Cost-effectiveness of insulin analogs from the perspective of the Brazilian public health system

Human insulin is provided by the Brazilian Public Health System (BPHS) for the treatment of diabetes, however, legal proceedings to acquire insulin analogs have burdened the BPHS health system. The aim of this study was to perform a cost-effectiveness analysis to compare insulin analogs and human insulins. This is a pharmacoeconomic study of cost-effectiveness. The direct medical cost related to insulin extracted from the Ministry of Health drug price list was considered. The clinical results, i.e. reduction in glycated hemoglobin (HbA1c), were extracted by meta-analysis. Different scenarios were structured to measure the uncertainties regarding the costs and reduction in HbA1c. Decision tree was developed for sensitivity of Incremental Cost Effectiveness Ratio (ICER). A total of fifteen scenarios were structured. Given the best-case scenario for the insulin analogs, the insulins aspart, lispro, glargine and detemir showed an ICER of R$1,768.59; R$ 3,308.54; R$11,718.75 and R$ 2,685.22, respectively. In all scenarios in which the minimum effectiveness was proposed, lispro, glargine and detemir were dominant strategies. Sensitivity analysis showed that the aspart had R$3,066.98 [95$ 6,163.97 [95% CI: 3919.29; 11401.57] for incremental costs. We concluded there was evidence that the insulin aspart is the most cost-effective

Health education can save the environment from medicine residues

The incorrect disposal of medicines and their environmental impact has been related to the health medicalization and the improper use of medication by society. In this sense, it is very important to know the profile of drug disposal for foster health policies. The aim was to identify the profile of disposal of medicines by the population, including the cost perspective. This is an inquiry descriptive study that began in September 2019. Medicine disposal health education program was carried out over six months in two University pharmacies. A questionnaire for sociodemographic and discarded medicines data collection was applied. Logistic regression analysis for variables association of correct disposal and the chi-square and t-student analysis for comparison between disposal programs were performed for a level of 5% and test power of 80%. Medicines weighed 23.3 kg and 28.5 kg, with the cost variation from US$13.5 to US$ 16.1 until the final treatment. The correct disposal was strongly associated with the disposal reason (p=0.013), source of information (p=0.006), prescription (p=0.03), form of use (p=0.01), acquisition source (p=0.001), cost with medication (p=0.0001), education (p=0.028) and age (p=0.05). The correct medicine disposal was associated with important features of the community related to education health

Clinical characteristics and risk for severe COVID-19: a systematic review: Características clínicas e risco para COVID-19 grave: uma revisão sistemática

COVID-19 has evolved into a serious clinical condition, especially in patients with comorbidities. However, the literature has diverged in relation to the main characteristics of patients prone to severe evolution. Objective: This study aimed to understand different variables that may be associated with the clinical management of COVID-19 for a better clinical response and prognosis. Methods: This is a systematic review in which the search in PubMed, Cochrane, EMBASE and LILACS databases. A manual and gray literature search on Google Scholar was also conducted. There was no country or region restriction and only studies in Portuguese, English and Spanish were included. Results: Of the 21 studies included in Primary Health Care (PHC) for eligibility, five studies from five countries involving 27,754 patients were analysed and, of the four eligible studies, one study was included for secondary care. Overall, the mean age of the COVID-19 population in PHC was around 41 years old, the number of cases was higher for females and, there was no difference between the groups without and with exposure, sex (ρ=0.322) and age (ρ=0.395). More than half of the patients had symptoms and, 47% had comorbidities. Heart diseases were the most prevalent among them. Approximately 79% of those infected had non-essential occupation. There was evidence that non-essential occupation was associated with infected individuals (ρ=0.002). Conclusions: This review identified that there may be greater vulnerability to contamination and aggravation of COVID-19 in female individuals, with adult age in non-essential activity, presence of chronic non-communicable diseases

