Abstract
ObjectivesTaiwan’s National Health Insurance (NHI) has encouraged physicians to use “chronic medication prescriptions” for patients with stable chronic diseases since 1995. Patients are allowed to refill such prescriptions at community pharmacies for a maximum of three months’ supply of medications without revisiting the doctor. In 2006, NHI initiated strategies targeting the public, doctors, and healthcare facilities to enhance the overall rate of chronic medication prescriptions, aiming to achieve 30% by 2010. We examined prescribing and dispensing of oral antidiabetic drugs from 2001 to 2010, before and after the start of the promotion strategies for chronic medication prescriptions in 2006.MethodsUsing outpatient care data from the NHI database and the interrupted time series design, we analyzed changes in rate of chronic medication prescriptions, share of prescriptions filled at community pharmacies, and share of reimbursed expenditures accounted by community pharmacies.ResultsDuring 2001-2010, the rate of chronic medication prescriptions for diabetes increased steadily by about 3% per year (from 3.5% to 26.2%). Three years after the promotion strategies, there was a non-significant reduction of 8.7% (95% confidence interval [CI]: -17.35%, 0.05%) in the rate of chronic medication prescriptions but increases in prescription refills at community pharmacies and associated reimbursed expenditures: 12.8% (95% C.I.:1.66%, 23.98%) and 15.8% (95% C.I.: -1.35%, 33.02%) respectively.ConclusionsWhile rate of chronic medication prescriptions was not significantly affected by the 2006 promotion strategy, shares of prescriptions refilled at community pharmacies and associated expenditures increased slightly but significantly.
Highlights
Diabetes mellitus has become a global epidemic [1,2,3] and is a major and growing cause of morbidity and mortality in most countries [4,5,6,7]
Using outpatient care data from the National Health Insurance (NHI) database and the interrupted time series design, we analyzed changes in rate of chronic medication prescriptions, share of prescriptions filled at community pharmacies, and share of reimbursed expenditures accounted by community pharmacies
While rate of chronic medication prescriptions was not significantly affected by the 2006 promotion strategy, shares of prescriptions refilled at community pharmacies and associated expenditures increased slightly but significantly
Summary
Diabetes mellitus has become a global epidemic [1,2,3] and is a major and growing cause of morbidity and mortality in most countries [4,5,6,7]. The prevalence of type 2 diabetes has. Oral hypoglycemic medications are the mainstay of treating type 2 diabetes. Given the growing prevalence of type 2 diabetes, the availability of new but more expensive medications is likely to. Studies have reported the utilization of antidiabetic medications over time in the US [14,15], the UK [5,7,16], Italy [3], Germany [6,17], France [2], and Hungary [18]. In Taiwan, Chiang et al [19] reported prescribing patterns of oral antidiabetic drugs from 1997 to 2003. No studies have reported recent trends in utilization of oral antidiabetic medications in Taiwan. Little is known about health policy impacts on access to oral antidiabetic agents
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