PHARMAC

““Wise Use of Antibiotics” Wise Use of Antibiotics” campaign resultscampaign results

• Use Pharmhouse data to measure changes in Use Pharmhouse data to measure changes in prescribing rates prescribing rates

• Use Pharmhouse data to measure shifts within Use Pharmhouse data to measure shifts within pharmaceutical group mix (from broad to narrow pharmaceutical group mix (from broad to narrow spectrum antibiotics) spectrum antibiotics)

• Use independent researchers to measure changes in Use independent researchers to measure changes in public attitude (Colmar Brunton) public attitude (Colmar Brunton)

PHARMAC

““Wise Use of Antibiotics”Wise Use of Antibiotics”

• IPA initiative which is funded and coordinated by PHARMAC.IPA initiative which is funded and coordinated by PHARMAC.

• Started in 1998 with 5 IPAs & 800 GPsStarted in 1998 with 5 IPAs & 800 GPs

• 1999, 2000 & 2001 campaigns:1999, 2000 & 2001 campaigns:

– 25 PCOs (mainly IPAs) 2,500+ GPs25 PCOs (mainly IPAs) 2,500+ GPs

– funding and support from PHARMACfunding and support from PHARMAC

– support from Royal NZ College of General Practice.support from Royal NZ College of General Practice.

• Resources distributed nationwide to surgeries:Resources distributed nationwide to surgeries:

– posters posters – pamphlets pamphlets – ““purple” prescription pads purple” prescription pads – practice commitment posterspractice commitment posters

PHARMAC

Reductions in volume and expenditure Reductions in volume and expenditure 1999/20001999/2000

(source: PharmHouse data):(source: PharmHouse data):

• Reduction in total number of dispensing of antibiotics of 14.8% (year-Reduction in total number of dispensing of antibiotics of 14.8% (year-end Dec data, 1999 and 2000). end Dec data, 1999 and 2000).

– Reduction in number of dispensing of antibiotics for Under 6 years Reduction in number of dispensing of antibiotics for Under 6 years of 8% (year-end data, 1999 and 2000), with some high monthly of 8% (year-end data, 1999 and 2000), with some high monthly reductions e.g. 20% (Dec 1999, Dec 2000). reductions e.g. 20% (Dec 1999, Dec 2000).

– Reduction in broad spectrum antibiotics compared to narrow Reduction in broad spectrum antibiotics compared to narrow spectrum antibiotics.spectrum antibiotics.

– Reduction in total antibiotic expenditure of over $7m, (year-end Dec Reduction in total antibiotic expenditure of over $7m, (year-end Dec 1999, 2000). 1999, 2000).

• Approx. $2m was due to the “Wise Use of Antibiotics” Approx. $2m was due to the “Wise Use of Antibiotics” campaign. campaign.

• $5m savings was due to supply side initiatives.$5m savings was due to supply side initiatives.

PHARMAC

Reduction in total antibiotic Reduction in total antibiotic dispensingsdispensings

Antibiotic Dispensings

0

500,000

1,000,000

1,500,000

2,000,000

2,500,000

3,000,000

3,500,000

4,000,00019

96

1997

1998

1999

2000

Antibacterials Total Dispensings

Antibacterial Dispensings under 6's

PHARMAC

Antibiotic dispensings for Under-Antibiotic dispensings for Under-6’s6’s

Y - (All)

0

20,000

40,000

60,000

80,000

100,000

120,000

140,000

1 2 3 4 5 6 7 8 9 10 11 12

prescription 1998

prescription 1999

prescription 2000

PHARMAC

Changes in broad vs. narrow Changes in broad vs. narrow spectrum antibiotic dispensingsspectrum antibiotic dispensings

Broad vs Narrow - (All)

0

200,000

400,000

600,000

800,000

1,000,000

1,200,000

Jan-

96

Apr

-96

Jul-9

6

Oct

-96

Jan-

97

Apr

-97

Jul-9

7

Oct

-97

Jan-

98

Apr

-98

Jul-9

8

Oct

-98

Jan-

99

Apr

-99

Jul-9

9

Oct

-99

Jan-

00

Apr

-00

Jul-0

0

Oct

-00

Jan-

01

Amoxycillin

Amoxycillin Clavulanate

PHARMAC

Antibiotics Expenditure SavingsAntibiotics Expenditure Savings

Antibacterials Total Cost ex

$0

$5,000,000

$10,000,000

$15,000,000

$20,000,000

$25,000,000

$30,000,000

$35,000,000

$40,000,000

1996

1997

1998

1999

2000

Antibacterials Total Cost ex

PHARMAC

Reductions in volume & expenditure Reductions in volume & expenditure 2000/20012000/2001

(source: PharmHouse data):(source: PharmHouse data):

• Reduction in total number of dispensing of antibiotics of 4.4% (year-end Reduction in total number of dispensing of antibiotics of 4.4% (year-end Oct data, 2000 and 2001). Oct data, 2000 and 2001).

• Reduction in number of dispensing of antibiotics for Under 6 years of Reduction in number of dispensing of antibiotics for Under 6 years of 1%. 1%.

• Possible reasons for lower results than previous year:Possible reasons for lower results than previous year:

– Campaign in ‘maintenance phaseCampaign in ‘maintenance phase

– Doctors adopted best practice prescribing behaviour in 2000Doctors adopted best practice prescribing behaviour in 2000

– Harder flu seasonHarder flu season

PHARMAC

Public attitude monitoringPublic attitude monitoring

• Independent survey of 1,000 New Zealanders per Independent survey of 1,000 New Zealanders per campaign (500 pre-campaign, 500 post-campaign)campaign (500 pre-campaign, 500 post-campaign)

• Measures changes in attitude and behaviour:Measures changes in attitude and behaviour:– treatment of colds/flustreatment of colds/flus

– understanding of role of antibioticsunderstanding of role of antibiotics

– expectation of receiving an antibiotic for a cold/fluexpectation of receiving an antibiotic for a cold/flu

– whether they received an antibiotic for a cold/fluwhether they received an antibiotic for a cold/flu

– understanding of the campaignunderstanding of the campaign

• Consistent survey 2000,2001 and for 2002.Consistent survey 2000,2001 and for 2002.

PHARMAC

Patients who expected to be Patients who expected to be prescribed antibiotics prescribed antibiotics

(Colmar Brunton, Oct 2000)(Colmar Brunton, Oct 2000)

Wave 1

No19%

Yes80%

Don't know1%

Wave 2

Don't know2%

Yes50%

No47%

PHARMAC