Expert Views

A Safe and Cost-effective Medication Management System

Michael Makara MD graduated from Semmelweis University, Hungary in 1983 and is currently Consultant in the Outpatients Clinic of Saint László Hospital, Budapest. In 1991 he and two colleagues established Melania Publishing Ltd., specialising in medical text books. He is also an Editor of the InforMed Health Portal and Consultant at Medical Drug Databases Ltd. His personal interest is knowledge management combined with cost-effective treatment decision support.

For the last ten years, Hungary’s Health Insurance Fund (OEP) has set the price of pharmaceuticals on a nationwide basis. However, faced with continually spiralling reimbursement costs, the Hungarian Ministry of Health began putting pressure on physicians to prescribe the most cost-effective medication.

Working within the scope of the OEP, private company Medical Drug Database Ltd (MDD) developed software to help physicians look at the lower-cost drugs available and make an informed choice.

The software program – called Medical Artificial Intelligence to Aid Diagnosis (mAId) – became available from June 2006, and was distributed free to 30,000 general practitioners and other prescribers.

“The system clearly and simply indicates the price level of equivalent pharmaceutical products, with green denoting the cheapest, red the most expensive, and yellow the middle range – just like a traffic light,” explains Makara.

Key clinical information added

In November 2006, the legislation for electronic drug prescribing in Hungary changed, requiring compulsory information on drugs to be added to e-prescribing software. To meet this requirement, a new version of mAId was developed and launched in 2007. It contains scientific and safety features, of which the most important parameter is the indication.

“The package insert or Summary of Product Characteristics (SPC) clearly defines the indications of drugs but it seldom gives guidance on treatment alternatives or combination treatments, which is what our software addresses,” explains Makara.

mAId therefore improves access to key clinical information when ordering patient medications, including potential drug-to-drug/food interactions and drug allergy alerts. Prescribers also receive on-screen prompts for drug-specific dosage information. 

Cost implications readily visible

Prescribers in Hungary using mAId are now able to clearly see the cost implications of their prescribing behaviour.

“The result was a dramatic change in drug prescribing behaviour,” says Makara. “Generic drugs were prescribed instead of original products and the cost of the drugs to the OEP dropped.”

The official data projects an annual saving by patients of 40 million euros, with the OEP expected to save around 80 million euros (after reimbursement) per year.

MDD is currently looking for other European partners to implement this safe and cost-effective medication management system.

Further information:
InforMed Health Portal: www.informed.hu
Medical Drug Databases Ltd: www.mdd.hu
Michael Makara: michael@makara.md