Antibiotic prescribing policy of the Republic health insurance fund of Montenegro in the period 2000-2004: Effects of drug utilization reform strategy

Abstract

Monitoring of antibiotic prescribing promotes rational use of these drugs, reduces costs and slows down the progress of resistance. The objective of present study was to analyze the effects of drug utilization reform strategy realized by the Republic Health Insurance Fund of Montenegro, during the period 2000-2004. This before-after comparative pharmacoepidemiological study comprised a sample of 100% prescription only antibiotics available in public pharmacies during the period 2000 - 2004. The drug use was calculated using ATC/DDD methodology and Wilcoxon's test for matched pairs was used in order to calculate the statistical significance of difference. Antibiotic prescribing was approximately lower by 12% in 2004 in regard to 2000 (12.80 vs. 14.57 DDDs, p > 0.05). The participation of this pharmacotherapeutic group in the total drug dispensing has remained almost equal (approximately 8%). The highest increase in prescribing was established for macrolides (1.05 vs. 1.64 DDDs, 59%); penicillins were also prescribed more frequently (6.41 vs. 6.56 DDDs, 2%), but other subgroups were prescribed less frequently: cephalosporins--(23%) (3.11 vs. 2.43 DDDs) and quinolones--(63%) (1.10 vs. 0.47 DDDs). The drug utilization reform strategy showed mostly positive effects on antibiotic prescribing during the period 2000 - 2004. Further educational activities are necessary in order to establish more rational approach to prescribing and utilization of antibiotics.