Physicians’ assessment of the Bavarian drug-expenditure control system: a qualitative study

BMC Health Services Research

Research Article

Julia Muth¹  Julia Gollnick¹  Norbert Donner-Banzhoff¹  Maria Sebastião²  Nikoletta Zeschick²  Thomas Kühlein²  Peter Killian³  Franziska Hörbrand³ 

[1] Abteilung Für Allgemeinmedizin, Philipps Universität Marburg, Präventive und Rehabilitative Medizin, Karl-Von-Frisch-Straße 4, 35032, Marburg, Germany;Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Allgemeinmedizinisches Institut, Universitätsstr. 29, 91054, Erlangen, Germany;Kassenärztliche Vereinigung Bayerns, Elsenheimerstraße 39, 80687, Munich, Germany;

关键词: Wirkstoffvereinbarung;    Active substance agreement;    Drug prescriptions;    Economic efficiency;    Drug costs;   

DOI  :  10.1186/s12913-023-09844-3

 received in 2022-10-20, accepted in 2023-07-24,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundIn 2014 a new system for drug expenditures, the Wirkstoffvereinbarung (WSV, English: Active substance agreement) was implemented in Bavaria. In pre-defined indication groups, economic prescription of medications shall be enabled based on the selection, quantity, and proportion of an individual drug. Ambulatory care physicians receive quarterly trend reports on their prescribing behavior. This study examines physicians’ perceptions of the WSV.MethodsQualitative interviews (n = 20) and seven focus groups (n = 36) were conducted with ambulatory care physicians (e.g. general practitioners, cardiologists, pulmonologists). The methodology followed Qualitative Content Analysis.ResultsPhysicians generally accepted the necessity of prescribing economically. The majority of them rated the WSV positively and better than the previous system. As an improvement, they especially named timely feedback in form of easily understandable trend reports, encouraging self-reflection as well as allowing early control options. Problems perceived were drug discount contracts that were strongly criticized as leading to patients mixing up medications. Some perceived constraints of therapeutic freedom.ConclusionsThe implementation of the WSV is mostly viewed positively by physicians. The restrictions of therapeutic freedom partially perceived might be met by improved information on the reasons why some drugs are rated as less economical than others.Trial registration numberMain ID: DRKS00019820 (German Register of Clinical Studies and World Health Organization).

【 授权许可】

CC BY   
© BioMed Central Ltd., part of Springer Nature 2023

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