Enforcement of National Health Insurance (NHI) system in Indonesia caused drug prescribing and drug used must refer to the National Formulary (NF). Aims of this research was as initial detection on rationality and efficiency in general of drug used such as quality and quantity also drug costs before and after the NF application. This research was cross-sectional study. This research used the data from the drug used report of outpatient from the 2013’s and 2015’s at 2 Primary Health Care (A and B) at Sungai Penuh City, Jambi Province. This research were performed by ATC/DDD methodology. Quantity, quality and total drug cost were compared before and after NF application. The result were obtained showed that the quantity of drug utilization at 2 of PHC were decreased after NF application but only B PHC had statistically difference (p= 0.008). Quality of drug utilization had no improve after NF application. The most used drug were vitamin B complex, thiamin, chlorampheniramin, amoxicilin, and levothyroxine sodium. Total of drug costs were also decreased after NF application but only B PHC were statistically difference (p=0.001).