Controlling Prescribing through “Preferred Drug” Targets—The Bavarian Experience

Julia Gollnick (), Nikoletta Zeschick, Julia Muth, Franziska Hörbrand, Kerstin Behnke, Peter Killian, Maria Sebastiao, Thomas Kühlein and Norbert Donner-Banzhoff
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Julia Gollnick: Institute of General Practice/Family Medicine, Philipps University of Marburg, Karl-von-Frisch-Straße 4, 35043 Marburg, Germany
Nikoletta Zeschick: Institute of General Practice, Friedrich-Alexander-University of Erlangen-Nürnberg (FAU), Universitätsstr. 29, 91054 Erlangen, Germany
Julia Muth: Institute of General Practice/Family Medicine, Philipps University of Marburg, Karl-von-Frisch-Straße 4, 35043 Marburg, Germany
Franziska Hörbrand: Association of Statutory Health Insurance Physicians, Bavaria, Elsenheimerstraße 39, 80687 München, Germany
Kerstin Behnke: Association of Statutory Health Insurance Physicians, Bavaria, Elsenheimerstraße 39, 80687 München, Germany
Peter Killian: Association of Statutory Health Insurance Physicians, Bavaria, Elsenheimerstraße 39, 80687 München, Germany
Maria Sebastiao: Institute of General Practice, Friedrich-Alexander-University of Erlangen-Nürnberg (FAU), Universitätsstr. 29, 91054 Erlangen, Germany
Thomas Kühlein: Institute of General Practice, Friedrich-Alexander-University of Erlangen-Nürnberg (FAU), Universitätsstr. 29, 91054 Erlangen, Germany
Norbert Donner-Banzhoff: Institute of General Practice/Family Medicine, Philipps University of Marburg, Karl-von-Frisch-Straße 4, 35043 Marburg, Germany

IJERPH, 2024, vol. 21, issue 9, 1-12

Abstract: Background: The rising costs of drugs are putting health care systems under pressure. We report on the Bavarian Drug Agreement, which employs prescribing targets for preferred and generic drugs in ambulatory care. Under this agreement, providers are regularly profiled with individual feedback but also possible sanctions. We investigated the degree to which targets were being met (or not) and why failure occurred. Methods: We analysed prescribing data aggregated by practice for the quarter 1/2018. We chose eight specialisation groups and analysed their drug targets with a high prescribing volume, widely missed drug targets (<90%), and drugs preventing drug target achievement. Characterisation of drug targets and preventing drugs was undertaken. Results: Drug targets with a high prescribing volume are mostly achieved, while highly missed drug targets mostly do not affect the main indication area of the specialisation groups considered. Generic drug targets seem to be more easily achieved than recommended drug targets. Paediatrics accounts for the largest number of missed drug targets. Conclusions: The Bavarian tool implemented uses the prescribing volume (DDD) and price components to evaluate the prescription behaviour of physicians. Well-established drugs with demonstrated effectiveness, safety, and lower costs are preferred. Nevertheless, me-too drugs, combination drugs, costly innovations with unclear value, and drugs with application methods of variable convenience challenge the drug prescribers and are reasons for missed drug targets.

Keywords: drug prescriptions; ambulatory care/economics; budgets; drug therapy/economics; drug therapy/trends; cost control/trends (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2024
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