[Potential impact of measures to minimize drug costs in Aragon's primary care system]. / Impacto potencial de medidas de minimización de costes en la prestación farmacéutica en atención primaria de Aragón.

OBJECTIVE: To analyse the potential saving in pharmaceutical expenditure which the use of drug products of the same composition and lower price would suppose, by three high-consumption therapeutic sub-groups. DESIGN: Retrospective observation study. SETTING: Primary care. PARTICIPANTS: All the medical prescriptions of the doctors in the 121 primary care health districts in the three provinces of the Autonomous Community of Aragon during 1997, divided into the sub-groups: peptic ulcer (AO2B), lipid-lowering (B04A) and hypotensor drugs (C02). MEASUREMENTS AND MAIN RESULTS: Consumption, cost of treatment per day and potential saving of eight active principles belonging to these 3 sub-groups were calculated. Potential overall saving reached the figure of 972 million pesetas in Aragon in 1997. CONCLUSIONS: The alternative of prescribing drugs with an identical composition and lower price offers great potential savings in pharmaceutical expenditure, and may be a useful measure to improve the efficiency of health resources, and in particular those devoted to drug prescription.

[The usefulness of theophylline in the treatment of moderate-severe asthma]. / Utilidad de la teofilina en el tratamiento del asma moderada-severa.

Theophylline has shown itself to be a useful bronchodilator in the treatment of asthma, although its use has been restricted of late due to its lesser potency and greater side effects when compared with beta-adrenergic inhalants. The objective of our study is to evaluate its clinical effectiveness in moderately severe asthma. We study 12 patients with stable chronic asthma on whom a spirometry in basal conditions was performed and after therapeutic levels of theophyllinemia were reached. Peak flow and clinical symptomatology were monitored during one-week periods in both phases of the study. Daytime and night-time symptoms were evaluated independently. No significant changes were observed in the spirometric values. No changes were observed in the bronchodilation test, the concomitant consumption of bronchodilators, or in the maximum expiratory fluids. However, significant differences were observed in the overall computation of symptoms and in the quantification of nocturnal symptoms. We conclude that retarded theophylline presents little usefulness in the treatment of asthma, even though its use can be recommended as symptomatic treatment of nocturnal asthma given its prolonged bronchodilating effect.