[Estimation of the cost in the medical treatment of benign prostatic hyperplasia in Navarre, Spain]. / Aproximación al coste del tratamiento médico de la hiperplasia benigna de próstata en la Comunidad Foral de Navarra.

We evaluate the cost and trends in the medical treatment of out patients suffering from lower urinary tract symptoms suggestive of clinical benign prostatic hyperplasia in Navarre (Spain) between 1998/2002. The estimated number of patients increased each year, to 10% of the male population over the age of 50 in 2002, with a cost of Euros 2,557,236 equivalent to 2.4% of the total drug expenditure spending of out patients (Euros 106.6 million). The use of tamsulosin tripled and the cost doubled to Euros 807,467 (31.5%) of the total), while the rest of alpha-blockers, wit the exception of doxazosin, was stationary. Phytotherapy decreased by a third and finasteride follows a slow upward trend. The introduction of reference prices set by the Health Department in 2001 to reduce medical budget, led to an initial decrease in cost, offsetted in the following year due to the incorporation of new patients. In this period, surgery for prostate adenoma diminished from 382 patients in 1998 to 270 in 2002 (-30%).

Aproximación al coste del tratamiento médico de la hiperplasia benigna de próstata en la comunidad foral de Navarra / Estimation of the cost in the medical treatment of bening prostatic hyperplasia in Navarra, Spain

Se estudia el coste y evolución del tratamiento médico ambulatorio de los pacientes afectos de clínica de prostatismo sugestiva de hiperplasia benigna de próstata en la Comunidad Foral de Navarra en el periodo 1998/2002. El número estimado de pacientes en tratamiento se incrementa cada año, llegando al 10% de la población masculina mayor de 50 años en el 2002, con un coste para el ente gestor de 2.557.236 € , el 2,4% del gasto médico farmacéutico extrahospitalario total (106,6 millones €). En dicho periodo, la tamsulosina triplica su uso y dobla el coste hasta los 807.467 € (31,5% del total) mientras que el resto de alfa-bloqueantes, con la excepción de la doxazosina, prácticamente se estacionan. La fitoterapia baja su utilización en casi un tercio y el coste en un 50%. El finasteride mantiene una línea ascendente con una cuota de mercado actual del 15%. La introducción de los precios de referencia el año2001 disminuye inicialmente el gasto, pero esta reducción queda sin efecto ya el año siguiente ante la incorporación de nuevos pacientes en tratamiento. En el mismo periodo, la cirugía por adenoma de próstata (cerrada y abierta) pasó de 265 y 117 pacientes en 1998 a 195 y 75, respectivamente, en el año 2002 (-30%) (AU)

We evaluate the cost and trends in the medical treatment of out patients suffering from lower urinary tract symptoms suggestive of clinical benign prostatic hyperplasia in Navarre (Spain) between 1998/2002.The estimated number of patients increased each year, to 10% of the male population over the age of 50in 2002, with a cost of € 2.557.236 equivalent to 2.4% of the total drug expenditure spending of outpatients (€ 106.6 million). The use of tamsulosin tripled and the cost doubled to € 807.467 (31.5%) of the total), while the rest of alpha-blockers, wit the exception of doxazosin, was stationary. Phytotherapy decreased by a third and finasteride follows a slow upward trend. The introduction of reference prices set by the Health Department in 2001 to reduce medical budget, led to an initial decrease in cost, offsetted in the following year due to the incorporation of new patients. In this period, surgery for prostate adenoma diminished from 382 patients in 1998 to 270 in 2002 (-30%) (AU)

[Usefulness of prescription of generic drugs for cost containment in pharmaceutics. Analysis in the Community of Navarra]. / Utilidad de la prescripción de genéricos en la contención del gasto en prestación farmacéutica. Análisis en la Comunidad Foral de Navarra.

OBJECTIVE: To determine the effect of the use of generics drugs on the costs of pharmaceutical prescription, in order to help decide on their use. DESIGN: Descriptive study. SETTING: Prescriptions from all the doctors in the Health Service of Navarra-Osasunbidea. MEASUREMENTS AND MAIN RESULTS: Pharmaceutical products with over 5,000 containers consumed during 1994 in Navarra, and with a generic drug which had the same presentation, were selected. The cheapest generics drug was chosen and the hypothetical saving over the brand-name drug was calculated. None of the 285 products in most common use were generics. Use of generics instead of brand drugs would have saved 109,748,344 pesetas. Use of generics drugs instead of commercial products would reduce cost for the drugs studied by 21%. This saving would mean a 1.2% decrease in the overall cost of pharmaceutical prescription. CONCLUSIONS: Although generics drugs are not readily available, their use would decrease the cost of pharmaceutical prescription, with results comparable to those obtained from negotiation with the industry and pharmacists' representatives. The effect would be more long-lasting, as it would mean a change in doctors' prescription habits.