Healthcare expenses in Georgia have risen steeply over the last decade. By 2009, they constituted an average of 35% of household income, with 60% of these health expenditures going toward prescription drugs. However, little data exists in Georgia to guide the formation of pharmaceutical policies that would make prescription drugs more affordable.

To fill this information gap, EWMI provided the Georgian Insurance Association (GIA) with a grant to survey Georgian physicians, households, and insurance companies to investigate the reasons for rising drug costs in Georgia.

One of GIA’s most important findings was that physicians rarely consider cost effectiveness when prescribing medicines. Only 4% of prescriptions are for generic brands, even though doctors’ attitudes toward generics are generally positive and the price of generics is approximately one-third that of brand name products. The fact that generics are not widely available in Georgia compounds the problem.

The study also found that doctors in Georgia prescribe a relatively high number of drugs per patient visit (2.9 on average), compared to internationally accepted standards (2.0). This means that people could be paying for drugs they don’t need.

Through EWMI’s Policy, Advocacy, and Civil Society Development Program in Georgia (G-PAC) Mentorship Program, Professor John Hall of Arizona State University provided advice to GIA on how best to present its results and recommendations. With Professor Hall’s input, GIA developed a policy paper based on its research and analysis of existing policies. GIA’s paper presented a number of policy options that included controlling the prices of brand name drugs, providing incentives for the increased distribution of generics, developing preferred drug lists, creating guidelines for prescription practices, and regulating drug promotion efforts for brand name drugs.

GIA then conducted an advocacy campaign to raise public awareness about the implications of unnecessary prescriptions, including holding presentations and discussions for the media and the public and appearing on TV and radio talk shows to discuss the issue. GIA’s research and public awareness efforts have contributed to a series of reforms, including a quadrupling of insurance benefits for 900,000 people covered under a new government health insurance program and new regulations establishing a list of approved brand name and generic drugs, and new requirements that pharmacies have adequate supplies of all drugs on the list and that they dispense the drugs as prescribed.

The Ministry of Labor, Health, and Social Assistance (MoLHSA), insurance companies, and medical service providers also collaborated on a list of prescription protocols for doctors, which took effect on January 1, 2013. Additionally, MoLHSA is developing an electronic prescription management system that will require all prescriptions to be registered and subject to audit by the end of 2012.

EWMI funded GIA’s project through G-PAC’s Think Tank Support Grant (TTSG) Program.