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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 from the 2013’s to 2015’s at 5 Primary Health Care at Sungai Penuh City. This research were performed by ATC/DDD methodology. Quantity, quality and total drug cost were compared before and after NF application. Percentage of drug uses submission toward NF was also counted. The result were obtained showed that the quantity of drug utilization at 5 of PHC were decreased after NF application but only 2 PHC had statistically difference (p= 0.014 and p = 0.024). Quality of drug utilization had no improve after NF application. The most used drug were vitamin B complex, amoxicillin, chlorampheniramin, levothyroxine sodium and prednisone. Total of drug costs were decreased after NF application but only three PHC were statistically difference (p=0.006, p=0.04 and p=0.004). Percentage of drug submissions toward NF at 5 PHC in 2014’s was 68% and increased to 71% in 2015’s.