Dr B. Stricker, Netherlands

Drug utilization studies in the Netherlands have three main measures: cost data, prescription volume, and defined daily dose. Regular drug utilization statistics are published every three years, but they can only improve rational drug use if they are applied with reference to the indications and actual use in well-defined populations.

This limitation is illustrated in a study of ACE-inhibitors used in cases of heart failure. In 202 such cases, 103 patients were treated with an ACE-inhibitor but only 24% received the recommended dosage. The ATC/DDD classification demonstrated this trend, whereas overall statistics would not have detected these findings.