The potential influence of various initiatives to improve rational prescribing for proton pump inhibitors and statins in Belgium

Jessica Fraeyman; Guido Van Hal; Brian Godman; Philippe Beutels

doi:10.1586/erp.12.88

The potential influence of various initiatives to improve rational prescribing for proton pump inhibitors and statins in Belgium

Jessica Fraeyman^*, Guido Van Hal, Brian Godman, Philippe Beutels

^*Corresponding author for this work

Research output: Contribution to journal › Article › peer-review

23 Citations (Scopus)

Abstract

Background: Proton pump inhibitors (PPIs) and statins have been among the top three most prescribed medicines in Belgium for more than a decade. Multiple demand-side measures have been introduced to improve rational prescribing generally, as well as for these two classes. Objectives: First, assessing the influence of general and specific reforms introduced in Belgium since 1997 on utilization and expenditure of the PPIs and statins. Second, suggesting additional measures to further improve rational prescribing based on experiences in other European countries. Methods: A retrospective observational study for assessing the influence of multiple initiatives in Belgium on utilization and expenditure of the PPIs and statins from 1997 to 2009 was carried out. Data were extracted from the administrative database Pharmanet. Utilization was measured in terms of defined daily doses (DDDs) and DDDs/thousand inhabitants per day. Results: Multiple reforms, including co-payments and reference pricing, appreciably enhanced rational prescribing for both PPIs and statins following generic availability. There was an eightfold increase in PPI utilization between 1997 and 2009, but only a twofold increase in reimbursed expenditure, helped by decreasing expenditure/DDD for the PPIs from €1.91 in 1997 to €0.52 in 2009. Similarly, a 20-fold increase was observed in statin utilization between 1997 and 2009, but only a fivefold increase in reimbursed expenditure, helped again by reimbursed expenditure/DDD decreasing from €2.05 in 1997 to €0.57 in 2009. Reduced co-payments for larger packs enhanced their prescription. Conclusion: Multiple reforms influenced utilization patterns and expenditure for the PPIs and statins, as well as the pack sizes dispensed. Additional demand-side measures are needed to further enhance rational prescribing, which can build on the experiences in other countries. These can be potentially transferred to other classes.

Original language	English
Pages (from-to)	141-151
Number of pages	11
Journal	Expert Review of Pharmacoeconomics and Outcomes Research
Volume	13
Issue number	1
DOIs	https://doi.org/10.1586/erp.12.88
Publication status	Published - Feb 2013
Externally published	Yes

Keywords

Belgium
demand-side measures
drug utilization studies
generics
pharmaceuticals
proton pump inhibitors
reference pricing
statins

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10.1586/erp.12.88

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@article{e1c90d734b534f3b923196346b32006f,

title = "The potential influence of various initiatives to improve rational prescribing for proton pump inhibitors and statins in Belgium",

abstract = "Background: Proton pump inhibitors (PPIs) and statins have been among the top three most prescribed medicines in Belgium for more than a decade. Multiple demand-side measures have been introduced to improve rational prescribing generally, as well as for these two classes. Objectives: First, assessing the influence of general and specific reforms introduced in Belgium since 1997 on utilization and expenditure of the PPIs and statins. Second, suggesting additional measures to further improve rational prescribing based on experiences in other European countries. Methods: A retrospective observational study for assessing the influence of multiple initiatives in Belgium on utilization and expenditure of the PPIs and statins from 1997 to 2009 was carried out. Data were extracted from the administrative database Pharmanet. Utilization was measured in terms of defined daily doses (DDDs) and DDDs/thousand inhabitants per day. Results: Multiple reforms, including co-payments and reference pricing, appreciably enhanced rational prescribing for both PPIs and statins following generic availability. There was an eightfold increase in PPI utilization between 1997 and 2009, but only a twofold increase in reimbursed expenditure, helped by decreasing expenditure/DDD for the PPIs from €1.91 in 1997 to €0.52 in 2009. Similarly, a 20-fold increase was observed in statin utilization between 1997 and 2009, but only a fivefold increase in reimbursed expenditure, helped again by reimbursed expenditure/DDD decreasing from €2.05 in 1997 to €0.57 in 2009. Reduced co-payments for larger packs enhanced their prescription. Conclusion: Multiple reforms influenced utilization patterns and expenditure for the PPIs and statins, as well as the pack sizes dispensed. Additional demand-side measures are needed to further enhance rational prescribing, which can build on the experiences in other countries. These can be potentially transferred to other classes.",

keywords = "Belgium, demand-side measures, drug utilization studies, generics, pharmaceuticals, proton pump inhibitors, reference pricing, statins",

author = "Jessica Fraeyman and {Van Hal}, Guido and Brian Godman and Philippe Beutels",

