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Monitor prescriptions
  [vote for,

Prescriptions can be very costly to the tax-payer in that for sensible countries the cost of drugs is subsidised by the government. Some of these drugs are incredibly expensive.

1) The government *could* issue a directive to reduce the use of (expensive) medicines, but without knowing the true demand it could deprive people where they are really needed.

2) Alternatively, the availability of a drug is unlimited and this just opens doors for back-handlers from drugs companies e.g. the over-prescription of opioids in the US.

3) This idea -

The availability of a drug should be for where it is beneficial with respect to cost. If people really need opioids they get them, if people need exotic drugs then those too ... but the supply is carefully monitored.

After a decent bit of number-crunching you get a bell curve of one type of prescription over the country. One practice prescribing ten times as many drugs is obviously suspect. So a crucial part of this idea is spot checks by trained medical personnel reviewing medical records to see if the patient history really warrants an expensive drug.

Likewise the other outlying data point is also covered by investigations into patient history and the potential drugs that *should* have been prescribed.

These spot checks would produce a statistic to say whether medicines are in general being over prescribed and provide an honest benchmark to combat corruption.

The cost savings could also fund e.g. reviews of poorly researched drugs like statins.

bigsleep, Jan 19 2017


       I thought they are using this kind of technique to catch over-prescribers, at least
theircompetitor, Jan 19 2017

       What [theirc] said. The idea of monitoring prescribing levels is excellent and obvious. Despite this, I suspect that the NHS already does it.
MaxwellBuchanan, Jan 19 2017

       The idea though is to follow the statistics up with spot checks on the reasons drugs were or were not prescribed. This would help give better guidelines to doctors.
bigsleep, Jan 19 2017

       Yes but, again, I wonder if this is not already done. Also, I suspect that doctors (good and bad) already spend a large percentage of their time supplying statistics and ensuring compliance with umpteen guidelines, when they could be spending an extra 5 or 6 seconds with a patient.
MaxwellBuchanan, Jan 19 2017

       //an extra 5 or 6 seconds with a patient//   

       slippery slope, that. Don't want to encourage the hypochondriacs
theircompetitor, Jan 19 2017

       // give better guidelines to doctors. //   

       Something along the lines of "Please, can you try not to damage or kill too many of your patients ?" would be the first rule to emphasize ...
8th of 7, Jan 19 2017

       //an honest benchmark to combat corruption//   

       I am sure there are some corrupt doctors, and I am also sure that they cost the NHS money. However, given the amount of shit (both literal and metaphorical) that the vast majority of honest doctors have to deal with, I'm not sure that adding yet more will provide a net benefit.
MaxwellBuchanan, Jan 19 2017

       //I'm not sure that adding yet more will provide a net benefit//   

       The initial analysis is just a computer digest of drug prescriptions - computer records already available. The follow-up spot checks by other independent medical staff are the ones streamlining the system, producing cost savings and covering the expense of OfPrescript.
bigsleep, Jan 19 2017

       Well, fair enough. The NHS has an impeccable record of managing big-data projects that require the intelligent application of computers and collation, so I'm sure this will work well.
MaxwellBuchanan, Jan 19 2017

       This NHS thing you guys keep bringing up, does it comply with the laws of thermodynamics? Or is it one of those something for nothing programs :)
theircompetitor, Jan 19 2017

       // does it comply with the laws of thermodynamics? //   

       Certainly not - it's a sort of perpetual emotion.   

       Think of it as a black hole for money, with a whiny voice that constantly demands "We need more resources !"   

       The idea is that if you're well, you pay huge amounts of tax. Then when you're sick, you get free treatment, which means you're still ill, but now dissatisfied, alienated, and bitter as well. Because of the huge tax burden, you can't afford private treatment to make you well again, so instead you claim state benefits, increasing the burden on the diminishing number of healthy workers, who eventually succumb to overwork and demoralization, and either die or emigrate. In the meantime, any spare resources are callously vacuumed up by wealthy pensioners, obsessed with keeping their savings and property out of reach of anyone except themselves, their immediate offspring and animal charities.   

       It's called a "socialist utopia", and it never works.
8th of 7, Jan 19 2017

       It is easier to analyze something that happened than something that didn't happen. So: easier to look closely at expensive drugs than situations where no expensive drug was used. US Insurance companies frequently mandate "prior authorization" for expensive drugs - an extra hoop to jump thru. For unorthodox uses of expensive drugs more justification might have to be presented. Each extra hoop is a potential money saver for the insurer.   

       The question of "should have used but didn't" is a question of quality control which has historically been of interest only in the case of truly egregious omissions that lead to a lawsuit.
bungston, Jan 19 2017


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