Does a computerized price comparison module reduce prescribing costs in general practice?

Abstract

Objective: We aimed to assess the trends in prescribed defined daily doses (DDD) and drug expenses before and after the introduction of a computerized cost containment module into the computer record system of a defined group of GPs. The GPs' expectations for and experiences with the module were examined.

Method: We performed a controlled follow-up study on antecedent data before and after intervention. A questionnaire was administered to the intervention group at the introduction and 1 year later. Data on prescribing were collected in the database of the Health Insurance Aarhus County, as a normal routine for accounting. The GPs were not aware of the ongoing cost supervision study. Additional cost information software was introduced on 1 January 1993 to 20 practices with 28 GPs. The software assisted the GPs in a semiautomatic way to identify and prescribe the cheapest drugs. The subjects comprised 158 practices including 231 GPs in Aarhus County, Denmark. Questionnaires were sent to the 20 intervention practices. The main outcome measures were prescribed DDD, reimbursement for prescribed drugs, and reimbursement per prescribed DDD quarterly during 1992 and 1993.

Results: Compared with the controls there were no changes in prescribed DDD, reimbursement for prescribed drugs, and reimbursement per prescribed DDD in the intervention group after the introduction of the module.

Conclusion: Simply giving a random group of GPs computer assistance to choose less expensive drugs did not reduce expenditure per DDD. Cost containment procedures should be more intensive than just giving the doctors a computer-assisted decision aid.