Estimation of severe drug-drug interaction warnings by medical specialist groups for Austrian nationwide eMedication.

OBJECTIVE: The objective of this study is to estimate the amount of severe drug-drug interaction warnings per medical specialist group triggered by prescribed drugs of a patient before and after the introduction of a nationwide eMedication system in Austria planned for 2015. METHODS: The estimations of interaction warnings are based on patients' prescriptions of a single health care professional per patient, as well as all patients' prescriptions from all visited health care professionals. We used a research database of the Main Association of Austrian Social Security Organizations that contains health claims data of the years 2006 and 2007. RESULTS: The study cohort consists of about 1 million patients, with 26.4 million prescribed drugs from about 3,400 different health care professionals. The estimation of interaction warnings show a heterogeneous pattern of severe drug-drug-interaction warnings across medical specialist groups. CONCLUSION: During an eMedication implementation it must be taken into consideration that different medical specialist groups require customized support.

JADE: a tool for medical researchers to explore adverse drug events using health claims data.

OBJECTIVE: The objective of our project was to create a tool for physicians to explore health claims data with regard to adverse drug reactions. The Java Adverse Drug Event (JADE) tool should enable the analysis of prescribed drugs in connection with diagnoses from hospital stays. METHODS: We calculated the number of days drugs were taken by using the defined daily doses and estimated possible interactions between dispensed drugs using the Austria Codex, a database including drug-drug interactions. The JADE tool was implemented using Java, R and a PostgreSQL database. RESULTS: Beside an overview of the study cohort which includes selection of gender and age groups, selected statistical methods like association rule learning, logistic regression model and the number needed to harm have been implemented. CONCLUSION: The JADE tool can support physicians during their planning of clinical trials by showing the occurrences of adverse drug events with population based information.

[Reimbursement strategies for botulinum toxin type A in Austria]. / Abrechnung und Kostenerstattung von Botulinum-toxin-Typ A in Osterreich.

In the last two decades, botulinum toxin A (BtxA) has become the treatment of choice for spasmodic torticollis, blepharospasm and hemifacial spasm. Since 1999 Dysport and Botox are approved in Austria for the treatment of these indications. BtxA is applied in the hospital (out- and in-patient clinics) and by specialists (especially neurologists) in private practices. Complete reimbursement of the costs by the health insurance is provided only if the treatment has taken place in the specialist's private practice. The costs of BtxA application in the hospital are partially covered by the so called "LKF points" (Austrian system for reimbursement of costs in the hospital) or by the flat rate fee for out-patients. Approval for other indications for BtxA is expected in the next years, therefore appropriate cost reimbursement for BtxA is of immense importance. Different reimbursement systems are discussed in the following article. It seems useful to adopt approved procedures in special situations, such as reimbursement for the ambulatory application of chemotherapy and Betainterferon in Austria. The appropriate reimbursement system has to consider the indication and documentation of Btx-treatments as well as the qualification of the Btx-user.