An Analysis On The Drug List Used In Hue Central Hospital In 2016 - Nguyen Ky Nhat

Journal of military pharmaco-medicine n o 5-2019 151 AN ANALYSIS ON THE DRUG LIST USED IN HUE CENTRAL HOSPITAL IN 2016 Nguyen Ky Nhat1; Nguyen Thanh Binh1; Pham Tri Dung1 SUMMARY Objectives: To verify the appropriateness of the list of drugs that have been selected and used by the hospital in 2016. Method: Descriptive, retrospective study. Results: There were 27 drug classes with 1,295 drugs in the list, with about 530.78 billion in total cost. In terms of costs, domestic medicine accounted for 15.84% among the drugs; imported drugs accounted for 84.16%; single component drugs accounted for 92.14%; multi-component drugs were 7.86%; generic drugs accounted for 76.32%; brand name drugs accounted for 23.68%; injections drugs accounted for 77.69%. The drugs were mainly used in the Ministry of Health (99.9%). Conclusion: The list of drugs to be used at Hue Central Hospital in 2016 is suitable for treatment in hospitals. * Keywords: Drug list; Hue Central Hospital; 2016. INTRODUCTION In developing countries, the management of drug supply is not effective at all steps in the supply chain and one of the reasons for this is that managers and policy makers do not have much analysis and evaluation to find the shortcomings and inadequateness in the system of drug supply towards management interventions. Drug selection is an important component of hospital drug supply, affecting the quality of medical care, which involves the building and implementation of a drug list [7]. The hospital drug list should include safe, high-efficacy, cost-effective and readily available medications that meet local treatment needs. Hue Central Hospital is a terminal general hospital, a special class with a very diverse disease pattern. Drug costs account for a large portion of the total treatment costs. In recent years, the hospital has made a lot of efforts in selecting drugs for safe, effective and economical use to improve the quality of medical examinations and treatments. For the purpose of making recommendations to improve the choice of drug use in the hospital, we conducted the topic "Analyzing the list of drugs used at Hue Central Hospital in 2016" with the following objectives: Verify the appropriateness of the selected hospital drug list and used in 2016. SUBJECTS AND METHODS Conducted data collection related to the drugs used in the hospital in 2016 based on the hospital drug use reports: - Name of drug, content, dosage form. - Pharmacological action group. - Quantity and value of use. 1. Hue Central Hospital Corresponding author: Nguyen Ky Nhat (nhatnguyenky@gmail.com) Date received: 02/01/2019 Date accepted: 20/05/2019 Journal of military pharmaco-medicine n o 5-2019 152 RESULTS 1. The proportion of single component drug and multi-component drug. Table 1: The proportion of single component and multiple components. Group Number of types Percentage (%) Costs (billion VND) Percentage (%) Single component drug 1,191 91.97 489.06 92.14 Multi-component drug 104 8.03 41.72 7.86 Total 1,295 100.00 530.78 100.00 Single component drugs accounted for a large proportion compared to multi-component drugs in the hospital drug list in 2016, 91.97% in terms of the number of types, and 92.14% in terms of costs. 2. The proportion of the drugs list by its origin and cost. Table 2: The proportion of imported drug - domestic drug. Origin Number of types Percentage (%) Costs (billion VND) Percentage (%) Imported drug 1,036 80.06 446.70 84.16 Domestic drug 259 20.00 84.16 15.84 Total 1,295 100.00 530.78 100.00 Imported drugs accounted for 80.06% by number of types, and 84.16% by costs. 3. The proportion of generic drugs and brand name drugs. Table 3: The proportion of generic drug and brand name drug analysis. Number of types Percentage (%) Costs (billion VND) Percentage (%) Generic drug 1,021 78.9 405.09 76.32 Brand name drug 174 21.1 125.69 23.68 Toal 1,295 100.00 530.78 100.00 Generic drugs accounted for 76.32% in the total drug purchase cost and accounted for 78.9% in total items. Drugs with the original brand name accounted for a small percentage of items (21.1%) and value (23.68%), mainly for diagnosis, cancer, cardiovascular and respiratory. Generic drugs are mainly antibiotics, domestic production intravenous, cardiac. Journal of military pharmaco-medicine n o 5-2019 153 4. The proportion of drug forms. Table 4: The proportion of drug forms. Intravenous drug Oral drug Other drug Value of consumption (billion) Percentage (%) Value of consumption (billion VND) Percentage (%) Value of consumption (billion VND) Percentage (%) 412.36 77.69 105.20 19.82 13.21 2.49 Results of analysis of drug formulations showed that infusion drug accounted for the highest proportion of use in value (77.69%). Oral drugs accounted for 19.82% in consumption value. Other types of drugs accounted for a small proportion (2.49%). 