Evaluation of the pilot program on the real-time drug utilization review system in South Korea

Purpose: A pilot drug utilization review (DUR) program was initiated by the Korean government, which provided safety information in real-time at the stage of prescribing and dispensing. This study aimed to compare the "physician/pharmacist Co-DUR" system and the traditional "pharmacist-only DUR" system. Methods: Data collected during a DUR pilot program from July 1 to October 31 of 2009 were obtained from the Health Insurance Review & Assessment Service. Descriptive analyses were conducted to investigate DUR-pop up alert rates, categories of alerts, the reasons for dispensing without prescription change after an alert, and changes in drug expenditures associated with the DUR. Results: DUR pop-up alert rates were 8.55% at clinics and 1.90% at pharmacies in the physician/pharmacist Co-DUR, whereas the rate was 2.22% in the pharmacist-only DUR. Rates of pop-up alerts were high for between-prescription ingredient duplication at pharmacies, whereas for clinics, the rate for drug-pregnancy contraindications was high. A greater reduction in drug expenditure was estimated in the physician/pharmacist Co-DUR compared to the pharmacist-only DUR. Conclusions: The physician/pharmacist Co-DUR has better sensitivity at detecting potential adverse drug events than the pharmacist-only DUR. Pharmacists also have opportunities to double-check prescribed drugs when doctors do not voluntarily modify pop-up alerts. Further comprehensive study will be needed to confirm the results of pilot program that favored the physician/pharmacist Co-DUR.