Drug Utilization Pattern and Cost Analysis of Drugs Prescribed at the Dermatology Outpatient Department of a Tertiary Care Hospital in Nepal

Abstract

Introduction
Skin diseases are common and often require long-term treatment, making rational prescribing essential. This study aimed to assess the drug utilization pattern and prescription cost at the Dermatology Outpatient Department (OPD).

Methods
A descriptive cross-sectional study was conducted among 362 patients attending the Dermatology OPD of our center using purposive sampling. Data were collected through structured face-to-face interviews and prescription review. Drug costs were obtained from the hospital pharmacy and standard market prices. Data were analyzed using SPSS version 25.

Results
The mean age of participants was 38.78 ± 16.16 years, and 251(69.3%) were female. Eczema (54,14.9%) and urticaria (38,10.5%) were the most common diagnoses. Antihistamines (212,58.6%) and emollients/keratolytics (175,48.3%) were the most frequently prescribed drug classes. The mean number of drugs per prescription was 2.89±1.28, exceeding the WHO reference range (1.6–1.8). Only 7(1.9 %) of drugs were prescribed by generic name, while (106, 29.3%) were prescribed from the Essential Medicines List. Topical formulations predominated, and fixed-dose combinations were prescribed in 51 (14.6 %) of encounters, most commonly fusidic acid–betamethasone. The mean prescription cost was NPR 1099.90 ± 959.05 (range: NPR 42–4352).

Conclusion
Prescribing practices at the Dermatology OPD were characterized by polypharmacy, very low generic prescribing, and limited use of essential medicines, although antibiotic and injection prescribing remained appropriately low. Promoting generic prescribing, regular prescription audits, and rational prescribing practices could improve the quality and affordability of dermatological care.