1. Strategies to Improve Drug Use
Educational: to inform or persuade
Managerial:
to structure or guide decisions
Regulatory:
to restrict or limit decisions
Framework for Changing Drug Use Practices

2. Managerial Strategies 1 GOAL: to structure or guide decisions
Changes in Selection, Procurement, Distribution
essential drugs lists
morbidity-based quantification
kit system distribution
Changes Aimed at Prescribers
utilization review (audit) and feedback
diagnostic and treatment guidelines
structured drug order forms
peer group monitoring
Framework for Changing Drug Use Practices

3. Managerial Strategies 2: GOAL: to structure or guide decisions
Changes Aimed at Dispensers
allowing generic substitution
improved labeling
course of therapy packaging
Changes in Economic Incentives
patient cost-sharing
revolving drug funds
cost controls
Framework for Changing Drug Use Practices

4. Standard Treatment Guidelines
STG’s lead prescribers to most cost-effective treatments
Particularly useful for low level workers
Can be used for training, examinations and audit
Used for procurement
Framework for Changing Drug Use Practices

5. Prescribing Audits plus "Feedback" to Prescriber
Establish Criteria & Guidelines for Review
AUDIT
(COLLECT DATA ON) PRESCRIBING
· Comparison with Guidelines
· Comparison with Peers
NOTIFY PRESCRIBERS
OF RESULTS
· Individuals or Groups
· Letters or Patient Notes or in Person
Framework for Changing Drug Use Practices

6. Regulatory Options GOAL: To Restrict Decisions
Market Controls
Limiting Drug Registration
Banning Previously Registered Drugs
Rx - only to OTC
Controlling Content in Drug Advertising
Prescribing and Dispensing Controls
Limiting Drugs Supplied in Public Sector
Restricting Specific Drugs to Higher Levels of Care
Required Generic Prescribing
Allowing Generic Substitution
Limits on Number or Quantity of Drugs per Patient
Framework for Changing Drug Use Practices