RESUMO
ABSTRACT In Brazil, 80% of hypertensive patients have no blood pressure controlled, this fact has caused severe financial consequences for the public health system (PHS) and the Pharmaceutical Care (PC) has emerged as an effective alternative. The aim of this study was to analyze the costs and outcomes of systemic arterial hypertension (SAH) for conventional assistance compared to assistance with PC in the PHS. This is a pharmacoeconomic study with cost-consequence analysis nested to clinical trial. Hypertensives patients were followed-up from 2006 to 2012. During 2009 they were assisted by the PC program in Ribeirão Preto-SP, Brazil. Clinical indicators, systolic and diastolic blood pressure (SBP and DBP), triglycerides, total cholesterol (TC) and its fractions and healthcare indicators, consumption of antihypertensive medication and consultations were analyzed. Costs were listed as direct medical and direct non-medical. The average cost of conventional care for 104 patients followed-up was US$ 198.97, in the PC period and after discharge was US$ 407.91 and US$ 214.96 patient/year. After discharge of patients from PC there was reduction of SBP, DBP, TC and cardiovascular risk, 9.4 mmHg, 4.6 mmHg, 12.0 mg/dL, and 23% [p<0.005], respectively. The PC program optimized clinical and healthcare indicators and impacted in the SAH costs for the PHS.
Assuntos
Humanos , Feminino , Pessoa de Meia-Idade , Gastos em Saúde , Custos e Análise de Custo/métodos , Hipertensão/patologia , Assistência Farmacêutica/estatística & dados numéricos , Farmacoeconomia/normas , Monitorização Ambulatorial da Pressão Arterial/classificaçãoRESUMO
OBJECTIVES: To suggest a scheme of decision making on pricing for medicines that are part of Free Regulated Regime, a regulation way of the pharmaceutical pricing policy in Colombia. It includes two regulation tools: international reference prices and a cost minimization analysis methodology. METHODS: Following the current pricing policy, international reference prices were built with data from five countries for selected medicines, which are under Free Regulated Regime. The cost minimization analysis methodology includes selection of those medicines under Free Regulated Regime with possible comparable medicines, selection of comparable medicines, and treatment costs evaluation. RESULTS: As a result of the estimate of International Reference Prices, four medicines showed in the domestic pharmaceutical market a bigger price than the Reference Price. A scheme of decision-making was design containing two possible regulation tools for medicines that are part of Free Regulated Regime: estimate of international reference prices and cost minimization analysis methodology. This diagram would be useful to assist the pricing regulation of Free Regulated Regime in Colombia. CONCLUSIONS: As present results shows, international reference prices make clear when domestic prices are higher than those of reference countries. In the current regulation of pharmaceutical prices in Colombia, the international reference price has been applied for four medicines. Would be suitable to extend this methodology to other medicines of high impact on the pharmaceutical expenditure, in particular those covered by public funding. The availability of primary sources about treatment costs in Colombia needs to be improved as a requirement to develop pharmaco-economic evidence. SISMED is an official database that represents an important primary source of medicines prices in Colombia. Nevertheless, having into account that SISMED represents an important advantage of transparency in medicines prices, it needs to be improved in quality and data availability.
Assuntos
Custos de Medicamentos/normas , Farmacoeconomia/normas , Programas Nacionais de Saúde/economia , Colômbia , Controle de Custos , Redução de Custos , Técnicas de Apoio para a Decisão , Custos de Medicamentos/legislação & jurisprudência , Competição Econômica , Farmacoeconomia/legislação & jurisprudência , Regulamentação Governamental , Política de Saúde , Pesquisa sobre Serviços de Saúde , Humanos , Internacionalidade , Modelos Econômicos , Programas Nacionais de Saúde/legislação & jurisprudência , Valores de ReferênciaRESUMO
OBJECTIVES: The first aim of this workshop was to define pharmacoeconomic concepts and terminology. Pharmacoeconomics can be defined as the branch of economics that uses cost-benefit, cost-effectiveness, cost-minimization, cost-of-illness and cost-utility analyses to compare pharmaceutical products and treatment strategies. Economic evaluations provide healthcare decision-makers with valuable information, allowing optimal allocation of limited resources. However, pharmacoeconomics is based on long-term benefits, whereas physicians are typically forced to seek immediate savings. The second aim was to review pharmacoeconomic studies in the field of onychomycosis and finally to discuss future perspectives. RESULTS AND CONCLUSIONS: We discussed current pharmacoeconomic issues on the management of onychomycosis. Consensus was reached on the following issues: * Published pharmacoeconomic studies concerning onychomycosis are flawed. Future studies should be based on internationally validated principles and appropriate models. The fact that costs of different drugs, laboratory examinations and physician visits vary worldwide should be considered. Cost-benefit studies are required. * The National Institute for Clinical Excellence (NICE) recommendations are often considered in countries other than the UK, even when not adapted to the country in question. * Generic drugs might reduce costs, but this depends on their effectiveness (bioavailability). * Sampling requests affect the economic cost (dependent on methodology, which depends on country) and physicians often trust their instincts even when tests are repeatedly negative. * The cost of adverse event management is usually considered to be 10%; this may be too high for onychomycosis, as treatments are relatively safe without severe side-effects. * Probability of recurrence for each drug should be determined. * Need for disease severity standardization, definition of diagnostic criteria and successful treatment (mycological and clinical cure).
