Analysis of prescriptions given on discharge from the emergencies department. Economic impact

Objective

To analyse the characteristics and cost of medical prescriptions given upon discharge from the casualty department, as well as the savings made by making substitutions with generis drugs or other equivalent pharmaceutical products in a third level hospital.

Methods

Six hundred sixty-nine patients were chosen using a cluster sample with a sub-sample. The following variables were considered: a) analysis of the prescription (medication quantification, active ingredients and most prescribed therapeutic groups, and possibility of prescribing generis drugs); b) calculation of cost and saving estimate (price to public and equivalent products); and c) prescription quality (adherence to the guide and percentage of products of high therapeutic use.)

Results

Three hundred seventy of the 669 patients received medication when they were discharged, with an average of 1.7 per patient. Six hundred twenty-nine products were prescribed, 16% due to their active ingredient, with 37.53% generic products available. The main active ingredients prescribed were paracetamol, ibuprofen, and omeprazole amounting to 26.70% of the total prescribed and the therapeutic groups that were highlighted were locomotor apparatus, the nervous system, the digestive apparatus, and metabolism with 69.39% of the total. Ninety-two point eighty-four pecent of the prescriptions adhered to the pharmacotherapeutic guide and 98.41% were of high therapeutic use. The annual cost of prescribed medication was €1 013 778 and the saving made by generic product substitution and a programme of therapeutic equivalents was €145 971.

Conclusions

A prescription based on its active ingredients and a therapeutic and generis substitution produce a significant saving both for the patient and for the hospital.