301–304, 1983PubMedCrossRefGoogle Scholar
  44. Lasagna L. A plea for the ‘naturalistic’ study of medicines. European Journal of Clinical Pharmacology 7: 153–154, 1974PubMedCrossRefGoogle Scholar
  45. Lasagna L. Are drug benefits also part of pharmacoepidemiology? Journal of Clinical Epidemiology 43: 849–850, 1990PubMedCrossRefGoogle Scholar
  46. Lee D, Bergman U. Studies of drug utilization. In Strom (Ed.) Pharmacoepidemiology, pp. 259–274, Churchill Livingstone, New York, 1989Google Scholar
  47. Lewis NJW, Patwell JT, Briesacher BA. The role of insurance claim databases in drug therapy outcomes research. PharmacoEconomics 4: 323–330, 1992CrossRefGoogle Scholar
  48. Liljestrand A. Drug utilization data in benefit analysis of drugs. Acta Medica Scandinavica 683: 135–139, 1984PubMedGoogle Scholar
  49. Lunde PKM.Baksaas I. Epidemiology of drug utilization: basic concepts and methodology. Acta Medica Scandinavica 721: 7–11, 1988PubMedGoogle Scholar
  50. Lunde PKM, Baksaas I, Halvorsen T, Strømnes B, Oydin K. The methodology of drug utilization studies. In Bergman et al. (Eds) Studies in drug utilization, Vol. 8, pp. 17–28, WHO Regional Publications: European Series, Copenhagen, 1979Google Scholar
  51. Maling TJB, Kawachi I. Minimum effective dosage in the drug treatment of hypertension: a cost effective strategy for prescribers. New Zealand Medical Journal 103: 231–233, 1990PubMedGoogle Scholar
  52. Mantel N, Haenszel W. Statistical aspects of the analysis of data from retrospective studies of disease. Journal of the National Cancer Institute 22: 719–748, 1959PubMedGoogle Scholar
  53. Morse ML, Leroy AA, Gaylord TA, Kellengberger T. Reducing drug therapy-induced hospitalization: impact of drug utilization review. Drug Information Journal, October-December: 119, 1982Google Scholar
  54. Raisch DW. A model of methods for influencing prescribing: Part I. A review of prescribing models, persuasion theories, and administrative and educational methods. DICP: Annals of Pharmacotherapy 24: 417–421, 1990PubMedGoogle Scholar
  55. Rucker TD. Data, sources, and limitations. Journal of the American Medical Association 230: 888–890, 1974PubMedCrossRefGoogle Scholar
  56. Sacristan JA, Soto J, Galende I. Evaluation of pharmacoeconomic studies: utilisation of a checklist. Annals of Pharmacotherapy 27: 1126–1133, 1993PubMedGoogle Scholar
  57. Serradell J, Bjomson DC, Hartzema AG. Drug utilization study methodologies: national and international perspectives. DICP: Annals of Pharmacotherapy 21: 994–1001, 1987Google Scholar
  58. Skegg DCG. Relation between drug utilization and morbidity. Acta Medica Scandinavica 683: 81–87, 1984PubMedGoogle Scholar
  59. Slone D, Shapiro S, Miettinen OS, Finkle WD, Slolley PD. Drug evaluation after marketing. Annals of Internal Medicine 90: 257–261, 1979PubMedGoogle Scholar
  60. Soumerai SB. Improving the quality and economy of in-hospital prescribing: getting more for less. Medical Journal of Australia 149: 574–576, 1988PubMedGoogle Scholar
  61. Soumerai SB, Avorn J. Economic and policy analysis of university-based drug ‘detailing’. Medical Care 24: 313–331, 1986PubMedCrossRefGoogle Scholar
  62. Steele MA, Bess DT, Franse VL, Graber SE. Cost effectiveness of two interventions for reducing outpatients prescribing costs. DICP: Annals of Pharmacotherapy 23: 497–500, 1989PubMedGoogle Scholar
  63. Stolar MH. Drug use review: operational definitions. American Journal of Hospital Pharmacy 35: 76–78, 1978PubMedGoogle Scholar
  64. Stole D, Shapiro S, Miettinen OS, Finkle WD, Stolley PD. Drug evaluation after marketing. Annals of Internal Medicine 90: 257–261, 1979Google Scholar
