Comparative evaluation of methods to determine efficiency potentials in drug utilisation

Background: Discussions in health-care policy frequently pursue a raising efficiency in drug utilisation. Therefore saving potentials are quantified based on health insurance company claims data. This article is a contribution to methodical discussions about the determination of saving potentials in drug utilisation. Methods: Based on claims data from the health insurance company Gmuender ErsatzKasse (GEK) of 2005, four different methods to calculate efficiency potentials in the generic drug market are presented. The different effects are illustrated for the example of Omeprazol. Results: Depending on the used methods, different estimates, abstractions and varied information are required. In the given example the identified increase in efficiency varies between 741,000 Euro and 165,000 Euro (80%). According to the used method, saving potentials range between 2.9% and 13.1% as measured by the total expenditure for Omeprazol. Conclusion: The amount and the pertinence of saving potentials in theory are highly dependent on underlying assumptions and used methods. Calculations on the level of several drugs should, in the best case, occur at the time of prescription under consideration of drug prices. A detailed methods description is required for an appropriate outcome evaluation.