Pharmacoeconomic evaluation of a patient education letter aimed at reducing long-term prescribing of benzodiazepines

Abstract

Objective: To determine the economic implications of sending an educational letter to patients, aimed at reducing long‐term BDZ prescribing.Method: Letters were sent to 242 patients from 2 general medical practices. BDZ usage and costs were compared in the years before and after intervention using numbers of defined daily dosages (DDDs) prescribed. The cost of intervention implementation was estimated using pharmacist, GP and administrative staff time, plus postage costs.Main outcome measures:Number of BDZ DDDs prescribed during the 12‐month periods before and after intervention. The cost implications of intervention.Results: Mean patient age was 67 years, 75% were female and the mean duration of BDZ usage was 19 years. A mean of 337 benzodiazepine DDDs per patient were prescribed during the baseline year. Overall BDZ usage at baseline was increasing by 13%. After receiving the letter, 31% of patients discussed BDZ usage with their GP and 10% had their drug or strength changed. During the year after intervention, a significant reduction of 17% in benzodiazepine usage was observed compared to baseline; 5% of patients ordered no more benzodiazepine prescriptions after receiving the letter.Mean BDZ costs reduced by £1.20 per patient after intervention. The cost of intervention implementation was £5.54 per patient, giving a net cost of £4.34 per patient, or £86.80 to obtain one BDZ discontinuation.Conclusion: This intervention is effective, simple, and inexpensive. Its minimal cost could be justified given the morbidity associated with the long‐term prescribing of benzodiazepines, particularly in the elderly.