Medicine Consumption by the Elderly in Argentine

Abstract

Background: The implementation of an information system on prescription drug plan that includes the pharmacological classification and the composition of the drugs, in addition to economic data, makes it possible to analyze prescriptions from a phannacotherapeutic and economic perspective and, accordingly, carry out administrative and information interventions that improve the quality and reduce tbe cost of prescriptions. Methods: The study will be conducted at the National Institute of Social Services for Retirees and Pensioners of Argentine (INSSJP), which basically covers the population aged 60 and over. The data source was the computarized billing of the prescriptions, used up to that time only as a mechanism to monitor billing; this was cross-referenced with a database in wich the drugs were broken down into tberapeutic groups and subgroups, with the composition of the active ingredients. Beginning in 1987, a series of periodic monthly reports was issued on container consumption and expenditures, by therapeutic groups and subgroups and by the active ingredients; this was done at the national level and regionally, according to the INSSJP divisions. These reports gave rise to a series of interventions, such as the establishment of a drug formulary and two changes in the system of coverage that attempted to promote the use of single-ingredient drugs of proven efflcacy. Results: The 1987 analysis of consumption revealed that the therapeutic group that accounted for the highest container consumption and expenditures was cardiovascular drugs (2 1% in number of containers and 32% in expenditures) and within tbis, cerebral and peripberal vasodilatos represented 42% of the container consumption and 52% of the expenditures; antihypertensive drugs, 21% and 19%; and coronary drugs, 19% and 22%. The establishment of the drug formulary and the changes in the system of coverage caused a decline in the use of cardiovascular drugs in 1990 in terms of expenditures (19% and 26%); within this category, vasodilators carne to represent 27% of the container consumption and 18% of expenditures, while antihypertensive drugs rose to 28% and 33%, and coronary drugs to 27% and 32%. Conclusions: Implementation of an Information System makes it possible: a) to periodically evaluate the profile of prescriptions at the country and regional levels; b) to appropiately introduce a drug formulary and modifications in the system of coverage: c) to asses the consequences of the interventions carried out.