Comparison of direct costs associated with the use of balanced general anesthesia and total intravenous anesthesia (TIVA) techniques / Comparación de los costos directos asociados al uso de técnicas de anestesia general balanceada y anestesia total intravenosa (TIVA)

Abstract Introduction: Healthcare costs are increasing against the backdrop of scarce resources. Surgical procedures are an important part of healthcare spending, and the cost of anesthetic techniques is relevant as part of the total cost of care and it is a potential target for expenditure optimization. Although important economic differences have been reported internationally for general anesthesia options, there are no publications in Colombia that compare current costs and allow for informed and financially responsible decision-making. Objective: To quantify and compare direct costs associated with the various general anesthesia options most frequently used at the present time. Methods: Cost minimization analysis based on a theoretical model of balanced general anesthesia using isoflurane, sevoflurane, desflurane in combination with remifentanil, and TIVA (propofol and remifentanil). Initial results were obtained using a deterministic simulation method and a sensitivity analysis was performed using a Monte Carlo simulation. Results: The average total cost per case for the different anesthetic techniques was COP 126381 for sevoflurane, COP 97706 for isoflurane, COP 288605 for desflurane and COP 222 960 for TIVA. Conclusions: Balanced general anesthesia with desflurane is the most costly alternative, 1.2 times more expensive than TIVA, and 2 and 3 times more costly than balanced anesthesia with sevoflurane and isoflurane, respectively. TIVA ranks second with a cost 1.8 times higher than balanced anesthesia with sevoflurane and 2.5 times higher than balanced anesthesia with isoflurane.

Resumen Introducción: Los costos de la atención en salud son crecientes y se enfrentan a un escenario de recursos escasos. La realización de procedimientos quirúrgicos hace parte importante de la atención y del gasto en salud, el costo de las técnicas anestésicas utilizadas es relevante en el costo total de la atención y es un objetivo potencial para la optimización del gasto. Aunque a escala internacional se han reportado diferencias económicas importantes entre las alternativas para anestesia general, en Colombia no se cuenta con publicaciones que comparen los costos actuales y permitan una toma de decisiones informada y responsable económicamente. Objetivo: Cuantificar y comparar los costos directos para Colombia de las diferentes alternativas para anestesia general usadas con más frecuencia en la actualidad. Métodos: Análisis de minimización de costos basado en un modelo teórico de anestesia general balanceada con isoflurano, sevoflurano, desflurano en combinación con remifentanilo y TIVA (propofol y remifentanilo). Se obtuvieron resultados iniciales utilizando una simulación con un método determinista y se realizó un análisis de sensibilidad con una simulación de Montecarlo. Resultados: El costo total promedio por caso para las diferentes técnicas anestésicas fue de COP 126.381 para sevoflurano, COP 97.706 para isoflurano, COP 288.605 para desflurano y COP 222.960 para TIVA. Conclusiones: La anestesia general balanceada con desflurano es la alternativa de mayor costo, es 1,2 veces más costosa que la TIVA, y 2 y 3 veces más que la balanceada con sevoflurano e isoflurano, respectivamente. La TIVA ocupa el segundo lugar con un costo 1,8 veces superior a la balanceada con sevoflurano y 2,5 veces a la balanceada con isoflurano.

Avanzando para mejorar el acceso a los medicamentos y tecnologías sanitarias para las enfermedades cardiovasculares / Moving toward improved access to medicines and health technologies for cardiovascular disease / Avançando para melhorar o acesso a medicamentos e tecnologias de saúde para as doenças cardiovasculares

