Effects of Mandatory Thiazide Prescribing for Hypertension
Author Information
Author(s): Atle Fretheim, Kari Håvelsrud, Graeme MacLennan, Doris Tove Kristoffersen, Andrew D. Oxman
Primary Institution: Norwegian Knowledge Centre for the Health Services
Hypothesis
Does making thiazides mandatory first-line drugs for hypertension reduce drug expenditures and improve treatment outcomes?
Conclusion
Thiazide prescribing in Norway more than doubled after a new rule was implemented, but savings on drug expenditures were modest and there were no significant changes in treatment outcomes.
Supporting Evidence
- Thiazide prescriptions increased from 10% to 25% after the new rule.
- Drug costs were reduced by an estimated NOK 4.8 million in the first year.
- No significant changes were observed in the achievement of treatment goals.
Takeaway
Doctors in Norway started giving more thiazide pills to patients with high blood pressure after a new rule said they had to, but it didn't really help patients get better faster.
Methodology
An interrupted time-series analysis was conducted on prescribing data before and after the new reimbursement rule was implemented.
Potential Biases
Potential bias due to non-participation of some practices and the lack of monitoring adherence to the new prescribing rule.
Limitations
The study may not be representative of all practices in Norway, and adherence to the new rule was not monitored.
Participant Demographics
General practices in and around Oslo, Norway.
Statistical Information
Confidence Interval
95% CI −0.2% to 0.8%
Digital Object Identifier (DOI)
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