Impact of administrative restrictions on antibiotic use and expenditure in Ontario: time series analysis

Abstract

Although no direct cause and effect can be shown with these observational data, the results suggest that the change in reimbursement policy to restrict prescribing of fluoroquinolones decreased their use and associated expenditures. These decreases were offset by increases in the use of other antibiotics. The balance of consequent benefit and harm of these shifts in prescribing patterns needs to be examined carefully. Alternative solutions to encourage appropriate use of antibiotics deserve exploration.

Analysis of the impact of removing mucolytics and expectorants from the list of reimbursable drugs on prescription rates: A time-series analysis for France 1998–2010

“…Our observations are consistent with previously reported results where major reductions in drug utilization were demonstrated after delisting or reimbursement restriction policies [7,15,16,[22][23][24][25], Nevertheless, only one of the published studies investigates the French situation. In this study drugs from three already declining therapeutic classes (40% of the anti-inflammatory enzymes, 17% of the intestinal adsorbent and 17% of the 'antacid with other drugs' class) were considered.…”

The impact of repeated cost containment policies on pharmaceutical expenditure: experience in Spain

“…Moreover, this methodology has been used to analyse the effect of results of clinical trials on prescribing patterns [13]. In a more general context, ARIMA time series models have also been used, for example, to analyse the impact of a cost sharing drug insurance plan on drug utilisation [14], the effect of administrative restrictions on antibiotic use and expenditure [15] and the impact of increased co-payments on the prescription of antidepressants, anxiolytics and sedatives [16].…”

Alternatives to randomisation in the evaluation of public health interventions: design challenges and solutions

“…Such studies are vulnerable to confounding from secular and maturational trends as well as contemporaneous influential events. The extent to which these undermine an evaluation depends on context: secular trends are less problematic where rates of an outcome among a population are stable and where intervention effects are large and specific, such as was the case for the evaluation of the introduction of administrative restrictions on the use of certain antibiotics in Canada 32. Evidence from before-after studies can be persuasive when assessing new behaviours, such as the use of new weaning food to promote child growth.…”