Encouraging consensus cost effective drug therapy : five years experience with a hospital drug utilisation review programme

AIMS: To evaluate the impact of a local hospital drug utilisation review (DUR) programme over the first 5 years of operation. METHODS: The local drug utilisation review programme focussed on improving the quality and cost effectiveness of drug use. It began with the introduction of a preferred medicines list (PML) to the six Christchurch hospitals in December 1990. The drug utilisation review program was evaluated by monitoring local and national hospital drug costs and local patient numbers. Compliance with the preferred medicines list was measured and clinical users were surveyed to gauge their response to the programme. The effects of guidelines were also evaluated in selected drug therapy areas. RESULTS: Local annual hospital drug costs increased 20% from $8.26M in 1991 to $9.96M in 1995. During this time patient numbers increased by 16% and national hospital drug sales have increased 65%. Before the programme introduction local drug costs were increasing on average 46% per year. Compliance with the preferred medicines list was 98%. Of the clinical users surveyed, 88% of respondents felt the programme caused no major restriction of personal clinical practice. Guidelines on ondansetron ceftriaxone and asthma drug therapy helped improve the quality of drug therapy. CONCLUSION: The local drug utilisation review programme, helped facilitate improved quality drug therapy and contain overall hospital drug costs.