  65. Stolley PD. The use of vital and morbidity statistics for the detection of adverse drug reactions and for monitoring of drug safety. Journal of Clinical Pharmacology 22: 499–504, 1982PubMedGoogle Scholar
  66. Strom BL. What is pharmacoepidemiology? In Strom (Ed.) Pharmacoepidemiology, pp. 3–12, Churchill Livingstone, New York, 1989Google Scholar
  67. Strom BL, Carson JL. Use of automated databases for pharmacoepidemiology research. Epidemiologic Reviews 12: 87–107, 1990PubMedGoogle Scholar
  68. Strom BL, Carson JL, Morse ML. The computerized on-line Medicaid pharmaceutical analysis and surveillance system: a new resource for postmarketing drug surveillance. Clinical Pharmacology and Therapeutics 38: 359–364, 1985PubMedCrossRefGoogle Scholar
  69. Strom BL, Morse ML. Use of computerized databases to survey drug utilization in relation to diagnoses. Acta Medica Scandinavica 721: 13–20, 1988PubMedGoogle Scholar
  70. Smith M. Medication, quality of life and compliance: the role of the pharmacist. PharmacoEconomics 4: 225–230, 1992CrossRefGoogle Scholar
  71. Spitzer WO. Drugs as determinants of health and disease in the population: an orientation to the bridge science of pharmacoepidemiology. Journal of Clinical Epidemiology 44: 823–830, 1991PubMedCrossRefGoogle Scholar
  72. Stika L. Patterns in drug utilization: national and international aspects - antidiabetic drugs. Acta Medica Scandinavica 683: 53–57, 1984PubMedGoogle Scholar
  73. Thomson MS, Fortess EE. Cost-effectiveness analysis in health program evaluation. Evaluation Review 4: 549–568, 1980CrossRefGoogle Scholar
  74. Townsend JR. Postmarketing drug research and development. DICP: Annals of Pharmacotherapy 21: 134–136, 1987Google Scholar
  75. Urquhart J, Chevalley C. Impact of unrecognized dosing errors on the cost and effectiveness of pharmaceuticals. Drug Information Journal 22: 363–378, 1988Google Scholar
  76. van der Lei J, Duisterhout JS, Westerhof HP, van der Does E, Cromme PVM, et al. The introduction of computer-based patient records in The Netherlands. Annals of Internal Medicine 119: 1036–1041, 1993PubMedGoogle Scholar
  77. Vestal RE, Guess H, Lipton H, Luscombe F, Oster G, et al. Panel IV: evaluation. The value and cost-effectiveness of drug utilization review programs. Clinical Pharmacology and Therapeutics 50: 636–638, 1991CrossRefGoogle Scholar
  78. Walley T, Edwards RT. Health economics in primary care in the UK. Containment of drug costs. PharmacoEconomics 3: 100–106, 1993PubMedCrossRefGoogle Scholar
  79. Wessling A, Boethius G. Measures of drug use in a defined population: evaluation of the Defined Daily Dose (DDD) methodology. European Journal of Clinical Pharmacology 39: 207–210, 1990PubMedCrossRefGoogle Scholar
  80. Westerholm B. Drug utilization studies: a valuable tool for the optimization of drug therapy and drug control. Journal of Social and Administrative Pharmacy 1: 1–8, 1983Google Scholar
  81. Westerholm B, Agenas I, Dahlstrom M, Nordenstam I. Relation between drug utilization and morbidity patterns. Acta Medica Scandinavica 683: 95–97, 1984PubMedGoogle Scholar
  82. WHO Expert Committee. The selection of essential drugs. Report of a WHO Expert Committee World Health Organization Technical Report Series 615: 1–36, 1977Google Scholar
  83. Wiholm BE, Westerholm B. Drug utilization and morbidity statistics for the evaluation of drug safety in Sweden. Acta Medica Scandinavica 683: 107–117, 1984PubMedGoogle Scholar

Copyright information

© Adis International Limited 1994

Authors and Affiliations

  • José A. Sacristén
    • 1
  • Javier Soto
    • 2
  1. 1.Health Economics Department and Clinical Research DepartmentLilly S.A.MadridSpain
  2. 2.Pharmacoepiderniology DepartmentAbbott LaboratoriesMadridSpain

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