Analysis of Cost and Content of 1326 Medical Prescriptions from the Area of Mount Lebanon Georges Choueiry 1 , Souheil Hallit 1,2* , Pascale Salameh 1,3 1 Department of Pharmacy, Lebanese University, Beirut, Lebanon 2 Department of Research, Psychiatric Hospital of the Cross, P.O. Box 60096, Jal El-dib, Lebanon 3 Department of Medicine, Lebanese University, Beirut, Lebanon * Corresponding author: Souheil Hallit, Department of Pharmacy, Lebanese University, Beirut, Lebanon, Tel: +961 71 199660; E-mail: souheilhallit@hotmail.com Rec date: June 05, 2017; Acc date: July 25, 2017; Pub date: July 30, 2017 Research Article ABSTRACT Objective: To describe the market share of importers, manufacturers and countries of origin of prescribed drugs in Lebanon; and to examine the effects of the price reductions enforced by the ministry of health on highly prescribed drugs. Methods: 1326 medical prescriptions were collected from 3 different pharmacies in Mount Lebanon during the period July 2015 and February 2017. Costs were analyzed using 16 lists of drug prices from November 2014 to March 2017 provided by the ministry of public health. We also included the composition and therapeutic class of each medication. We used a one-tailed Z-test in order to check the validity of the claim that the reduction in prices enforced by the ministry of health affected highly prescribed drugs more than others on the total population of drugs prescribed. Results: Out of 4265 drugs in our prescriptions, 19.5% were manufactured in Lebanon and 61.9% imported from European countries whose manufacturers dominated the top 10 manufacturers count. Mersaco topped the importers list July with 18.9% market share followed by Phenicia (10.8%). The most commonly prescribed drug classes in the sample were anti-infectives (24% of all drugs), followed by pain and inflammation agents (17.6%). The mean drop in prices between November 2, 2014 and March 21, 2017 is larger for highly prescribed drugs than for others (p-value<0.00001), with a 99.8% confidence interval of (17.6%, 19.3%). Conclusion: The cost of medication decreased in the last 2.5 years, however we still need to investigate the effects of this change on community pharmacists and the patients. Keywords: Market share, Cost, Price, Community pharmacy, Lebanon INTRODUCTION Pricing of a pharmaceutical drug is determined by the value it brings to patients and the competitive environment it enters. If it is priced too high, physicians and payers may shy away from prescribing or reimbursing it because they might perceive that the drug provides too little benefit for the added cost. Ironically, if a new drug is priced at a discount to an existing therapy, it might also be avoided because the lower price might imply inferiority [1] . Price changes of drugs certainly affect the market from manufacturers to agents and pharmacies to consumers. In Lebanon, it is practically hard to quantify the change since there are many variables to take into consideration: the regular recall [2] and addition of new drugs, the exchange rate determined in the currency market and some reductions in prices [3] enforced by the Lebanese ministry of public health (MOPH) through changes in some of the laws and regulations [4] , which in turn affected the availability of branded and generic medicines [5] , but mainly the problem of which drugs are prescribed by physicians and with what proportions is by far the most interesting and hardest to quantify. A survey conducted by the MOPH in 2004 showed that almost all the surveyed medicines (total of 32) are priced higher than the international reference price and innovator brands are possibly used more extensively as there are no incentives to prescribe and sell generic equivalents [6] . A later MOPH survey in 2013 concluded that prices of lowest priced generics increased, but prices of originator brands were similar and that medicines were more affordable in 2013 compared to e-ISSN: 2320-1215 p-ISSN: 2322-0112 www.rroij.com Research Reviews: Pharmacy and Pharmaceutical Sciences RRJPPS | Volume 6 | Issue 3 | September 2017 10