note = "Funding Information: J Fraeyman, G Van Hal and P Beutels acknowledge financial support from the Special Research Fund (Bijzonder Onderzoeksfonds) of the University of Antwerp, and B Godman acknowledges financial support from the Karolinska Institute. P Beutels reports that a research chair in evidence-based vaccinology at the Vaccine & Infectious Disease Institute is currently sponsored by a gift from Pfizer to the University of Antwerp. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.",

year = "2013",

month = feb,

doi = "10.1586/erp.12.88",

language = "English",

volume = "13",

pages = "141--151",

journal = "Expert Review of Pharmacoeconomics and Outcomes Research",

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T1 - The potential influence of various initiatives to improve rational prescribing for proton pump inhibitors and statins in Belgium

AU - Fraeyman, Jessica

AU - Van Hal, Guido

AU - Godman, Brian

AU - Beutels, Philippe

N1 - Funding Information: J Fraeyman, G Van Hal and P Beutels acknowledge financial support from the Special Research Fund (Bijzonder Onderzoeksfonds) of the University of Antwerp, and B Godman acknowledges financial support from the Karolinska Institute. P Beutels reports that a research chair in evidence-based vaccinology at the Vaccine & Infectious Disease Institute is currently sponsored by a gift from Pfizer to the University of Antwerp. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

PY - 2013/2

Y1 - 2013/2

N2 - Background: Proton pump inhibitors (PPIs) and statins have been among the top three most prescribed medicines in Belgium for more than a decade. Multiple demand-side measures have been introduced to improve rational prescribing generally, as well as for these two classes. Objectives: First, assessing the influence of general and specific reforms introduced in Belgium since 1997 on utilization and expenditure of the PPIs and statins. Second, suggesting additional measures to further improve rational prescribing based on experiences in other European countries. Methods: A retrospective observational study for assessing the influence of multiple initiatives in Belgium on utilization and expenditure of the PPIs and statins from 1997 to 2009 was carried out. Data were extracted from the administrative database Pharmanet. Utilization was measured in terms of defined daily doses (DDDs) and DDDs/thousand inhabitants per day. Results: Multiple reforms, including co-payments and reference pricing, appreciably enhanced rational prescribing for both PPIs and statins following generic availability. There was an eightfold increase in PPI utilization between 1997 and 2009, but only a twofold increase in reimbursed expenditure, helped by decreasing expenditure/DDD for the PPIs from €1.91 in 1997 to €0.52 in 2009. Similarly, a 20-fold increase was observed in statin utilization between 1997 and 2009, but only a fivefold increase in reimbursed expenditure, helped again by reimbursed expenditure/DDD decreasing from €2.05 in 1997 to €0.57 in 2009. Reduced co-payments for larger packs enhanced their prescription. Conclusion: Multiple reforms influenced utilization patterns and expenditure for the PPIs and statins, as well as the pack sizes dispensed. Additional demand-side measures are needed to further enhance rational prescribing, which can build on the experiences in other countries. These can be potentially transferred to other classes.

AB - Background: Proton pump inhibitors (PPIs) and statins have been among the top three most prescribed medicines in Belgium for more than a decade. Multiple demand-side measures have been introduced to improve rational prescribing generally, as well as for these two classes. Objectives: First, assessing the influence of general and specific reforms introduced in Belgium since 1997 on utilization and expenditure of the PPIs and statins. Second, suggesting additional measures to further improve rational prescribing based on experiences in other European countries. Methods: A retrospective observational study for assessing the influence of multiple initiatives in Belgium on utilization and expenditure of the PPIs and statins from 1997 to 2009 was carried out. Data were extracted from the administrative database Pharmanet. Utilization was measured in terms of defined daily doses (DDDs) and DDDs/thousand inhabitants per day. Results: Multiple reforms, including co-payments and reference pricing, appreciably enhanced rational prescribing for both PPIs and statins following generic availability. There was an eightfold increase in PPI utilization between 1997 and 2009, but only a twofold increase in reimbursed expenditure, helped by decreasing expenditure/DDD for the PPIs from €1.91 in 1997 to €0.52 in 2009. Similarly, a 20-fold increase was observed in statin utilization between 1997 and 2009, but only a fivefold increase in reimbursed expenditure, helped again by reimbursed expenditure/DDD decreasing from €2.05 in 1997 to €0.57 in 2009. Reduced co-payments for larger packs enhanced their prescription. Conclusion: Multiple reforms influenced utilization patterns and expenditure for the PPIs and statins, as well as the pack sizes dispensed. Additional demand-side measures are needed to further enhance rational prescribing, which can build on the experiences in other countries. These can be potentially transferred to other classes.

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KW - reference pricing

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The potential influence of various initiatives to improve rational prescribing for proton pump inhibitors and statins in Belgium

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