Drug database and performance indicators for utilization monitoring

1
Drug database and performance indicators for
utilization monitoring

• by
• Petcharat Pongcharoensuk, et al.
• Faculty of Pharmacy, Mahidol University
• e-mail pyppn_at_mahidol.ac.th
• Sponsor The National Health Security Office

2
Introduction

• Drugs, 30 of health expenses
• Drug database in hospitals (purchasing and
  dispensing)
• Limited utility
• Lack standard format and code
• Insufficient information technology
• Drug information for decision making

3
Objective

• To determine key performance indicators for drug
  utilization monitoring
• Total purchase
• ratio EDNED
• by drug group, etc.
• Unit price statistics

4
Methodology

• Sample 26 public hospitals (10-1000 bed)
• 5 small, 21 medium and large
• Source Electronic purchase database (2000-2002)
• Data transformation (mapping different codes into
  standard code)
• Data consolidation and analysis

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Results Key performance indicators

• I. Total drug purchase (million baht)
• --------------------------------------------
• Year Purchase change
• (adjusted) (adjusted)
• ---------------------------------------------
• 2000 817.8
• 2001 908.3 (898.4) 11.0 (9.9)
• 2002 978.4 (947.7) 7.7 (5.6)
• -----------------------------------------
• Notes adjusted for inflation of 1.1 in 2001
  and 1.9 in 2002 (NESDB).

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II. Drug as total expenses, 2002

• -----------------------------------------------
• Type of Hospital (bed) N Range Avg.
• -----------------------------------------------
• Regional (500-1000) 7 15.6-29.4 20.7
• General (200-500) 14 11.2-27.2 18.3
• Community (10-90) 5 12.5-19.6 17.5
• -----------------------------------------------

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III. Ratio NEDED

• -----------------------------------------
• Year Ratio (NEDED)
• -----------------------------------------
• 2000 15 85
• 2001 17 83
• 2002 18 82
• -----------------------------------------

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IV. Pharmacological sub-groups ()

• -----------------------------------------------
• Rank Group 2002 2001 2000
• -----------------------------------------------
• 1 Anti-bacterials 21.6 23.8 26.6
• 3 Anti-asthma 4.0 4.4 3.9
• 4 Anti-diabetics 3.9 3.3 3.0
• 5 Hypo-lipidemic 3.3 2.8 2.4
• 6 Anti-anaemic 3.3 2.7 2.1
• 8 NSAIDS 2.5 2.6 2.0
• 10 Cytostatic 2.2 1.7 1.4
• -----------------------------------------------
• Total (million) 824 779 730
• -----------------------------------------------

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V. Unit price statistics

• --------------------------------------------------
  -
• Drug N Min Max Avg. p50 p75
• --------------------------------------------------
  -
• Aledronate 10 mg tab 48 45.9 81.7 49.0
  48.2 48.2
• Alprazolam .25 mg tab 44 0.2 5.0 0.7
  0.5 0.8
• Atorvastatin 20 mg tab 32 50.3 58.4 52.3
  50.3 52.3
• Captopril 25 mg tab 27 1.4 26.3 6.1
  7.5 7.5
• Cefoperazone 1 g inj 65 220 487 422
  486 486
• Ceftriaxone 1 g inj 22 20.2 124 36.6
  31.0 38.0
• Ciprofloxacin 250 mg tab 59 1.2 14.1
  4.2 3.8 5.4
• Simvastatin 10 mg tab 66 2.0 8.9
  4.7 4.2 5.4
• Rosiglitazone 4 mg tab 12 57.3 87.9 59.9
  57.3 57.3
• --------------------------------------------------
  -

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Discussions

• Lesson learned
• Urgent need for data management and policy
  implementations
• Policy implications
• Central data warehouse (MoPH?)
• Agency for standard drug code (FDA?)
• Quantity and quality indicators

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Recommendations

• Research
• Cost of illness and quality of drug use
• Outcomes of treatment
• Systematic management of drugs

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Acknowledgement

• Team
• Mr Mungorn Angsanant
• Ms Pornpimol Chantarakunopars
• Preeyaporn Phutong
• Siritorn Kongsawat
• Etc.