RESUMEN Los objetivos del presente artículo son describir las intervenciones realizadas por el Fondo Estratégico de Organización Panamericana de la Salud, para facilitar el acceso y disponibilidad de medicamentos antihipertensivos y dispositivos para la medición de la presión arterial a los países de la Región de las Américas en apoyo a la implementación de la Iniciativa HEARTS; y presentar los resultados preliminares de los análisis de los precios de los medicamentos antihipertensivos. La metodología del estudio incluyó la revisión de informes realizados por el Fondo Estratégico durante los años 2019-2020, la evaluación de las modalidades de adquisición y revisión de las bases de datos de compras públicas para 5 medicamentos antihipertensivos, y el análisis comparativo con el precio obtenido por el Fondo Estratégico. Se identificaron diferencias que oscilaron entre 20% y 99%, lo que evidencia oportunidades de ahorro significativas. Asimismo, se presentan las acciones interprogramáticas desarrolladas en apoyo a la Iniciativa HEARTS, entre las que se destacan la inclusión de medicamentos antihipertensivos recomendados por la Organización Mundial de la Salud; la consolidación de la demanda regional y el establecimiento de precios competitivos con acuerdos a largo plazo para gestionar la adquisición de productos genéricos de calidad; y la definición de especificaciones técnicas y requisitos regulatorios para apoyar con la adquisición de dispositivos para la medición de la presión arterial. A través de este mecanismo, los Estados Miembros pueden disminuir sus costos significativamente, extendiendo cobertura del tratamiento y diagnóstico a más personas.

ABSTRACT The objectives of this article are to describe the interventions carried out by the Strategic Fund of the Pan American Health Organization to facilitate access to and availability of antihypertensive drugs and devices for measuring blood pressure in the countries of the Region of the Americas, supporting implementation of the HEARTS initiative; and to present the preliminary results of price analyses of antihypertensive drugs. The study methodology included a review of reports made by the Strategic Fund during 2019-2020, evaluation of modalities of procurement, a review of the public procurement databases for five antihypertensive drugs, and a comparison with the price obtained by the Strategic Fund. Differences ranging from 20% to 99% were identified, indicating significant opportunities for savings. Interprogrammatic actions in support of the HEARTS initiative are also presented, such as the inclusion of antihypertensive drugs recommended by the World Health Organization; consolidation of regional demand and establishment of competitive prices with long-term agreements to manage the procurement of quality generic products; and the definition of technical specifications and regulatory requirements to support the procurement of devices to measure blood pressure. Through this mechanism, Member States can reduce their costs significantly, enabling them to extend treatment and diagnostic coverage to more people.

RESUMO Os objetivos deste artigo são descrever as intervenções realizadas pelo Fundo Estratégico da Organização Pan-Americana da Saúde para facilitar o acesso e a disponibilidade de medicamentos anti-hipertensivos e aparelhos de medição de pressão arterial aos países da Região das Américas, em apoio à implementação da iniciativa HEARTS; e apresentar os resultados preliminares da análise dos preços dos medicamentos anti-hipertensivos. A metodologia do estudo incluiu a revisão de relatórios feitos pelo Fundo Estratégico durante os anos de 2019 e 2020, a avaliação das modalidades de aquisição e revisão dos dados de compras públicas de 5 medicamentos anti-hipertensivos e uma análise comparativa com o preço obtido pelo Fundo Estratégico. Foram identificadas diferenças que oscilaram entre 20% e 99%, o que evidencia oportunidades de economia significativas. Da mesma forma, são apresentadas as ações interprogramáticas desenvolvidas em apoio à iniciativa HEARTS, entre as quais se destacam a inclusão de medicamentos anti-hipertensivos recomendados pela Organização Mundial da Saúde; a consolidação da demanda regional e o estabelecimento de preços competitivos com acordos de longo prazo para gerenciar a aquisição de genéricos de qualidade; e a definição de especificações técnicas e requisitos regulatórios para subsidiar a aquisição de aparelhos de medição de pressão arterial. Por meio desse mecanismo, os Estados Membros podem reduzir seus custos significativamente, ampliando a cobertura de tratamento e diagnóstico para atingir mais pessoas.

