Dyspepsia drugs account for nearly 0.5% of the National Health Service budget in the UK. Improved management of dyspepsia would therefore be expected to lead to a reduction in health costs.
R. M. Valori and colleagues, from several health authorities and research institutes in the UK, have therefore conducted a controlled trial among general practitioners in Gloucestershire, England.
The researchers determined whether a multifaceted educational strategy for general practitioners, aimed at improving the quality of dyspepsia management, would reduce drug costs.
|£1.13 million of savings were made following the intervention
This type of intervention was delivered to practitioners in West Gloucestershire, but not to those in the east of the county.
Dyspepsia drug costs, the primary outcome measure, were obtained from the Prescription Pricing Authority and compared between the two sides of the county.
Referral rates for endoscopy, admissions to gastrointestinal bleed units, and delayed diagnoses of gastric cancer were secondary measures recorded in West Gloucestershire only.
Following the intervention, drug costs declined and then stabilized in West Gloucestershire.
Drug costs peaked in the control group 15 months after those in the intervention group.
It was estimated, using an appropriate model, that the overall costs in the intervention group were reduced by 57.9 pence per head of population per half year, when compared to the control group.
This difference was maintained for three consecutive years, resulting in a cumulative saving of £1.13 million ($1.7 million).
Referral rates for upper gastrointestinal endoscopy remained stable during the study period.
The authors conclude that this type of approach (a multifaceted educational intervention), designed to improve the quality of care of patients with dyspepsia, is an effective means of controlling dyspepsia drug costs without increasing demand for endoscopy.