Richard Thomson said a family member was recently prescribed large amounts of tramadol and paracetamol at the end of a stay in Dunedin Hospital, and the prescription was filled at a city pharmacy.
The person received 732 pills in total, and used only a small portion. Pharmaceuticals seemed like an ideal target for cost savings. By cutting just 1% of its pharmaceutical spend, the board would save nearly $1 million a year. This would be both a significant saving and a sensible measure, Mr Thomson said.
It was not about rationing medicine. A patient could be dispensed a smaller amount and be readily supplied more, if required.
It was not a specific Dunedin Hospital issue and, to his knowledge, it was also an issue in the GP sector.
Board members wondered what effect the new pharmacy contract, introduced in the middle of last year, had on dispensing patterns. The contract changes the business model of pharmacies, and was brought in to combat an annual 8% increase in prescriptions.
Chairman Joe Butterfield said Mr Thomson's prescribing concerns raised two issues, safety and waste, and the board would look at the matter.
Mr Thomson warned earlier in the discussion the board might be cutting costs in the wrong place, pointing to deferred maintenance, which was helping its bottom line.
He said longer-serving members might remember a past situation when deferred maintenance had a cumulative effect, eventually becoming a ''crisis situation''. He sought an assurance that could not happen again.
He was advised the board was undertaking an asset management plan, which would incorporate maintenance matters.
Pharmac medical director Dr Peter Moodie, contacted after the meeting, said through a spokesman tramadol cost $4.95 for a pack of 100 capsules. Paracetamol was $9.38 for a pack of 1000 tablets.
Health boards also paid a dispensing fee and GST, on top of the cost of the medicine.
He confirmed the new pharmacy contract model encouraged less frequent prescribing, where appropriate.
''Pharmac is always interested in clinicians making good prescribing decisions. However, the amount of medicine prescribed and dispensed for each patient is a matter for the prescribing clinician to decide, in consultation with the patient.
''If pharmacists consider the amount of medicine prescribed is inappropriate, they can question this with the prescriber,'' he said.
The Southern District Health Board's updated forecast for 2012-13 is a $12.2 million deficit.