CHINA PH ARMACY Volume 33，Number 10，May 30，2022 Semimonthly Table of Contents Effect evaluation of comprehensive drug cost control in China based on the entropy method-cluster analysis / 中国药房

OBJECTIVE To evaluate th e effects of comprehensive drug cost control in China ，and to provide reference for further improving the effects of cost control. METHODS Entropy method was used to establish a comprehensive evaluation index system of the comprehensive drug cost control effect from the respective of drug price control ability ，drug cost control ability and patient affordability. The comprehensively evaluate the effects of drug cost control in 31 provinces （autonomous regions and municipalities）during 2016-2020. The k-means cluster method was used to analyze the effects of comprehensive drug cost control in various provinces. RESULTS & CONCLUSIONS During the period of 2016-2020，the total score of comprehensive drug cost control effect of 31 provinces were 14.64，16.71，17.58，17.57，17.88，respectively. The results of cluster analysis were similar to the ranking of entropy method. Medical and health system reform policy had entered a stable period after achieving phased results ； the effects of comprehensive drug cost control was characterized by regional steps in 31 provinces；the effects of comprehensive drug cost control were better in developed coastal areas and some provinces and cities of western regions ，followed by provinces and cities in central China ；however，comprehensive drug cost control in 3 provinces of northeast China showed poor effect. The effects of comprehensive drug cost control in pilot cities of comprehensive medical reform were significantly improved. It is suggested that the successful experience of pilot cities of comprehensive medical reform should be promoted nationwide ，and policies such as volume-based drug procurement ，medical insurance drug price negotiation ，and diagnosis-related groups / diagnosis-intervention packet payment method reform should be further deepened.

Analysis of the Utilization of Antidepressant Drugs in 11 Hospitals from Zhejiang Province during 2013-2017 / 中国药房

OBJECTIVE： To investigate the application of antidepressants in Zhejiang province and to provide reference for rational drug use in clinic. METHODS： WHO-recommended defined daily dose （DDD） method was used to statistically analyze consumption sum， main types， defined daily dose system （DDDs）， daily drug cost （DDC） and ranking ratio （B/A value， i.e. consumption sum rank/DDDs rank， B/A＜1 means the price of drugs was higher， whereas the price of drugs was lower） of antidepressant drugs in 11 hospitals from Zhejiang province during 2013-2017. RESULTS： The consumption sum of antidepressants was increased year by year in 11 hospitals from Zhejiang during 2013-2017， and increased from 3 235 200 yuan in 2013 to 4 569 100 yuan in 2017； the proportion of consumption sum of antidepressants in total consumption sum of all drugs kept stable， ranging from 0.47％ to 0.50％. The top 5 drugs by consumption sum were fluoxetine， duloxetine， olanzapine and venlafaxine； consumption sum of escitalopram accounted for a larger increase （proportion ration increased from 8th place in 2013 to first place in 2017）. Within 5 years， DDDs of fluoxetine， paroxetine and sertraline took up the first 3 place； DDC of olanzapine， quetiapine and duloxetine took up the first 3 place； the drugs with B/A value＜1 included duloxetine， olanzapine， venlafaxine and quetiapine， etc； the drugs with B/A value＞1 were paroxetine and sertraline. CONCLUSIONS： The use of antidepressant drugs in 11 hospitals from Zhejiang province is rational in structure； selective 5-hydroxytryptamine （5-HT） reuptake inhibitors （SSRI）， selective 5-HT and noradrenaline reuptake inhibitor （SNRI） take up the predominant place. New antidepressant drug escitalopram shows a good clinical prospect.

Analysis and Evaluation of Human Serum Albumin Use in 8 760 Inpatients / 中国药房

OBJECTIVE:To provide references for rational use of human serum albumin.METHODS:The inpatients receiving human serum albumin in the hospital during Jan.-Dec.2014 were investigated retrospectively and analyzed in respects of general information of patients,serum albumin level before medication,drug dosage,drug cost and reasons.RESULTS:Eight thousand seven hundred and sixty patients from top 8 departments in the list of the number of patients of human serum albumin were included in the study,accounting for 64％ of total.There were 5 244 male (59.9％) and 3 516 female (40.1％);patient's age mainly ranged ＞ 30-60 year-old (52.6％).The number of patients of albumin was the largest in general surgery department (2 588 cases) and cardio vascular surgery department (2 348 cases).Referring to domestic package inserts,8 210 patients (about 93.7％) were in accor dance with indications,and hypoproteinemia was the most common medication indication (35.6 ％).The drug dosage per capita of ICU was the highest (152.5 g);total drug cost was the highest in general surgery department (13 334 396.4 yuan);treatment course per capita of infection disease department was the longest (10.7 d).CONCLUSION:There is irrational use of human serum albumin in our hospital and difference of drug use among departments.It is necessary to strengthen human serum albumin use monitoring and establish rational medication evaluation system so as to promote standard drug use and realize rational distribution of medical resources.