5. The appropriateness with the main drug list of the Ministry of Health. Table 5: In main drug list of Ministry of Health. Group Value of consumption Number of types Costs (billion VND) Percentage (%) Number of types Percentage (%) In main drug list 530.24 99.9 1286 99.31 Out main drug list 0.54 0.1 9 0.69 Drugs in main drug list accounted for 99.9% of total drug costs, and accounted for 99.31% of total drug items. The results showed that the list of drugs used in the hospital was based on main drug list used in medical facilities issued by the Ministry of Health. Drugs not on the primary drug list were mainly cancer medicines, anti-rejection drugs in kidney transplant and anti-thrombotic drugs. DISCUSSION In order to meet the demand for medical examination and treatment and at the same time to well implement the regulations of the Ministry of Health, the Hue Central Hospital annually organizes the bidding for the purchase of medicines and building the list of drugs to be used at hospitals. The 2016 list of drugs ensures that the full group of drugs used in the Ministry of Health's medical facilities are on the list. One of the criteria recommended by the World Health Organization when choosing a drug is to select one that is prepared in a mono-form [5]. The drugs used in the hospital in 2016 were mostly single component drugs, accounting for 91.97% by type and 92.14% by cost. When selecting drugs, the DTC considered the choice of proven drugs for therapeutic efficacy and safety. Hospitals that prefer to use single component drugs will be more favorable in controlling drug interactions. This result is similar to the study done at the Central Endocrinology Hospital, which accounted for 88.7% by type. Journal of military pharmaco-medicine n o 5-2019 154 Domestic medicine will reduce the costs for patients and also promote domestic production. With the hospital domestic drugs using rate in 2016 accountting for 15.84%, it proved that the hospital was interested in using quality domestic medicine. This result was also consistent with Vu Thi Thu Huong’s study, the value of domestic drug use in central hospital ranged from 12.1% to 27.9% [4]. The hospital uses a lot of imported medicines, partly because the patient is treated at the end-line, and many patients in serious conditions need specialized imported drugs. However, the hospital should be more concerned about imported drugs that are mainly used in India and Korea for the origin of these drugs. Generic drug - brand name drug analysis results showed that generic drugs accounted for 78.9% in items and 76.32% in value. Generic drugs, with the advantage of cheaper costs than the patented drug and still the necessary active ingredients, have been used widely in many countries around the world, such as in the United States (50%), Germany (60%), Malaysia (40%), and their use are on the rise in developing countries. Therefore, the use of generic drugs brings great benefits to both business and patients. Using generic drugs is a way to reduce the cost of treatment. Many imported drugs and expensive brand - name drugs are used at central hospitals. This is unavoidable when patients are in severe conditions. However, the hospital also needs to increase the use of domestic drugs and generic drugs because there are many domestically produced drugs that are of good quality and cheap but as effective as brand - name drugs. The proportion of injectable drugs in the hospital was higher than that of oral drugs. The use of injectable drugs was more effective for treatment of more severe patients. Worldwide, there were 4.7 million cases of hepatitis B/C and 160,000 people infected with HIV each year. Therefore, the hospital should reduce some injectable drugs in hospital drug list if other drugs can meet the needs of patients. The results of the analysis also show that 99.31% of the drugs used were within the primarily drug list of the Ministry of Health. This showed that DTC has selected drugs based on primary drug list from the Ministry of Health and primary drug list have met the requirements of hospital treatment and guarantee health insurance benefits for participants. CONCLUSION The 2016 hospital drug list included 27 drug classes with 1,295 drug categories. Total cost of use was 530.78 billion VND. Single component drugs, multi-component drugs accounted for 92.14% and 7.86% of funding. The proportion of domestic medicine accounted for 15.84%. Generic drugs accounted for 76.32% of funding. Drugs are mainly used in main drug list of the Ministry of Health (99.31%). The hospital has selected reasonable use drugs, the drug structure is compatiple with disease patterns and characteristics of the hospital. The drugs used are mainly imported drugs, in the form of single component, trade name, most of which Journal of military pharmaco-medicine n o 5-2019 155 have active ingredients in primary drug list covered by health insurance. The hospital was interested in the use of domestically produced medicines and generic drugs. REFERENCES 1. Hue Central Hospital. Hospital drug list. 2016. 2. Ministry of Health. 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