Health education can save the environment from medicine residues

Abstract The incorrect disposal of medicines and their environmental impact has been related to the health medicalization and the improper use of medication by society. In this sense, it is very important to know the profile of drug disposal for foster health policies. The aim was to identify the profile of disposal of medicines by the population, including the cost perspective. This is an inquiry descriptive study that began in September 2019. Medicine disposal health education program was carried out over six months in two University pharmacies. A questionnaire for sociodemographic and discarded medicines data collection was applied. Logistic regression analysis for variables association of correct disposal and the chi-square and t-student analysis for comparison between disposal programs were performed for a level of 5% and test power of 80%. Medicines weighed 23.3 kg and 28.5 kg, with the cost variation from US$13.5 to US$ 16.1 until the final treatment. The correct disposal was strongly associated with the disposal reason (p=0.013), source of information (p=0.006), prescription (p=0.03), form of use (p=0.01), acquisition source (p=0.001), cost with medication (p=0.0001), education (p=0.028) and age (p=0.05). The correct medicine disposal was associated with important features of the community related to education health

Estudo das prescrições de antibacterianos para pacientes idosos (HU/UFJF)

Os idosos constituem a parcela da população que mais cresce em todo o mundo. No Brasil, o envelhecimento populacional tem ocorrido de forma rápida e acentuada. Os pacientes acima de 60 anos chegam a somar 50% dos multiusuários do SUS. Com o objetivo de descrever e analisar os antibacterianos prescritos a pacientes idosos no âmbito hospitalar, foi realizado um estudo descritivo retrospectivo e tranversal. Em um universo de 1.148 prescrições, 360 (31,36%) eram destinadas a pacientes idosos e 129 (11,24%) continham ao menos um antibacteriano prescrito a esses pacientes, o que totalizou 188 antibacterianos prescritos a idosos (5,70% do total de medicamentos). O antibacteriano representa uma parcela importante dentre os medicamentos prescritos a idosos

A New Approach to Atopic Dermatitis Control with Low-Concentration Propolis-Loaded Cold Cream

Atopic dermatitis (AD) is a chronic inflammatory skin disease that is difficult to treat. Traditional cold cream, a water-in-oil emulsion made from beeswax, is used to alleviate AD symptoms in clinical practice, although its effectiveness has not been scientifically proven. The addition of propolis has the potential to impart anti-inflammatory properties to cold cream. However, in high concentrations, propolis can trigger allergic reactions. Thus, the objective of this work was to develop a cold cream formulation based on purified beeswax containing the same amount of green propolis present in raw beeswax. The impact of adding this low propolis concentration to cold cream on AD control was evaluated in patients compared to cold cream without added propolis (CBlank). Raw beeswax was chemically characterized to define the propolis concentration added to the propolis-loaded cold cream (CPropolis). The creams were characterized as to their physicochemical, mechanical, and rheological characteristics. The effect of CPropolis and CBlank on the quality of life, disease severity, and skin hydration of patients with AD was evaluated in a triple-blind randomized preclinical study. Concentrations of 34 to 120 ng/mL of green propolis extract reduced TNF-α levels in LPS-stimulated macrophage culture. The addition of propolis to cold cream did not change the cream’s rheological, mechanical, or bioadhesive properties. The preclinical study suggested that both creams improved the patient’s quality of life. Furthermore, the use of CPropolis decreased the disease severity compared to CBlank

Sistema de dispensação do Hospital Universitário/UFJF: identificação e prevenção de erros

-O conhecimento sobre o sistema de medicação hospitalar constitui uma ferramenta importante aos profissionais da saúde para garantir umaassistência responsável e segura ao paciente. Por isto, o presente estudo teve como objetivo analisar o sistema de medicação do HospitalUniversitário da Universidade Federal de Juiz de Fora (HU/UFJF). Foi aplicada entrevista estruturada aos farmacêuticos e auxiliares de farmáciadurante os meses de maio e junho de 2007. As características do sistema descritas pelos entrevistados foram: predominância da prescrição manual;ausência de um centro de informações sobre medicamentos; uso de códigos de barras na documentação e dispensação dos medicamentos; doseindividualizada por horário; ausência de um comitê formal de investigação de erros de medicação. Os resultados obtidos reforçam a importância doconhecimento sobre sistema de medicação para desenvolvimento de ações com segurança, consciência, responsabilidade e eficiência. A etapaseguinte da pesquisa deverá analisar fatores relacionados a prescrição e dispensação no Serviço de Farmácia do HU/UFJF