Pharmaceutical management in ProCare Health Limited

Aims. To review pharmaceutical budget holding and management in ProCare Hea lth Limited by; describing budget holding strategies implemented in 1995/6, identifying prescribing savings achieved, analysing variation in prescribi ng behaviour and comparing the findings with experience elsewhere. Methods. With 340 members, ProCare is one of the largest and most progressi ve of New Zealand's independent practitioner associations (IPAs). Data were obtained for the three years 1994 to 1996 to determine pharmaceutical expe nditure against budget and against national trends, by member and general m edical services (GMS) consultations. Results. ProCare has established a classical, quality focussed pharmaceutic al management strategy. Savings against the agreed budget was 9.5% comparin g 1996 with 1995 but 5.7% compared with national trends. Wide variation in per capita and per consultation costs was not reduced and was entirely expl ained by prescribing volumes not drug prices. Conclusions. The most important finding is that general practitioners (GPs) , working collaboratively, can establish a strategy of clinical and corpora te governance which may be exerting a wide ranging influence over clinical behaviour. Although there may be doubts about the actual levels of saving t hese appeared to be well in excess of the financial investment in the strat egy. Greater savings appear possible with a focus on addressing the large a nd apparently inappropriate per capita prescribing volume variation between practices, Understanding and successfully addressing this variation will b e one of the key issues facing the implementation of the government's prima ry health care strategy.