Utilization Analysis of Carbapenems in 34 Hospitals of Wuhan Area during 2007-2014 / 中国药师

Objective: To investigate the application and tendency of carbapenems in the hospitals of Wuhan area.Methods: The application of carbapenems in 34 hospitals of Wuhan area during 2007-2014 was analyzed statistically in terms of consumption sum, DDDs, DDC and so on.Results: The total consumption sum of carbapenems increased year by year.Compared with that in 2007, the total consumption sum increased by 4-fold in 2014.The growing rate of total consumption sum of biapenem was the fastest among various varieties.Since 2009, three injections including meropenem, biapenem and imipenem / cilastatin predominated the market of Wuhan area, followed by faropenem with oral administration.The changing trend of DDDs was basically consistent with the total consumption sum.DDC of all the drugs was relatively high and demonstrated decreasing tendency, and that of biapenem decreased most notably, while still ranked the first place.DDC of meropenem and imipenem/cilastatin both exceeded 400 yuan.The price of faropenem fluctuated notably during 2007-2009, while increased by 2-fold in 2009 (453 yuan) and then remained stable.Conclusion: The special rectification measures show positive impact on the selection of antimicrobial agents in Wuhan area.The drug varieties are proper, while the average daily cost is still high.The government should continue to strengthen the management of antibiotics to ensure the rational use of carbapenems.

Clinical Observation of Budesonide Combined with Salbutamol in the Treatment of Infant Bronchiolitis / 中国药房

OBJECTIVE:To investigate therapeutic efficacy,safety and economics of budesonide for infant bronchiolitis based on salbutamot. METHODS:In prospective study,160 inpatient children with bronchiolitis during Oct. 2014-Apr. 2016 were divid-ed into observation group and control group according to admission order,with 80 cases in each group. Both groups received conventional treatments. Control group was given Salbutamol solution for inhalation 0.25 mL added into 0.9% Sodium chloride injection 3 mL,q8 h. Observation group was given Budesonide suspension for inhalation 2 mL added into 0.9% Sodium chlo-ride injection 1 mL+Salbutamol solution for inhalation 0.25 mL,q8 h. Both groups received oxygen driven inhalation,and treat-ed for 5-7 d. Clinical symptom disappearance time,hospitalization time and clinical efficacy were compared between 2 groups as well as therapy drug cost(aerosol inhalation,other therapy drugs). The occurrence of ADR was recorded. RESULTS:There was no statistical significance in cough disappearance time,wheezing disappearance time,lung rale disappearance time,tri-re-traction sign disappearance time and hospitalization time between 2 groups(P>0.05). There was no statistical significance in to-tal response rate between observation group (95.00%) and control group (92.50%)(P>0.05). The cost of inhalation drugs in observation group [(355.77±10.98)yuan] was significantly higher than control group [(26.83±2.86)yuan],with statistical signif-icance (P0.05). There was no significant ADR between 2 groups during treatment. CONCLUSIONS:For infant bronchiolitis,aerosol inhalation of budesonide based on salbutamol sulfate can not significantly shorten disease,shorten hospitalization time and improve clinical ef-ficacy,but increase therapy cost.