Assuntos
Antifúngicos/economia , Custos de Medicamentos , Farmacoeconomia/normas , Onicomicose/tratamento farmacológico , Antifúngicos/uso terapêutico , Redução de Custos , Análise Custo-Benefício , Tomada de Decisões , Feminino , Alemanha , Humanos , Masculino , Onicomicose/diagnóstico , Sensibilidade e EspecificidadeRESUMO
Se realizó una evaluación farmacoeconómica de los diferentes esquemas de tratamientos para las infecciones vaginales, según terapéuticas fundamentadas en metodologías establecidas por los organismos internacionales que permita obtener una utilización racional de los medicamentos, con mayor efectividad y menos costos en la estrategia de tratamiento de la infección genital, aspecto que tiene una alta prioridad para el Sistema Nacional de Salud. Se señala que actualmente no existe el mejor conocimiento médico de los tratamientos farmacológicios y del enfoque sindrómico de las infecciones vaginales, aspecto que conspira con una adecuada prescripción de los medicamentos, y por ende, con la curación de la enfermedad. Para darle solución a esta problemática, se demuestra retrospectivamente la eficiencia farmacoterapéutica de las alternativas de tratamientos seleccionados, lo que permitirá una actualización del formulario nacional de medicamentos para las infecciones vaginales, así como establecer las líneas de investigación de nuevos fármacos para engrosar el arsenal terapéutico del país. Se establece un esquema por orden de prioridad de los tratamientos farmacológicos para las distintas infecciones vaginales, teniendo en cuenta el criterio farmacoeconómico como vía para la elaboración de una política al nivel nacional en el empleo de estos medicamentos, y que esté en concordancia con la situación farmacoepidemiológica, y de los niveles de resistencia de los antibióticos para su prescripción generalizada a nuestra población en el nivel primario de atención de salud(AU)
Assuntos
Farmacoeconomia/normas , Doenças Vaginais/tratamento farmacológico , Antiparasitários/economia , Antibacterianos/economiaRESUMO
Se realizó una evaluación farmacoeconómica de los diferentes esquemas de tratamientos para las infecciones vaginales, según terapéuticas fundamentadas en metodologías establecidas por los organismos internacionales que permita obtener una utilización racional de los medicamentos, con mayor efectividad y menos costos en la estrategia de tratamiento de la infección genital, aspecto que tiene una alta prioridad para el Sistema Nacional de Salud. Se señala que actualmente no existe el mejor conocimiento médico de los tratamientos farmacológicios y del enfoque sindrómico de las infecciones vaginales, aspecto que conspira con una adecuada prescripción de los medicamentos, y por ende, con la curación de la enfermedad. Para darle solución a esta problemática, se demuestra retrospectivamente la eficiencia farmacoterapéutica de las alternativas de tratamientos seleccionados, lo que permitirá una actualización del formulario nacional de medicamentos para las infecciones vaginales, así como establecer las líneas de investigación de nuevos fármacos para engrosar el arsenal terapéutico del país. Se establece un esquema por orden de prioridad de los tratamientos farmacológicos para las distintas infecciones vaginales, teniendo en cuenta el criterio farmacoeconómico como vía para la elaboración de una política al nivel nacional en el empleo de estos medicamentos, y que esté en concordancia con la situación farmacoepidemiológica, y de los niveles de resistencia de los antibióticos para su prescripción generalizada a nuestra población en el nivel primario de atención de salud
Assuntos
Antiparasitários , Antibacterianos/economia , Farmacoeconomia/normas , Doenças VaginaisRESUMO
Objetivo: analisar a adesäo dos médicos ao instrumento "Impresso Especial de Solicitaçäo de Albumina" elaborado pela direçäo do hospital, com informações técnicas orientadoras e näo restritivas e seu impacto na prescriçäo de albumina para administraçäo parenteral no hospital, pelo período de um ano. Materiais e métodos: foram analisados todos os documentos prescritos pelos médicos da instituiçäo, na forma de receita, prescriçäo ou impresso especial, utilizado para solicitaçäo e dispensaçäo de albumina humana à Divisäo de Farmácia no período de primeiro de outubro de 1998 a trinta de setembro de 1999. Para auxiliar a análise dos resultados, os pedidos foram separados em "ADEQUADOS" e "INADEQUADOS"...
Assuntos
Humanos , Adulto , Albuminas , Farmacoeconomia/normas , Prescrições de Medicamentos/normas , Protocolos Clínicos/normas , Serviço de Farmácia Hospitalar , Condutas Terapêuticas Homeopáticas , Controle de Formulários e Registros/métodos , Controle de Formulários e Registros , Coleta de Dados , Bases de Dados como AssuntoRESUMO
Visando o desenvolvimento de metodologia para organizaçäo e disponibilizaçäo de informações técnicas atualizadas sobre medicamentos padronizados no Hospital, desenvolveu-se banco de dados computadorizado com informações sobre a nomenclatura do medicamento, suas diferentes especialidades farmacêuticas, restrições de prescriçäo, orientaçäo de receituário e classes terapêuticas. Esse foi adotado pela institutiçäo e resultou na ediçäo do novo Guia Farmacoterapêutico do HC-FMUSP. Desenvolveu-se estudo de utilizaçäo de medicamentos em Enfermaria de Clínica Geral para identificaçäo do perfil de prescriçäo e de gasto em medicamentos, visando apontar possíveis intervenções para racionalizaçäo...