Impact of drug policy on the use of parenteral cephalosporins in Italy

Springer Science and Business Media LLC - Tập 24 - Trang 169-171 - 2002
Gianfranco Damiani1, Bruno Federico1, Marco Oradei1, Gian Carlo Vanini1, Rino Bellocco2
1Institute of Hygiene, Catholic University Rome, Italy
2Karolinska Institutet, Stockholm, Sweden

Tóm tắt

Objective: To evaluate the effects of the 1998 revision of CUF Note 55 on doctors" prescribing behaviour and drug costs with regard to intramuscularly administered cephalosporins.Method: National data on drug use between January 1998 and June 2000 were provided by the Drug Utilisation Monitoring Centre of the Ministry of Health. The Anatomic Therapeutic Chemical classification and the Defined Daily Dose methodology, as well as population estimates obtained from the Italian National Statistics Institute were used to define consumption as the number of defined daily doses per 1000 inhabitants per day. The cost of these antibiotic medications was determined using the wholesale price reported in Informatore Farmaceutico. Italian inflation rates were used to annuitize the expenditure. “STATA 6.0” software was used for all statistical analyses.Results: The use of cefonicid rose dramatically after the revision (+ 136.3%), whereas the utilisation of the other active ingredients decreased. A decrease of 5.6% in the expenditure for all parenteral cephalosporins was observed in this period while the same figure increased by 2.3% after one year.Conclusion: The exclusion of cefonicid from a restricted list appears to have significantly affected doctors' prescribing practices, while the effect on drug expenditure was contradictory.

Tài liệu tham khảo

Cars O, Molstad S, Melander A. Variation in antibiotic use in the European Union. Lancet 2001;357:1851–3. Osservatorio nazionale sull'impiego dei medicinali. L'uso dei farmaci in Italia-1°Rapporto nazionale-I semestre 2000. Rome: Ministero della Sanità, Dipartimento per la Valutazione dei Medicinali e la Farmacovigilanza, 2001 Dipartimento per la Valutazione dei Medicinali e la Farmacovigilanza. Elenco delle ”Note” aggiornate e revisionate dalla Commissione Unica del Farmaco. Bollettino d'Informazione sui Farmaci 1998;2:20–1. WHO Collaborating Centre for Drug Statistics Methodology. ATC Index with DDDs. Oslo: WHO; 2000. http://www.istat.it (8 August 2001). L'Informatore Farmaceutico. Milano: OEMF, 2000. Gill PS, Freemantle N, Bero L, Haaijer-Ruskamp F, Markela M, Barjesteh KP. GP's prescribing behaviour may be affected by drug promotion. BMJ 1996; 313: 367. World Health Organization. World Health Organization Report on Infectious Diseases 2000. Overcoming antimicrobial resistance http://www.who.int/infectious-disease-report/ 2000/ index.html. (6 August 2001) Seppala H, Klaukka T, Vuopio-Varkil J, Muotiala A, Helenius H, Lager K et al. The effect of changes in the consumption of macrolide antibiotics on erythromycin resistance in group A streptococci in Finland. Finnish Study Group for Antimicrobial Resistance. N Engl J Med 1997;337(7): 441–6. Dipartimento per la Valutazione dei Medicinali e la Farmacovigilanza. Le nuove note CUF. Bollettino D'informazione sui Farmaci 2000;5–6 (Sept-Dec):20–1.