Subject(s)
Drug Costs , Drug and Narcotic Control , Pharmaceutical Preparations , Private Sector , Public SectorSubject(s)
Africa , Costs and Cost Analysis , /epidemiology , /therapy , Drug Costs , Insulin/administration & dosageABSTRACT
"The general objective of this study was to investigate the prescribing patterns and cost of antidiabetic medicine in the private health care sector in South Africa by using a medicine claims database. A quantitative; retrospective drug utilisation study was performed on data for the year 2004. Oral antidiabetic medicine accounted for 81 (n =143 447) and 39 (R29 734 360.61) respectively of the total prevalence and cost of all antidiabetic products prescribed. Metformin was the most frequently prescribed oral antidiabetic medicine; with an average cost of R58.42 (SD = 31.78). The three most frequently prescribed classes of insulin (insulin lispro; soluble insulin and isophane; and soluble insulin aspartame and protamine) together accounted for 63 of all the insulin prescribed; and 67 of the total cost of prescribed insulin. Almost 39 (n = 62 717) of the ""combination therapy"" prescriptions were for a sulfonylurea in combination with a biguanide plus at least one other antidiabetic product. A trend towards combination therapy away from monotherapy was observed. Prescribed Daily Doses (PDDs) calculated for oral antidiabetic medicines were more or less in line with recommended treatment guidelines. Drug utilisation review studies thus provide valuable insight into the treatment of diabetes - indicating areas of possible over- and under usage; providing decision-makers with critical information to curb unnecessary costs."
Subject(s)
Diabetes Mellitus , Drug Costs , Hospitals , Hypoglycemic Agents , Pharmaceutical Preparations , PrescriptionsABSTRACT
PURPOSE: Inappropriate prescribing has been identified in many health facilities in developing countries. The purpose of this study was to evaluate the prescribing practices in two health care facilities in Warri located in south-south geopolitical region of Nigeria and identify factors influencing the practices. METHOD: WHO Prescribing Indicators were applied to evaluate 2000 prescription records; retrospectively; from a private and a public hospital in Warri. Factors influencing the prescribing practices in the facilities were identified through informal interviews of 10 prescribers in the facilities. Using a self-administered questionnaire administered to 40 prescribers in the facilities; we also evaluated the order of importance of the factors affecting drug prescribing. RESULTS: Average number of drugs per encounter in the health facilities is 3.4 (3.9 in the public hospital and 2.8 in the private hospital). Generic prescribing was generally low (54 percent in the public hospital and 16 percent in the private hospital) while the percentage of encounters with antibiotics prescribed was high (75 percent in the public hospital and 55 percent in the private hospital). Antimalarials; antihypertensives; antidiarrhoeals and analgesics accounted for 47.4 percent; 7.5 percent; 1.0 percent and 18.2 percent; respectively. The overuse of drugs and generic prescribing were significantly lower in the private hospital than in the public hospital. Major factors influencing prescribing practices included drug availability; clinician's level of training; cost of drugs; feedback from patients and socio-economic status of patients. CONCLUSION: Polypharmacy; overuse of antibiotics and low rate generic prescribing still occur in the health facilities studied. Drug availability; clinician's level of training; cost of drugs; feedback from patients and socio-economic status of patients are major factors influencing prescribing in the facilities
Subject(s)
Comparative Study , Drug Costs , Health Facilities , Pharmaceutical Preparations , Prescriptions , Social ClassABSTRACT
Despite growing international pressure to provide HIV-1 treatment to less-developed countries; potential demographic and epidemiological impacts have yet to be characterised. We modelled the future impact of antiretroviral use in south Africa from 2000 to 2005. methods: We produced a population projection model that assumed zero antiretroviral use to estimate the future demographic impacts of the HIV-1 epidemic. We also constructed four antiretroviral-adjusted scenarios to estimate the potential effect of antiretroviral use. We modelled total drug cost; cost per life-year gained; and the proportion of pe-person health-care expenditure required to finance antiretroviral treatment in each scenario. Findings: With no antiretroviral use between 2000 and 2005; there will be about 276000 cumulative HIV-1-positive births; 2;302;000 cumulative new AIDS cases; and the life expectancy at birth will be 46.6 years by 2005. By contrast; 110;000 HIV-1-positive births could be prevented by short ourse antiretroviral prophylaxis; as well as a decline of up to 1 year of life expectancy. The direct drug costs of universal coverage for this intervention would be US$54 million - less than 0.001of the per-person health-care expenditure. In comparison; triple-combination treatment for 25of the HIV
Subject(s)
HIV , Anti-Retroviral Agents , Drug CostsABSTRACT
