ABSTRACT
Rational prescribing is one of the essential components of good medical practice targeted to provide successful and relatively safe drug therapies. The present study was carried to assess the rationality of the current prescribing practices in Khartoum State. A descriptive, observational, 1-time study was carried out in Khartoum State hospitals and community pharmacies, to evaluate the five main prescribing indicators adopted by the WHO. Data were collected using the WHO prescribing indicator form. The total number of prescriptions collected and analyzed was 7377 prescriptions, 67% from Khartoum city, 22.5% from Khartoum North city and 10.5% from Omdurman city. The total number of drugs prescribed was 20,482, the average number of drugs per prescription: 2.776 drugs, percentage of generics: 37.3%, percentage of antibiotics: 54.3%, percentage of injections: 38.6% and the percentage of drugs on the essential drug list [EDL] was 72.8%. The number of encounters included in this study is sufficiently large compared to other previously reported studies allowing us to consider the results obtained as an acceptable representative of the total population to describe the overall prescribing pattern. Except for the value obtained for the percentage drugs on the EDL, the values of the other four indicators are indicative of prescribing irrationality in the study population. The observed irrational prescribing behavior necessitates the development of certain policies as well as practical and effective implementation mechanisms to promote rational prescribing. We, therefore, recommend the conduction of one or more of three interventions namely, administrative, managerial and/or educational addressing the prescribers population
ABSTRACT
The aim of this study to measure medicines prices, their availability, affordability and price structure carried out in different sectors in Sudan. Methods: A field study was undertaken in the public and private sector in Sudan from March 2012 to April 2013 using a standardized methodology developed by the [World Health Organization] and [health action international]. Results: Based on median price ratio [MPR], the central medical store was procuring lowest priced generics [LPGs] at 1.2 times their international reference price [IRP], while they were selling generics at 2.34 times the IRP. The revolving drug fund was procuring LPGs at 1.55 times IRP, and selling generics at 5.13 times the IRP. In public pharmacies, the median MPR for LPG medicines was 2.99 and 8.03 for originator brands [OBs]. In private retail pharmacies, the median MPR is 3.84 for LPGs and 19.37 for OBs. Generic medicines were the predominant products in public and private pharmacy sectors [39.5% and 56.6% respectively], while for OBs were 1.8% in public sector pharmacies and 9.3% for private pharmacy sector. The affordability of LPGs in the public sector was good for half of conditions, with standard treatment costing a days' wage or less for 53.3% of treatments. In the private sector, the affordability of LPGs was similar to the public sector. The government worker would have to work 2.5 days to pay for 1-month of treatment with OB Glibenclamide for diabetes when purchased from private pharmacies, for LPG Glibenclamide he has to pay about half-a day's salary to buy the medicines from public and private sectors. In Sudan, the availability of the surveyed medicines was low in all sectors as both OBs [<10%], and 40-50% as generics depending on the sector. LPGs have been accepted in the country as they are more available than OBs. In both the private and public sectors, considerable price differences were seen between OBs and LPGs. Medicines are often unaffordable for ordinary citizens