gms | German Medical Science

Context: Discussions in health care policy frequently pursue an raising efficiency in drug utilisation. Therefore saving potentials are quantified based on health insurance companies claims data. However, calculation of saving potentials is a complex matter, because they are depending on different underlying assumptions and abstractions.

Aim of the study: Aim of this study was to present different methods to calculate saving potentials and discuss their advantage and disadvantage.

Material and methods: Claims data from the health insurance company Gmuender ErsatzKasse (GEK) from 2005 were used, to present four different methods to calculate efficiency potentials in the generic drug market. The different effects are illustrated due to Omeprazol.

Results: Depending on the used methods, different estimates, abstractions and varied information are required. In the given example the identified increase in efficiency varies between 741,000 Euro and 165,000 Euro (80%). According to the used method, saving potentials range between 2.9% and 13.1% measured by the total expenditure for Omeprazol.

Conclusion: The amount and the pertinence of saving potentials in theory are highly depending on underlying assumptions and used methods. Calculations on the level of several drugs should in best case occur at the time of prescription under consideration of drug prices. A detailed methods description is required for an appropriate outcome evaluation.