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Research Article Open Access
Objective: To study and assess the prescribing pattern and cost analysis in dermatology outpatient department (OPD) in a tertiary care hospital.
Methods: Data was collected for three months by reviewing OPD cards and prescription data and rationality and cost were assessed by WHO/DSPRUD Indicators and WHO Recommended clinical guidelines 2013 (Diagnosis and treatment manual). Average per prescription cost was calculated. For cost analysis, we used Cost-Minimization method. Although we only considered total drug treatment cost. All drugs cost were calculated in Indian rupee from the Current Index of Medical Specialties (CIMS). For each drug cost was calculated in as either cost per μg, mg, gm or ml as appropriate. We further divided total drug cost into two parts, first the total cost of drugs which are purchased from Paid pharmacy shops and second, the total cost of drugs which are freely available in Free OPD pharmacy.
Findings: Pre and post interventional data analysis showed that, average no. of drugs prescribed was 2.95/ prescription and 2.62/prescription respectively. Before Intervention average cost of drugs per prescription was found to be 376.97 INR and after intervention average cost of drugs per prescription was found to be 299.20 INR. During pre-intervention study period, combination preparations (28.54%) were the most commonly prescribed class of drugs followed by others(Multivitamins, topical Vasodialators, antipyretic, retinoid etc.) (18.86%) and antihistamines (17.69%) while during post-intervention study period, combination preparations (32.37%) were the most commonly prescribed class of drugs followed by antifungals (19.42%) and antihistamines (17.62%).
Conclusion: Clinical pharmacist can conduct such periodic audit to rationalize the prescription, reduce errors and suggest a cost effective management of skin diseases. The programs should conduct into the hospital for Physicians and Post graduate students, to show comparison and benefits of generic versus branded drugs also to improve generic prescribing practice and to make therapy economic to the patients.
WHO: World Health Organization, EDL: Essential drugs list, CIMS: Current index of medical specialties, DRPs: Drug related problems, NFI: National Formulary of India, ADR: Adverse drug events, Clinical Pharmacovigilance