Up to code: validating a chromatography system.
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Chromatography↗
Biomedical subjects
P Sax
Publications and source records attributed to P Sax.
Recent trends in drug utilization in Israel.
There has been a considerable increase in the rate of medicine expenditure and consumption in Israel in the latter half of the 1980s in dollar terms compared to the previous decade both in total and per capita expenditure. At constant medicine prices there has been only a slight increase, reaching an average 9.4% annual growth in per capita consumption in the latter half of the 1980s. From the late 1970s to the late 1980s Israel had one of the highest rates of growth in total expenditure and per capita consumption at constant prices compared to OECD countries (Organization for Economic Cooperation and Development). The driving forces behind the real growth in overall expenditure continue to be the introduction of new drugs and changes in drug therapy. However, mainly as a result of substantial quantitative growth in per capita consumption in the private pharmacy sector, there was a greater growth in this sector than in Kupat Holim Klalit (Medical Insurance Scheme of the General Federation of Labor). An attempt to break down the aggregate into private pharmacy and Kupat Holim Klalit, according to expenditure, prices and consumption, indicate that although the latter has a much lower per capita expenditure, the price adjusted per capita consumption is similar in both sectors. Price adjusted per capita consumption is well below that of France and Italy, and close to that of the USA, the UK, West Germany and Switzerland. These findings are briefly discussed in terms of demographic differences.
Data Collection↗
Cost-effectiveness of misoprostol for prophylaxis against nonsteroidal anti-inflammatory drug-induced gastrointestinal tract bleeding.
Patients who take nonsteroidal anti-inflammatory drugs (NSAIDs) are at increased risk of upper gastrointestinal tract bleeding, which may be prevented with prophylactic prescription of misoprostol. Using data from the literature, we estimated rates of gastrointestinal tract bleeding in NSAID users, direct medical costs, years of life lost, and cost-effectiveness of a 1-year course of misoprostol in three clinical populations of NSAID users: all users, users aged 60 years or older, and users with rheumatoid arthritis. The incremental cost-effectiveness ratios for misoprostol as primary prevention were $667,400 per year of life saved for all NSAID users; $186,700 per year of life saved for users aged 60 years or older; and $95,600 per year of life saved for users with rheumatoid arthritis. Misoprostol as secondary prevention for those who continued to take NSAIDs despite having had an episode of gastrointestinal tract bleeding in the previous year was associated with incremental cost-effectiveness ratios less than $40,000 per year of life saved in all patient groups. We conclude that misoprostol is costly as primary prevention for NSAID-induced gastrointestinal tract bleeding in the groups examined but may be cost-effective as secondary prevention in patients with a proved history of gastrointestinal tract bleeding.
Aged↗
Availability and timing of new drugs in Israel: analysis and international comparison.
Whereas the latest data suggest that the number of new chemical entities (NCE) launches worldwide may be on the increase, both recent and longer term data show a decline in the rate of NCE introductions into Israel. In terms of percentage availability, only 30% of NCEs available worldwide during 1978-1987 were introduced in Israel during the same period, compared with 42% for the U.S.A. In both countries there has been a decreasing percentage availability since 1983/84. The percentage availability of commercially significant NCEs was greater (47%) compared to all NCEs introduced in Israel. Whereas in the U.S.A. the lower the therapeutic rating the higher the proportion of NCEs, in Israel the B- and C-rated drugs were equally represented. NCEs with an A-rating had a similar share of all NCEs (ca 15%) in both countries. The average time lag for NCEs launched worldwide to reach Israel during 1978-1987 was 4 to 5 years, but in recent years there has been a considerable decline. Commercially significant NCEs introduced in Israel had on average a shorter time lag of 0.5 years than the average for all NCEs introduced. In spite of a preponderance of NCEs first launched in the U.S.A. there was on average a slight relative lag into the U.S.A. compared to Israel. This was probably due to there being a number of NCEs first introduced in Israel with a long delay before they were subsequently approved in the U.S.A.(ABSTRACT TRUNCATED AT 250 WORDS)
Drugs, Investigational↗
Expenditure and consumption of medicines in Israel 1975-85: analysis of trends and elements of growth.
Data on the annual expenditure on medicines and medical supplies have been collected and used to provide the expenditure on medicines only, by the main purchasing sectors for each of the fiscal years from 1975/76 to 1984/85 inclusive. During the decade total expenditure at constant prices increased by 145% with an average annual growth of 10.7%; on a per capita basis the growth was 107 and 8.7%, respectively. The average annual growth decreased during the later years. The real average cost of all medicines actually consumed at constant prices was derived from a pharmaceutical audit. The changes in this cost element are an indication of qualitative changes in drug therapy and in the introduction of new drugs. The analysis shows that this structural change is more significant than changes in quantity of drugs consumed per capita and changes derived from the increase in population. Comparing cross-national per capita expenditure in common units of currency, Israel had one of the lowest levels of consumption among the developed countries. Nevertheless, from 1975 to 1982 Israel had one of the highest rates of growth in per capita consumption at constant medicine prices. A discussion of environmental factors leads to the conclusion that the quality of therapeutic advantage gained by a (decreasing) number of innovative products, coupled with an increase in demand from the unprecedented growth in the number of the elderly and chronically ill, has resulted in a significant growth in consumption during the decade.
Costs and Cost Analysis↗