• Evaluation Of The Cost-Effectiveness Of Auditing-Feedback Intervention On Drug And Paraclinic Prescribing Indicators In The Social Security Organization Of Tehran between 2016 and 2018
  • Yasaman Avazeh,1,* Ali Heydari,2 Fatemeh Soleymani,3 Hanieh Sadat Sajjadi,4
    1. Department of Pharmacoeconomics and Pharmaceutical Administration, Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran
    3. Department of Pharmacoeconomics and Pharmaceutical Administration, Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran


  • Introduction: One of the most important challenges in the field of pharmacotherapy is the inappropriate and irrational prescription of drugs, which itself causes unwanted consequences both from the perspective of society's health and from the perspective of cost in the health system. In order to prevent and reduce the amount of irrational drug prescription and consumption, various solutions have been proposed by the World Health Organization and implemented by many countries. One of the most effective solutions proposed in the field of management strategies is the implementation of an audit-feedback intervention on the performance of doctors' prescriptions. Therefore, in this study, the cost-effectiveness of auditing-feedback interventions on drug prescribing and paraclinical indicators in Tehran Social Security Organization with the aim of using the results of this study in planning, policy development and resource allocation management to develop strategies to promote rational drug prescribing was investigated.
  • Methods: First, in order to evaluate the level of effectiveness, intervention effectiveness indicators were determined and their values were extracted using TDMS software. Then, the calculation of changes in the indicators was examined, and at the end, the growth rate, the calculation of gross profit due to the implementation of the intervention and the calculation of net profit (savings) due to the implementation of the intervention were calculated by analytical methods.
  • Results: The changes in the average effectiveness indicators of the study showed that the average number of prescribed medicinal items and the amount of antibiotics prescribed in these 3 years have decreased. While the percentage of prescriptions containing serum, the average prescription of tests per prescription and the percentage of prescriptions containing tests to the total prescription have been increasing. The amount of prescription containing corticosteroid drugs and injectable drugs had a fluctuating trend. The important point is the calculation of the costs incurred for the implementation of the intervention in relation to the changes in the effectiveness indicators, the results showed that the implementation of this intervention, in addition to controlling the amount of irrational prescription of this group of drugs, also saved drug costs from a financial point of view. So that the amount of savings based on the average reduction of medicinal items in this study was estimated as 29,561,193 dollars.
  • Conclusion: This study showed that the implementation of the audit-feedback intervention on the percentages of antibiotics and the average of pharmaceutical items written in physicians' prescriptions had made good progress. But in terms of the percentage of serum prescribed in the prescription, the percentage of tests and the average number of tests, as well as the percentage of injectable drugs and corticosteroids, it has not performed well. In order to improve it, education and culturalization to retrain some doctors to change their prescribing behavior, as well as pharmacists to advise patients and perform several interventions simultaneously, are needed.
  • Keywords: Rational drug prescription, Audit-Feedback intervention, Economic evaluation.