Evaluation of multi-dose repackaging for individual patients in long-term care institutions: savings from the perspective of statutory health insurance in Germany

Aims and objectives Elderly people often have difficulty adhering to multi-drug medication regimens. The current study aimed to evaluate whether multi-dose repackaging for individual patients reduces medication expenses from the perspective of statutory health insurance in Germany. Setting A total of 307 residents, mean age 76.8 years, median age 80 years, from four long-term care facilities were included in the prospective pre—post study conducted from September 2004 to December 2005. Minimum periods of 9 months prior to and 9 months following the introduction of multi-dose packaging were compared at the individual level with respect to the expenses for medications that were repackaged in weekly blister packs. Method The main outcome measure was savings in medication expenses. Statistical evaluation was carried out using the program Rversion 2.1.0. Adjustments were made for effects of age and con currently increasing morbidity in so far as number of prescriptions were held constant at the individual level. Key findings In the subset of 181 people included in this analysis, approximately 6.0% (95% confidence interval, 5.1–7.0%; P < 0.001) of expenses for medication were saved: 2.0% (1.6–2.3%; P < 0.001) was due to price differences and 4.1% (3.2–5.0%; P < 0.001) to reduced wastage of prescribed medication. The probability of being prescribed a generic compared with a brand-name medication was significantly lower prior to the introduction of repackaging (0.92, 0.89–0.94; P < 0.01), although this did not have any effect on turnover of medications (0.996, 0.988–1.005; P < 0.01). Conclusion Significant savings in medication expenses were found. Nonetheless, cost savings should not be the sole objective in reorganising drug dispensing.