Research project SO/10/074 (Research action SO)
Context
Belgium has a high quality health care system. The demographic development and new innovative but more expensive medical techniques exercise an upward pressure on the health care budget. These factors may jeopardise in the medium to long term the principle of equity in access to healthcare.
Eighteen percent of the health care costs are due to drugs (2001 data). Pharmaceutical expenditures increased with an average of 9.11% in the last decade (vs. 7.2% for the other health expenditures).
By providing objective and independent information through feedbacks on prescribing habits, public authorities try to prompt prescribers to a more rational way of prescribing. A more normative phase was introduced in 1999 with the introduction of a partially closed budget for the financing of antibiotics used prophylactically in surgical interventions. Currently, the intention is to extend this way of financing to other drug categories. This will have important consequences for the actors involved in the pharmacotherapeutic process in the hospitals (the hospital administrator, the medico-pharmaceutical committee, the prescribers, the hospital pharmacists, …)
Objectives
Initiating a partially closed budget obliges hospitals to look into the prescribing habits of their physicians and, if needed, to take the necessary steps to correct those. The impact of those measures on the group targeted, namely the prescribers, depends mainly on the strategies used to disseminate the information.
A first objective of this project is to examine which processes may influence prescribing habits. The public authorities, scientific organizations, pharmaceutical industry and medico-pharmaceutical committees try to influence prescribers in their decision to add a drug to their personnel list of drugs to prescribe.
An in-dept analysis of the factors influencing this decision process can make this process more transparent and favour a more rational pharmacotherapy. Based on a review of the literature a theoretical model of communication adapted to pharmacotherapy will be developed and tested in daily practice.
This will allow to develop a communication strategy concerning pharmacotherapy in the hospital.
A second objective is to list the problems encountered by the implementation of a partial budget for antibiotics used in prophylaxis. This step will be linked to an analysis of quantitative data from de database CIES. This multicentre analysis will help to develop a methodology to provide hospital administrators, medico-pharmaceutical committees as well as individual physicians, with an efficient and appropriate feedback on prescribing habits.
A third objective aims at developing and validating potential quality indicators which could measure the relationship between a pharmacotherapeutic steering and effective drug utilization. Among others, the relationship between reinforcement actions initiated by the administrators (formulary) and drug utilization will be tested taking into account the pathology data.
An analysis of the use of new drugs and their added therapeutic value will help to model the breakthrough power of those drugs.
Keuze en gebruik van geneesmiddelen in de Belgische ziekenhuizen : werking van het medisch Farmaceutisch Comité : rapport final = Choix et utilisation des médicaments dans les hôpitaux belges : activités du Comité medico-pharmaceutique : eindrapport
Closon, Marie-Christine - Robays, Hugo Gent : Academia Press, 2005 (PB6152)
Choix et consommation des médicaments dans les hôpitaux belges. Activités du comité medico-pharmaceutique : résumé
Bruxelles : Politique scientifique fédérale, 2005 (SP1528)
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Keuze en gebruik van geneesmiddelen in de Belgische ziekenhuizen. Werking van het medisch farmaceutisch comité : samenvatting
Brussel : Federaal Wetenschapsbeleid, 2005 (SP1529)
[To download]
Choice and use of medications in Belgian hospitals. Activities of the drug and therapeutic committees : summary
Brussels : Belgian Science Policy, 2005 (SP1530)
[To download]
