ABSTRACT
@#Drug utilization of oral hypoglycemic agents (OHAs) in a private healthcare setting is useful to examine the prescribing pattern of OHAs, especially the newer fixed dose combination (FDC) products. This study was aimed to evaluate the prescribing pattern of OHAs indicated for Type 2 diabetes mellitus (T2DM), to determine the costs of OHAs prescribed and total cost per prescription in the treatment of T2DM in an outpatient department of a private hospital located in central Malaysia. Retrospective review of electronic medical record (EMR) study design was adopted. Patient’s demographic characteristics, medications prescribed, prescribers’ details and cost per prescription were documented. Defined daily dose (DDD) of OHAs and drug cost were calculated. Research ethics protocol was approved and no personal data was collected. Out of the 396 EMR screened, 135 fulfilled the inclusion criteria and subsequently were analysed. In term of demography, mean age of the sample was 51 years old with 59% were male and ethnicity composition of 71% Malay and 19% Chinese. Metformin and “metformin+dipeptidyl peptidase-4 inhibitor” (DPP-4i) were the most commonly prescribed single-drug and FDC OHA, respectively. Average cost of OHAs and total cost per prescription was less than USD 68 and USD 185, respectively. Meanwhile, FDC covered 28.91% of incidences of prescriptions, but 44.6% of cost and SGTL-2i covered 9% incidences of prescriptions and 16.29% of cost. Prescribing pattern of OHA was appropriate based on patient’s T2DM diagnosis, however, dosage given were not in accordance with WHO DDD.
ABSTRACT
Out-of-pocket [OOP] payments may burden Methadone Maintenance Clinic patients. Since treatment is fully .subsidized by the government, financial constraint might lead to patients being made to pay or be given incentive for inconvenience of therapy. This study thus evaluates the characteristic and commitment of methadone therapy patient's in terms of OOP cost, Willingness-To-Pay [WTP]and Willingness-To-Accept [WTA]concept. This survey utilizes the questionnaire by Boris ova and Goodman [2003] on the OOP, WTP and WTA. The forty adult patient's selected medical records from year 2009-2011 were from an urban government methadone clinic. Subject's selection was by convenient sampling based on the predetermined criteria. Most were male [95%] and Malay [60%] was the predominant group. Patients were group into three income groups; /=RM1000 - /=RM3000. The average OOP cost per month was RM391.30 [s.d RM337.50], which is about 35% of employed patient's monthly income. The wide variation could be attributed by high inter-individual and significant differences between patients in terms of transport, times taken to clinic, cost per trip and weekly household income [p=<0.05]. Patients with income of less than RM1000 showed the highest tendency to pay for treatment, asked for the least money for inconvenience and many are unwilling to accept any payments. These findings showed that WTP and WTA is less of a concern for patients in the low-income group. To conclude, OOP payment is not a treatment barrier for most of the urban MMT patients
Subject(s)
Humans , Adult , Female , Male , Middle Aged , Opiate Substitution Treatment , Health Expenditures , Surveys and Questionnaires , Costs and Cost AnalysisABSTRACT
This study is an observational cross-sectional study aimed to examine the possible demographic and social characteristics of patients enrolled at the Methadone Maintenance Therapy Adherence Clinic [MMTAC] in Malaysia. Medical records from year 2009 - 2011 were reviewed. Demographic, social characteristics and laboratory examinations such as age, gender, race, clinic attendances and urine analysis were recorded. Subjects were selected by means of convenient sampling but based on the specified inclusion and exclusion criteria. Data were analyzed by either Chi-square test, Fisher's exact test Mann-Whitney U-test, with the limit of significance was set at p