Evaluating the Cost Efficiency of Refilling Medicines at the Chiangrai Prachanukroh Hospital Pharmacy Network

Abstract

Background and Rationale: Chiangrai Prachanukroh Hospital implemented a project aimed at reducing congestion and waiting times for patients with chronic non-communicable diseases by enabling them to obtain medications from local pharmacies. This initiative service model 1 allows participating hospital procuring and dispensing medications for individual patients and delivering them to patients at partnered pharmacies (network). The objective of this study was to evaluate of efficiency of service model 1 from the hospital's perspective.

Methodology: A descriptive study was conducted using data collected from the hospital’s information system spanning the fiscal years 2020 to 2023. The cost efficiency focused on total management and delivery costs per prescription, complemented with the reliability cost incurred from medication returns and errors. The system's capacity to manage medication distribution for variety of diseases was another complementary indicator.

Results: From 2020 to 2023, there were 36,415 prescriptions dispensed through partnered pharmacies, equivalent to 8.7% of all prescriptions (4.5% of during office hours and 43.3% of after-hours). Most services served the patients of the universal coverage scheme. Cost analysis revealed a reduction in dispensing costs from 105.50 THB in 2020 to 41.23 THB in 2023, attributed to saving in overtime wages, despite a cost rise from the medication return rate of 2.5% in the most recent year. The service model demonstrated improved cost efficiency, but not covered the reimbursement of 49 THB per prescription set by the National Health Security Office. The distribution capacity covered conditions such as glaucoma, hypertension, hyperlipidemia, diabetes, and chronic kidney disease.

Conclusion: Future policy considerations should address adequate reimbursement rates to cover costs and promote integrated services to optimize resource utilization and health outcomes. These adjustments will help ensure the financial sustainability of the initiative and enhance the quality of healthcare delivery.