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Medical News & Perspectives
April 21, 1999

Hyperprescribers Feel Pain of Legal Prosecution in Spain

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JAMA. 1999;281(15):1364-1366. doi:10.1001/jama.281.15.1364-JMN0421-2-1

Barcelona—Hyperprescribers will soon be feeling the heat in Spain.

As the result of an ambitious program to find, follow up, and control those it believes write too many prescriptions, Insalud, the Spanish national health insurance organization, has begun disciplinary proceedings against 422 primary care physicians.

From 1994 to 1997, a total of 4284 hyperprescribers were found and the more than 23 million prescriptions they had issued during those years were examined. Physicians who were suspected of fraudulent prescribing (providing patients with blank prescriptions, for example) or taking bribes from drug firms are among the first to be prosecuted. Evaluation is continuing of another 1550 physicians who were judged to be hyperprescribers last year. Although some of the drugs prescribed are of little or no therapeutic efficacy, there has been no evidence of harm to any patients. The program aims to reduce fraud as well as to cope with increasing government expenditure for drugs.

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