Study on the Effects of Total Cost Prospective Payment System on the Consumption of Drugs / 中国药房

OBJECTIVE:To investigate the consumption of drugs after the inplementation of total cost prospective payment sys-tem(PPS),and to provide reference for hospital drug cost control. METHODS:The data of prescriptions collected from 9 hospital during 2007-2014 were divided into group A,B and C according to PPS,and then summarized statistically in respects of increase rate of total consumption sum,consumption sum ratio of major category;the drug cost per time of outpatient department,emergen-cy department and inpatient department were calculated as well as consumption sum ratio of self-paid drugs;the dosage per time of drugs in blood pressure and diabetes prescription were also calculated. RESULTS:The total consumption sum of drug increased slowly after the implementation of total cost PPS;the consumption sum ratio of major category kept stable,while that of anti-infec-tive agent decreased;the emergency drug cost per time achieved a negative growth,and outpatient and inpatient drug cost per time increased slightly. The proportion of self-paid drugs was relatively stable. The dosage per time of drugs in hypertension and diabetes prescriptions was stable,too. CONCLUSIONS:Total cost PPS is useful in controlling the rapid growth of drug costs,and promote the reasonable drug use. The consumption sum of self-paid drugs are well controlled. The increase of drug cost per time in outpa-tient and inpatient should arouse the attention of the relevant departments. In addition,it has no effect on drug dosage for the pa-tients with hypertension and diabetes.

Análisis comparativo de insulina glargina frente a la insulina detemir: un modelo de minimización de costos aplicable en Colombia / Comparative analysis of insulin glargine vs. insulin detemir: A cost-minimization study applicable to Colombia

Introducción. Más del 90 % de los individuos diagnosticados con diabetes mellitus presentan el tipo 2, cuya resistencia periférica a la acción de la insulina es conocida. Objetivo. Desarrollar un modelo de minimización de costos del tratamiento con insulina glargina una vez al día o con insulina detemir, una o dos veces al día, en pacientes con diabetes mellitus de tipo 2 que requieren insulina, desde la perspectiva del tercer pagador en Colombia. Materiales y métodos. Se hizo una búsqueda sistemática de estudios clínicos comparativos de la administración de insulina glargina e insulina detemir en pacientes con diabetes mellitus de tipo 2 que requieren insulina, con el fin de extraer los datos sobre su uso y efectividad, y sobre la frecuencia de eventos secundarios. La meta establecida de control glucémico fue de HbA1c=7 %. Los costos de la insulina se tomaron del Sistema Integrado de Precios de Medicamentos, 2012, del Ministerio de Salud y Protección Social, y los precios por tableta se basaron en el promedio móvil de doce meses en diciembre de 2012 según el IMS Consulting Group. Los análisis de sensibilidad se hicieron con simulaciones de Montecarlo para las dosis y los costos de la insulina. Resultados. Cinco publicaciones cumplieron con los criterios de inclusión. El rango de la diferencia entre dosis de insulina fue de 3,2 a 33 UI. El porcentaje de pacientes que requirieron dos dosis de insulina detemir estuvo entre 12,6 y 100 %. No hubo diferencias significativas en los eventos hipoglucémicos. Tanto para el canal de compra al por menor como para el de compras institucionales, la diferencia de costos entre la insulin glargina y la detemir favoreció a la primera en cuatro y cinco estudios, respectivamente. Solo un estudio mostró lo contrario en lo concerniente a la venta al por menor. Conclusiones. La diferencia en cuanto a la dosis promedio entre la insulina ganglir y la detemir, genera costos anuales que favorecen el uso de la insulina ganglir, lo que la convierte en una alternativa costo-efectiva frente a la determir.

Introduction: More than 90% of subjects diagnosed with diabetes mellitus present with type 2, which is recognized for peripheral insulin resistance. Objective: To determine the costs of achieving glycemic target with the use of basal insulin analogs, insulin glargine (IG) once a day vs. insulin detemir (ID) once or twice a day, with a cost minimization model built from a third-party payer perspective in Colombia. Materials and methods: A systematic review of comparative clinical trials between IG and ID in patients with insulin-resistant type 2 diabetes was performed to determine data of use, effectiveness and frequency of and adverse events. The goal of glycemic control (effectiveness measure) was defined as HbA1c=7%. The costs of insulin were extracted from the Integrated System of Medication Prices 2012 (Ministerio de Salud y Protección Social de Colombia) and the IMS Consulting Group mobile average cost for the past year as of December, 2012. Sensitivity analyses were performed via Montecarlo simulations for dose and medication costs (insulin). Results: Five publications met inclusion criteria. The range of the difference between insulin doses was 3.2 IU to 33 IU. The percentage of patients requiring two ID doses was 12.6-100%. There were no significant differences in hypoglycemic events. For both retail and institutional channels, there was a higher differential cost between IG vs. ID favoring IG in 4 and 5 studies, respectively. For the retail channel only one study showed the opposite results. Conclusions: As only medication costs are considered, differences in insulin units between IG and ID result in a differential cost in favor of IG that makes it a cost/effective alternative.

