OBJECTIVES: The aim of this study is to evaluate the prescriptive behavior in two Italian regions (Campania and Lombardy).

METHODS: The study was a non-randomised controlled trial. Data was retrieved from administrative databases of Campania (Naples 1, Naples 2, Avellino and Caserta) and Lombardy regions (Bergamo, Mantova, Lecco and Monza). The analysis of prescriptions was restricted to eight specific therapeutic categories related with the following ATC codes: A02BC; J01; RO3; C10AA; C09AA; C09CA; N06AB; N06AX. The study population includes the percentage of people using at least one of the above drugs, in age groups 40-64 years and ≥65 years during the years 2014-2016 in the local health units (LHU) involved.

RESULTS: Out of 3,294,735 residents in the LHUs involved in Campania Region: 924,849 (27%) was in 40-64 age groups; 572,125 (17%) was in ≥65 age groups. Out of 2,233,697 residents in the Local Health Units involved in Lombardy Region: 1,566,603 (57%) was in 40-64 age group; 564,680 (21%) was in ≥65 age group. In the age group 40-64 years, the most prescribed drug were the antibiotics. The percentage of patients that using antibiotics ranging from 50,3% in Naples 1 to 55.7% in Naples 2 for Campania Region and ranging from 19.2% in Mantova to 29,2% in Monza for Lombardy Region. In the age group ≥65 years the most prescribed drug were the antibiotics for Campania region ranging from 71% in Naples 1 to 73.7% in Naples 2. In Lombardy region, for the same age group, the most prescribed drug were the proton pump inhibitors, ranging from 32.5% in Lecco to 43.1% in Mantova.

CONCLUSIONS: The observed regional variability can be explained by different prescription models between doctors and different local health policies. Therefore, interventions aimed at reducing such variability can reduce the total costs of the health system.