Oraluck Pattanaprateep MBA*, Petcharat Pongcharoensuk PhD*, Patcharin Suvanakoot MSc**, Sming Kaojarern MD***
Affiliation : * Department of Pharmacy, Faculty of Pharmacy, Mahidol University, Bangkok, Thailand ** Pharmacy Division, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand *** Department of Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
Background : The use of statins at Ramathibodi, a teaching hospital, has been rising rapidly.
Objective : Determine how price, volume, and drug mix (use of five brands and one generic) affect expenditure.
Material and Method: Dispensing records of the six statins were retrieved from database and analyzed for factors contributing
to increased drug expense.
Results : Overall, statins’ expenditure rose 35.6% and 6.4% in 2006 and 2007 respectively, mainly from civil servant
outpatients who are more likely to be prescribed with brand drugs, even among new patients. In all schemes, volume effect
was positive, more people use statins, and each one used a larger quantity of drug in 2007 than in 2005. The price effect was
negative. Drug mix effect indicated that there was a shift from higher to lower priced drugs in capitation scheme and from
lower to higher priced original drugs in a fee-for-service scheme.
Conclusion : There is a trend of more statins utilization but with a different pattern of drug prescribed between health schemes
and possible drug over-prescribed in some patients. However, indication for statin use was not studied, which needs to be
considered. With high use of original drugs, effective policy initiative to promote generic drug use should be implemented in
order to efficiently use the limited health care resources.
Keywords : Statins, Drug expenditure, Price, Quantity
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