Authors: Yaron Bar-Dayan; Yitzhak Rosen; Naomi Yachelevich; Paul Benedek; Itamar Grotto; Avishy Goldberg; Yair Morad; Hadar Marom; Nissim Ohana

Source: Military Medicine, Volume 169, Number 11, November 2004 , pp. 932-936(5)

Publisher: AMSUS - Association of Military Surgeons of the U.S.

Abstract:

Background: Over the last few years, major health care systems have been trying to control increasing pharmaceutical expenditures by a variety of methods, such as the controversial copayment policy, as essential health expenditures were being jeopardized. Objective: To analyze the regulatory intervention of preauthorization on a rofecoxib model in the medical corps of the Israeli Defense Forces (IDF) in terms of indications for prescription, consumption, and cost. Interventions: Guidelines established by the medical services branch based on current literature and communication with diverse specialists and hospitals were implemented by a general practitioner who checked each rofecoxib prescription that was written for IDF personnel by a specialist. The intervention was initiated in November 2000 and continued until August 2001 and after the study. Design: The study was divided into two parts. The first part was a retrospective monthly, preintervention analysis of computerized medical records of IDF personnel (N = 247) for whom rofecoxib was prescribed. The second was a prospective monthly, postintervention analysis of filled-out guideline forms (N = 250) of approved rofecoxib prescriptions. Participants: Patients were IDF personnel, age 18 to 45, treated in military and civilian outpatient clinics for whom rofecoxib was prescribed. Setting: The study took place at the Medical Service Branch of the IDF between August 2000 and August 2001. Results: We demonstrated a significant decrease in average monthly consumption (43.0%) and estimated monthly expenditures (40.84%) of rofecoxib, as well as significant shifts (p < 0.001) in indications for whom rofecoxib was approved. These shifts (from pre- to postintervention) include the following: others/nonspecified (80 to 12%), known peptic disorder (7 to 32%), peptic complaints (4 to 22%), and rheumatic (8 to 19%). Conclusion: This type of intervention can be cost-effective, can provide quality care, and may be a viable alternative to the controversial and problematic copayment policy.

Document Type: Research article

Publication date: 2004-11-01

More about this publication?

• Military Medicine is the Association's official monthly journal. The objective of the Journal is to promote awareness of Federal medicine by providing a forum for responsible discussion of common ideas and problems relevant to Federal healthcare. Its mission is: To increase healthcare education by providing scientific and other information to its readers; to facilitate communication; and to offer a prestige publication for members' writings.
• Editorial Board
• Information for Authors
• Submit a Paper
• Subscribe to this Title
• Membership Information
• Information for Advertisers
• Terms & Conditions
• Reviewer Information
• ingentaconnect is not responsible for the content or availability of external websites

Related content

• In this: publication
• By this: publisher
• In this Subject: Medicine (General) ,  Political Science
• By this author: Yaron Bar-Dayan ;  Yitzhak Rosen ;  Naomi Yachelevich ;  Paul Benedek ;  Itamar Grotto ;  Avishy Goldberg ;  Yair Morad ;  Hadar Marom ;  Nissim Ohana

Website © Publishing Technology. Article copyright remains with the publisher, society or author(s) as specified within the article.

• Terms and conditions
• Privacy policy
• Information for advertisers