Background The board in the Danish Regions decided on a new specialist consultancy structure called ‘The Council for Use of Expensive Hospital Medicine’ (RADS). The aim of RADS is to help standardise the rational use of medicine throughout Denmark, to be achieved primarily by setting guidelines for the use of expensive hospital medicine at the clinical level. The intention is to obtain the best healthcare in relation to expenditure whilst ensuring a high quality of treatment.
Purpose The purpose of this study was to identify an effective way of implementing the RADS guidelines in a multi-centred clinical practise and optimise the pressure on the pricing of the drugs concerned. This was exemplified using data on HIV treatment.
Materials and Methods The task was to change the HIV-treatment from a triple compound to three single compounds. To implement the RADS guidelines, the Capital Regional Pharmacy formed a taskforce consisting of the pharmacy director, top leaders from logistics and clinical pharmaceutical services, IT-department and a data-expert on medication use analysis. The implementation of the HIV-guideline was followed in each clinic during which time the leadership was in close dialogue with the clinicians. Feedback on actual prescribing behaviour was supplied every month to the responsible clinician.
Results The national goal for guidelines implementation was 95%. At 98% the Capital Region has the highest rate for guidelines implementation in Denmark. Following the next tender and one year after guidelines implementation, the price of the triple compound had dropped by 16%. Result – the price of the clinicians’ first choice medicine was acceptable to the Region.
Conclusions The interdisciplinary taskforce achieved its goals. Intensive monitoring and feedback to the clinician in charge, followed by direct management involvement and support at all centres, is an effective implementation strategy.
No conflict of interest.
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