Application Analysis of Antitumor Chinese Herbal Injections of 32 Hospitals in Wuhan Area During 2010-2012 / 中国药师

Objective: To investigate the current situation of consumption and development tendency of antitumor Chinese herbal injections in Wuhan area. Methods:The analytical method of the defined daily dose ( DDD) recommended by WHO was used to ana-lyze the application of antitumor Chinese herbal injections in 32 hospitals of Wuhan area during the period of 2010-2012. Results:The consumption sum and the DDDs of antitumor Chinese herbal injections were increased year after year, while the daily drug cost ( DDC) was stable in general. The sort of consumption was generally in accordance with the sequence of DDDs. Conclusion:The status quo of antitumor Chinese herbal injections during the period of 2010-2012 is in line with the characteristics of clinical application, indicating the use is rational.

<b>The Difference in Analgesic Use of Acetaminophen between in Japan and Other Countries, and Possible Drug Cost Reduction </b><b>Caused by the Acetaminophen Prevalence in Japan </b> / 薬剤疫学

Acetaminophen is commonly used as the global standard of analgesics. For example, the WHO lists acetaminophen as an essential drug and various clinical guidelines in many countries include acetaminophen as a first-line drug for pain relief because of it's efficacy and safety profile. In particular, there is not significant risk of such as gastrointestinal disorders, renal dysfunctions, bleeding, or cardiovascular events, and it is considered to be a safer option than non-steroidal anti-inflammatory drugs(NSAIDs). In Japan, however, NSAIDs are widely used to treat pain while the use of acetaminophen for pain relief is quite limited. This difference could be attributed to the low approved dose of acetaminophen in Japan, which is less than half of that used elsewhere. This lower approved dose causes difficulty in obtaining analgesic effect with acetaminophen. In January 2011, however, the approved dose of acetaminophen in Japan was increased to the world standard dose, making it easier to obtain an analgesic effect. In the near future, an increase in the use of acetaminophen for pain relief can be expected in Japan. NSAIDs are common drugs for pain in Japan, but often require co-prescription of a gastric mucosal protective agents, H₂- blockers, or proton pump inhibitors(PPI) to prevent gastrointestinal disorders. On the other hand, acetaminophen has much less risk of such adverse reactions and there is no need for co-prescription of digestive medicines. Thus, increased use of acetaminophen could decrease the cost for pain relief in Japan. (Jpn J Pharmacoepidemiol 2012; 17(2): 75-86)

Exploration and Practices of Drug Cost Control in Large Public Hospital / 中国卫生经济

Cancelling drug price addition is one of public hospital reform content, under the condition of insufficient financial input, public hospitals should enhance the drug cost management, taking measures to reduce drug proportion, to deal with all kinds of hospital operation problems produced by hospital income decline due to the cancellation of drug addition. Through years of exploration and practice, Affiliated Hospital of Jining Medical University has controlled the rising of drug cost effectively and received better effect, which built a good foundation of public hospital reform.

Preço dos medicamentos utilizados nas doenças cardiovasculares no Brasil / Cost of drugs used to treat cardiovascular disease in Brazil