Dans un travail prospectif du 10/02/92 au 12/06/92 (4 mois) visant a l'analyse de la prise en charge therapeutique des IRA dans trois centres de la PMI d'Abidjan; les auteurs ont etudie les prescriptions de 189 enfants ages de 0 a 71 mois. Le modele de prise en charge de reference etait celui de l'OMS. 70 pour cent des sujets etaient ages de 0 a 23 mois. Les IRA investiguees se repartissent en 67 pour cent de formes hautes et en 33 pour cent de formes basses. Les IRA hautes etaient constituees de 88 rhinites; 25 pharyngites; 13 otites. Concernant les traitements; pour 180 ordonnances; 677 lignes de prescriprions (LP) ont ete recensees soit 3;7 LP par malade. Le nombre eleve des specialites et presentations (149) temoigne d'une non standardisation des protocoles therapeutiques. Les antibiotiques (84 pour cent des ordonnances); les antitussifs (62 pour cent des ordonnances); les antipyretiques (59 pour cent des ordonnances) etaient les classes therapeutiques les plus retrouvees. Les betalactamines; les macrolides constituent 92 pour cent des antibiotiques prescrits. Parmi les antitussifs 34 pour cent etaient purs et 66 pour cent des fludifiants. Dans les rhenites sans pneumopathie; les auteurs ont note une prescription abusive d'antibiotiques (75 pour cent) ainsi que des gouttes nasales contenant des antibacteries et/ou des vasoconstricteurs; des corticoides dans 96 pour cent des cas; le serum physiologique ne represente que 4 pour cent des gouttes nasales. Le cout moyen de l'ordonnance est de 6350 F CFA dans ces centres ou sont traites des malades de milieu socio-economique modeste. Devant ce constat; les auteurs preconisent la mise en place d'un programme de lutte contre les IRA de l'enfant pour une prise en charge standardisee et moins couteuse dans les centres de sante publique
Subject(s)
Drug Costs , Infant , Prescriptions , Respiratory Tract Infections , Respiratory Tract Infections/drug therapy , Respiratory Tract Infections/economics , Respiratory Tract Infections/prevention & controlABSTRACT
Les auteurs analysent l'attitude therapeutique des medecins au Departement de Medecine Interne devant l'insuffisance cardiaque congestive. 26 patients des 30 patients insuffisants cardiaques admis ont ete retenus dans cette etude retrospective allant de janvier a decembre 1989. L'analyse du type de traitement prescrit; de la mortalite au cours de l'hospitalisation et de l'impact financier de chaque association medicamenteuse montre une tendance elevee de prescrire les vasodilateurs veineux qui levent plus tot l'insuffisance cardiaque congestive; un impact financier moins important avec ces vasodilateurs; une lourde mortalite en presence du SIDA. Les femmes (65;4 pour cent) sont plus nombreuses que les hommes (34;6 pour cent). La cardiomyopathie idiopathique est l'etiologie couramment rencontree avec 54;2 pour cent
Subject(s)
Acquired Immunodeficiency Syndrome , Cardiomyopathies , Drug Costs , Heart Failure , Heart Failure/drug therapy , Heart Failure/mortality , Prescriptions , Vasodilator AgentsABSTRACT
Au Zaire ou le probleme d'approvisionnement en medicaments se pose avec acuite et leurs couts hors de portee de la population demunie; l'usage rationnel du medicament est une composante qui a son importance dans la politique pharmaceutique. Car il faut eviter aux malades deja demunis des depenses inutiles tout simplement parce que faute d'appui diagnostique adequat et d'information utile
Subject(s)
Drug Costs , PrescriptionsABSTRACT
Despite the progress achieved in immunization; The basic African health infrastructures are dysfunctional and unappealing to the people. Plagued by chronic underfinancing; the public health sector in Sub-Saharan Africa is characterized by dilapidated buildings; frustrated health workers who are poorly renumerated and a lack of drugs and equipment. Indeed; the perceived quality of health services is mainly judged by the availability of drugs and the attitude of the providers. The Bamako initiative was therefore providing UNICEF and the countries with the opportunity to look directly at the system and to promote two major inter-related principles which are the people contribution to the financing of the system and their right to co-manage the resources
Subject(s)
Cost Sharing , Drug Costs , Health Policy , Health Services Needs and Demand , Health Workforce , Public Health AdministrationABSTRACT
Public health in developing countries are facing serious problems in terms of quality and maintenance. Staff are underpaid and therefore not motivation; equipment is often missing for functioning poorly and drugs are in short supply. The basis for this deplorable development is lack of funds for health. In Sub-Saharan Africa less 5 per cent of government budgets is usually spent on health care. There is therefore an urgent need to find more fund to finance health services
Subject(s)
Developing Countries , Drug Costs , Health Expenditures , Health Services Needs and Demand , Health Workforce , Public Health AdministrationABSTRACT
Two hundred and twenty patients with epilepsy attending the neurologic clinic at Connaught Hospital were reviewed. Male predominance; greater prevalence of primary generalised seizures and low family history are consistent with reports from other African countries. Similarly the majority of patients had idiopathic epilepsy. Only 35 per cent of patients attented clinic for six months and 12 per cent for two years. Cultural attitudes; cost of medication and distance from clinic may contribute to the low level of clinic attendance. It is suggested that integrating the follow up and treatment of epileptics into primary health care programmes will make a greater impact on epilepsy control
Subject(s)
Cultural Characteristics , Drug Costs , Epilepsy/complications , Epilepsy/diagnosis , Epilepsy/drug therapy , Epilepsy/epidemiology , Epilepsy/mortality , Epilepsy/prevention & control , Primary Health CareABSTRACT
In the past; drugs have not been available to all South Africans; due to structured inequalities and inaccessibility caused by apartheid. This situation will be changed through the implementation of the National Drug Policy; which reflects and provides the means of carrying forward many of the elements of the National Health Policy