A pharmacoepidemiological approach to investigating inappropriate physician prescribing in a managed care setting in Israel (original) (raw)

Health insurance fraud involving inappropriate physician prescribing of drugs is a growing concern globally, particularly in managed care settings. In Israel, the misuse of membership cards to acquire prescriptions illegitimately raises issues for health maintenance organizations (HMOs). This study evaluates the prevalence of illegitimate prescriptions in the Leumit Health Fund, assessing instances where sex-specific drugs were prescribed to patients of the opposite sex, highlighting systemic flaws and exploring the potential for pharmacoepidemiological methods as tools for improving prescription practices.