OBJETIVO: A mortalidade brasileira tem como causa principal as doenças do aparelho circulatório. Considerando os medicamentos dispensados na Farmácia Popular do Brasil (FPB), analisaram-se os preços daqueles utilizados no tratamento dessas doenças para verificar a contribuição dos produtos genéricos e da FPB. MÉTODOS: O preço de cada medicamento foi obtido no Guia de Preços da Farmácia e na tabela de preços da FPB. O custo de 15 medicamentos disponíveis na FPB foi comparado ao de três especialidades farmacêuticas genéricas, três similares e a de referência. RESULTADOS: Os genéricos foram os que apresentaram menor preço para dez medicamentos e os similares para quatro. Na FPB encontraram-se os produtos de menor custo. CONCLUSÕES: Os medicamentos genéricos e os medicamentos da FPB são de fácil acesso à população, contribuindo com a continuidade da farmacoterapia na falta de disponibilidade pelo Sistema Único de Saúde e/ou de renda suficiente para aquisição do medicamento de forma regular. O acesso aos medicamentos deve ser considerado no momento da prescrição, principalmente para aqueles empregados no tratamento de doenças crônicas.

OBJECTIVE: Diseases of the circulatory system are a principal cause of mortality in Brazil. Using as a basis drugs dispensed through Brazil's Popular Pharmacy Program (FPB, for its name in Portuguese), prices for drugs used to treat circulatory diseases were analyzed to identify the advantages of using generic drugs and the FPB. METHODS: Drug prices were obtained using Brazil's Pharmacy Price Guide and FPB price tables. The costs of 15 drugs available through the FPB were compared with those of three generic pharmaceutical products, three similar products, and the reference drug. RESULTS: The generic drugs were lower in price for 10 of the drugs and for four of the similar products. The FPB drugs were of the lowest price. CONCLUSIONS: Generic and FPB drugs are easily accessed by the population and thus facilitate the continuity of pharmacotherapy when these drugs are not available through the Unified Health System and/or are not affordable through other means. Access to drugs should be taken into consideration at the time prescriptions are filled, especially as regards those used to treat chronic diseases.

Analysis of Drug Utilization by 98 Cases of Renal Transplant Inpatients During 2005 / 药物流行病学杂志

Objective:To analyze the situation of immunosuppressants utilization of renal transplantation inpa- tients in our hospital.Method:The records and relevant data of 98 case of renal transplant inpatients during 2005 were col- lected,and analyzed according to drug cost and defined daily dose(DDDs)ranking.Result:The average age was(42.50?10.56)a,the average drug cost was(18745.36?7603.86)yuan,the average inmunosuppressant cost was 13456.58 yuan,and all the drug utilization indicators(DUI)were≤1.Conclusion:The analysis shows that the inmunosuppressant utilization rate was high and the inmunosuppressant utilization by renal transplant inpatients was basically rational.

Analysis of 5-HT_3 Receptor Antagonists Used in 25 Hospitals of Wuhan During the Period of 2003-2005 / 药物流行病学杂志

Objective:To evaluate the current situation and the developing trend of 5-HT3 receptor antagonists used in 25 hospital of Wuhan during the period of 2003～2005 in order to provide reference for clinical doctors and pharmacists. Method:The 5-HT3 receptor antagonists were statistically analyzed in respect to the purchase sum of money,DDDs and daily costs. Result:During the 3 years, purchase sum of money of 5-HT3 receptor antagonists were yearly increasing. The share of the market of domestic drugs showed an increasing tendency,while the imported drugs decreased year by year. Granisetron, ondansetron and tropisetron were much more frequently used than others. Conclusion:The market of the oral agents of 5-HT3 receptor antagonists will further expand in China.

Drug Use in Elder Hospitalized Patients:Analysis of 12614 Cases / 中国药房

OBJECTIVE:To study the status quo of drug use in the elder hospitalized patients(over 65 years old)and their demand for drugs.METHODS:The drugs used in the 12 614 elder hospitalized patients(over 65 years old)between July,2005 and June,2006 were statistically analyzed.RESULTS:The drugs used in elder hospitalized patients totaled 1 347 kinds,which were mainly administered orally or by injection.The consumption sum of injection accounted for 85.81% of the total.The most common diseases in the elder hospitalized patients were tumor diseases,cardiovascular and cerebrovascular diseases,and which were more often seen in males than in females.CONCLUSION:The drugs used for the elder hospitalized patients were many in kinds.The expenses of injection showed a highest proportion in the total drug costs.Cerebrovascular and cardiovascular diseases and tumor diseases are main diseases that threat health of aged people.