Changing Physician-Prescribing Behaviors
There’s a dangerous curve in my neighborhood. A dusty road descends a tree-lined hill and turns sharply. The pavement is broken and rutted on one side so that cars traveling in both directions steer onto a single smooth lane. Collisions have been averted (so far), mainly because few cars travel this section of road. However, an accumulation of near-misses has prompted community members to generate plans to prevent a tragedy.






The use of nonsteroidal anti-inflammatory drugs (NSAIDs) has risen more than 18% in the hospital setting in the last two years. Using data from our Hospital Diagnosis and Therapy Audit (HDTA), comparing the second quarter of 2002 with the same time period in 2000, MediMedia USA, Inc., evaluated patient characteristics such as age, sex, and diagnostic information. Most of the patients taking NSAIDs were women between the ages of 18 and 39 who were in the hospital for an obstetrical diagnosis; however, when the concomitant use of aspirin was examined, the patient profile and diagnoses changed dramatically. Although only 10% of the patients who received NSAIDS received aspirin as well, more than 50% of them were men and more than 90% were over age 40.
David’s idea, in a nutshell, is as follows: “Any new prescription drug program should incorporate mechanisms to inform Congress and the public about the benefits or harms associated with the program and create incentives to prescription drug plans, providers, and consumers to make effective use of the new benefit.”2 Under this new Medicare drug benefit that he envisions, public disclosure of information about the performance of prescription drug plans would serve multiple objectives:

