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At least 19 recordsLinked to original sources
PubMedDate not supplied

[Analysis of antibiotic use in the Community of Valencia (2000-2002)].

OBJECTIVE: To quantify antibiotic prescriptions in the Autonomous Community of Valencia in the years 2000-2002 and analyze the differences in antibiotic use among 20 Valencian Community health areas. METHODS: Retrospective observational population study (3,983,464 inhabitants) of prescriptions recorded in Valencian Community pharmacies during the period 2000-2002. We calculated defined daily doses per 1000 inhabitants and day (DHD), for the population without pharmaceutical fees (e.g. pensioners), the population with pharmaceutical fees (e.g. actively working) and the total population. The antibiotics analyzed belonged the J01 group (ATC/DDD classification). RESULTS: Antibiotic consumption was 26.47 DHD in 2000, 23.56 DHD in 2001 and 23.48 DHD in 2002. The most frequently prescribed drug groups included: broad-spectrum penicillins (J01C) 11.8 DHD, macrolides (J01F) 5.6 DHD, and other beta-lactams (J01D) 3.95 DHD. There was considerable variation between the population without pharmaceutical fees and the population with pharmaceutical fees: JO1C (DHD 18.49 vs. 9.73), JO1F (11.06 vs. 3.84) and quinolones (J01M) (9.16 vs. 1.22) (p < 0.05). There was also substantial variation between areas, both overall and by groups (p < 0.05): J01C 6.36 DHD to 12.14 DHD; (J01F), 3.78 DHD to 6.08 DHD; (J01D), 2.28 DHD to 4.65 DHD, and (J01M) 2.39 DHD to 3.6 DHD. CONCLUSIONS: There was a slight trend to decreasing antibiotic use in the Community of Valencia over the period of 2000-2002. The population without pharmaceutical fees showed much higher antibiotic use than those with pharmaceutical fees, and there was considerable variation in prescriptions between the different public health care areas.

Anti-Bacterial Agents↗
PubMed2004

[Investigation of cost and medical service fee for pharmaceutical management in home medical care].

Due to the evolvement of the aged society and the steep rise in medical costs, the environment encircling the medical care industry has been changing remarkably. For this reason, it has become both necessary and fundamental for a community pharmacist to participate in home medical care through the pharmaceutical management service. We have studied the associated costs and medical service fees for pharmaceutical management in home medical care. The costs and medical service fees were calculated based on the pharmaceutical management service data collected during the three years from November 1998 to October 2001. As a result, the medical service fees were calculated using the old system which lasted until March 2002. Calculations using this system took into account 550 points per visit, up to two visits per month. Under the new system which started in April 2002, the number of visits taken into account is four times a month, 500 points for the first visit, 300 points from the second through to the forth visit. Then, we simulated a break-even point (BEP). It is clear that it is difficult for any community pharmacy to be specialized in home medical care. In order for the pharmacist to actively participate in home medical care in the future, it is necessary to further improve the system.

Aged↗
PubMed2004

The high cost of medicines in Ireland. Is it time to change the pricing mechanism?

This study compared the prices of prescription medicines in Ireland to those in other countries to determine potential cost savings on the largest community drug scheme if an alternative pricing mechanism were adopted. The analysis covered a sample of 39 drugs (44.8% of the total ingredient cost) selected from the top 70 drugs in order of total ingredient cost. Potential cost savings ranged from Euro 20.73 million if a Danish price were adopted, to Euro 16.23 million for the average European price, to Euro 6.82 million for the UK price. The estimated savings were statistically significant for the Danish and average European price but not for the UK price. This study demonstrates the high ex-wholesale price of prescription medications in Ireland.

Cost Control↗
PubMed2006

[Limitations of pharmacoeconomics from a clinical-pharmacological point of view].

Pricing decisions for pharmaceuticals usually follow a two-step process. A final economic evaluation needs to be based on a prior clinical-pharmacological evaluation of a new drug in light of therapeutic alternatives. However, major limitations for this evaluation process may be encountered. Most notably a lack of (1) evidence-based data, (2) clinical endpoint data, (3) direct comparator studies or (4) an impaired "assay sensitivity" may cause uncertainty about the appropriate value of a new drug. Moreover situations with (5) incremental, small benefit, (6) lack of precedents in case of innovations or (7) obvious "efficacy-effectiveness gaps" may pose challenges in the pricing decision process for pharmaceuticals.

Austria↗
PubMed2005

[Pharmaceutical reference pricing in Germany: definition of therapeutic groups, price setting through regression procedure and effects].

The German reference pricing system defines a reimbursement threshold for groups of pharmaceuticals. Pharmaceuticals are grouped according to certain criteria by the Federal Joint Committee. To make different active ingredients comparable, so called reference values are defined. Subsequently, the federal association of sickness funds sets reference prices using a regression procedure. However, the impact of the reference price system is limited. On the one hand there is a strong incentive for pharmaceutical companies to decrease prices to the reference price. On the other hand there is no incentive for further price reductions. Additionally, only one part of the pharmaceutical market is affected by reference pricing. Therefore the instrument has only managed to lower pharmaceutical expenditure in the short run. For sustainable long-term cost containment the use of other regulatory instruments is necessary. Nevertheless, compared to other instruments of price-regulation, reference pricing seems to be a good alternative to control pharmaceutical prices, since rationing is kept as little as possible.

Cost Control↗
PubMedDate not supplied

Perspectives on the pharmaceutical industry.

This paper seeks to provide an economic perspective on the pharmaceutical industry, which has come under increasing criticism on a number of issues. In the main, that criticism amounts to a rather ineffective flailing at the supply side of the market for pharmaceutical products-much of it based on inaccurate perceptions-when a more productive policy would be to strengthen the hitherto weak and poorly informed demand side of the market.

Accounting↗
PubMedDate not supplied

The price of progress: prescription drugs in the health care market.

Pharmacy costs are rising in excess of general and medical cost inflation, leading to calls for price and utilization controls by public and private payers. Such controls would be ineffective and counterproductive because they would attempt to reverse two profound, historic phenomena at work in the U. S. health care system. The added costs associated with breakthrough medicines represent a major structural shift from the provision of traditional medical services to the consumption of medical products; they also represent the creation of economic, social, and public health utility that we value as a society. The balkanization of medical delivery, institutionalized under traditional reimbursement strategies and galvanized by federal law, does not adequately account for or efficiently accommodate this rotation and increased utility. Federal and state laws regulating health insurance and provider risk sharing need to be revamped to encourage rather than constrain the social progress embodied in expensive, breakthrough medical technologies.

Economics, Pharmaceutical↗
PubMedDate not supplied

[Health outcomes analysis and its applications].

The goal is to describe the applications of outcomes studies to improve health care. Health care has structure, process and outcomes (clinical, economic and humanistic). Pharmacoeconomic studies identifies, measures and compares the costs and consequences of pharmaceutical products and services. The main source of information in health-related quality of life is the patient's perspective. The patients' opinion are used to assess drug treatments and healthcare programs. Although there are still controversies about their standardisation, pharmacoeconomics studies are important tools for decision-making process. We should use the terminology property and know the methodologies in pharmacoeconomic studies for applying and interpreting these studies. Health outcomes' assessing permits to us improve quality and efficiency of our services that we offer to the society.

Cost-Benefit Analysis↗
PubMed2002

[The budget control function of the Drug Reimbursement System].

We now have 10 years of experience with the Dutch Price Reference System (Dutch acronym GVS), which was instituted in order to reduce the growth of extramural pharmaceutical costs to 4.1% annually, assuming no loss of medical quality. The system focussed mainly on budget control rather than on increasing cost-effectiveness by substitution. The budget-control aims were not achieved. As epidemiological and demographic developments would account for about 3% annual budget growth given an unchanged individual consumption of pharmaceuticals, the 4.1% criterion left only 1% room for autonomous growth (price, volume). The current 8% average annual growth rate indicates 5% autonomous growth. This rate is low, however, compared to other European countries, where a number of autonomous growth factors are not systematically counterbalanced at the product level by substitution incentives and control over prices and indication by health-care authorities and health-insurance companies. The GVS and related administrative measures have therefore most likely exerted a significant budget-controlling influence. The current policy of the Dutch Ministry of Health, Welfare and Sports in terms of goals, actors' roles and incentives fits well with the GVS, which should therefore be continued.

Cost Control↗