Background: This is a follow-up study to evaluate and improve quality health care for the majority of the population in Bloemfontein. The aim of this study was to evaluate the changes implemented to address the cost of prescribing drugs at National District Hospital, Bloemfontein as described in a previous study

Methods: The 20 most expensive or inappropriate prescribed drugs were identified from the results of the first study. These drugs were grouped together in order to address the problems systematically, e.g. revising and updating the current treatment protocols for chronic conditions and using cheaper alternatives. Three months after the implementation of the new measures, the affected drugs were re-evaluated over an eight-week period.

Results: A total of 28 drugs (the 20 drugs + eight drugs on which they may have a direct influence) was evaluated over an eight-week period. The introduction of the treatment protocols not only saved a large amount of money, but also made prescribers aware of the correct dosages of the drugs. A saving of R215 395 in the dispensing of medicine in eight weeks was demonstrated. A massive calculated saving of R1.4 million could be achieved over a one-year period at NDH with adherence to the saving measures.

Conclusion: Drug costs can be substantially reduced through review of drug use and introduction of protocols and guidelines.