| Summary: | Importance: Providing cost feedback has been demonstrated to decrease demand from clinicians.
Objective: We tested the hypothesis that providing the cost of drugs to clinicians would modify total expenditure.
Design: A prospective study design with a step-wise intervention.
Setting/Participants: Individuals who were admitted to the XXX from November 2013 to November 2015 under the physicians.
Intervention: The cost of all antibiotics and inhaled corticosteroids was added to the electronic prescribing system.
Main outcomes: The weekly cost for antibiotics and inhaled corticosteroids in the intervention period compared to baseline.
Results: Mean weekly expenditure on antibiotics per patient decreased by £3.75 (95% confidence intervals CI: -6.52 to -0.98) after the intervention from a pre-intervention mean of £26.44, and then slowly increased subsequently by £0.10/week (95%CI: +0.02 to +0.18). Mean weekly expenditure on inhaled corticosteroids per patient did not substantially change after the intervention (-£0.03, 95%CI: -0.06 to -0.01 after the intervention from a pre-intervention mean of £5.29 per person).
New clinical guidelines for inhaled corticosteroids were associated with a decrease in weekly expenditure.
Conclusions and relevance: Provision of cost feedback resulted in no sustained change in institutional expenditure. However, clinical guidelines have potential for modifying clinical prescribing behaviour.
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