34 research outputs found
A pilot study to determine the cost of pharmaceutical drug treatment for chronic conditions prescribed in relation to patients' age
Objective: To determine the age distribution of
patients and the total drug cost. To establish the average
cost per age group and identify factors that may influence
cost.
Method: A pilot study was conducted by selecting
by convenience sampling a number of patients over 18
years who were registered in the Pharmacy of Your Choice
scheme with a community pharmacy where the study was
carried out. For each patient, type, frequency and cost
of medication supplied were identified from treatment
cards and from Government Health Procurement Services
(GHPS).
Key findings: Data was collected for 491 patients
(aged between18-98 years) were 272 (55%) were females
and 10% (n = 47) were institutionalised. Eight percent
(n=395) were prescribed drugs for cardiovascular diseases
which constituted 50% of the total drug expenditure. Daily
cost per patient was one euro. Pearson correlation value
(p<0.05) revealed a significant relationship between the
increase in cost, unit doses and number of diseases with
increasing age, between gender and different settings.
Gender variation between drug categories was not
significant (p>0.05).
Conclusions: Cost of drug treatment is vital
information that financing providers and policy makers
require for the allocation of budgets. Findings suggest
that populations are ageing, cost increases with age and
that gender and setting influence the treatment being
provided.peer-reviewe
Reference pricing for pharmaceuticals : a policy perspective
Objective: To analyse the introduction of reference
pricing systems for pharmaceuticals in Malta, their
effectiveness and adequacy to-date, and to propose
possible improvements.
Method: A study on 18 interviewees associated
with pharmaceutical and economical pricing policies
was performed. A literature review analysis of the local
published media regarding the subject was also undertaken
to confirm personal interpretations given and to bridge
information gaps.
Key Findings: There are two separate reference
pricing systems in place; one for the private and another for
the public health sector, operating via different economic
mechanisms. Reasons for resorting to such systems centred
around the lack of access and affordability of medicines.
This situation had emanated from an inefficient business
environment, lack of proper government regulation
and management and an imbalance of power between
medicines’ suppliers, consumers and patients. A total of
18 respondents participated in the study. Two out of the 18
respondents considered the system successful, 6 deemed it
unsuccessful and 7 thought the system had limited success.
Results show that reference pricing may be regarded as a
fair and simple means of monitoring and comparing local
medicine prices with those of other countries. Reference
pricing systems do not cater for many of the problems
associated with such pricing.
Conclusions: Reference pricing cannot be taken
out of context in an integrated pharmaceutical system.
The situation must be tackled holistically to address the
real issues hindering the establishment of fair prices of
medicines for Maltese consumers. Policy systems should be
constructed in accordance with Malta’s particular political,
economic and cultural requirements in line with local and
European Union (EU) legislation.peer-reviewe
Applying quality systems to computerised stock management systems
OBJECTIVES: To investigate the impact of applying
quality systems to an established computerised stock
management system of a local pharmaceutical wholesale
dealer.
METHOD: An established computerised stock
management system was analysed to determine the
compliance of recorded data with actual stock. A risk
assessment of all the steps for each parameter was carried
out and a risk management plan was established as
necessary following risk evaluation. After a one-year period,
the same parameters were re-evaluated using the same
methodology and compared with baseline.
KEY FINDINGS: All parameters showed an improvement
from baseline at the end of the study.
CONCLUSION: The application of quality systems
to computerised stock management systems should be
a mandatory requirement to ensure data reliability in line
with Good Distribution Practice (GDP)1 ensuring batch
traceability and reconciliation throughout the storage,
distribution and recall procedures and other GDP-related
activities.peer-reviewe
Cost analysis of standard operating procedures in community pharmacies
Objective: The objectives were to compile Standard
Operating Procedures (SOPs) for processes undertaken in
community pharmacies and to assess and compare the
financial implications of implementing these SOPs.
Method: Two community pharmacies of different sizes
were identified using purposive sampling. Eighty hours of
non-participant and participant observation were conducted
in both pharmacies and 5 SOPs were compiled. The 5 SOPs
compiled were: Temperature Monitoring and Control, Inward
Order: Specified Drugs for Dangerous Drugs (DDA), Inward
Order: Cold Chain Product, Housekeeping and Pest Control.
The SOPs were psychometrically evaluated for content validity
by a focus group. Readability of the SOPs was tested by means
of the Gunning Fog Index. The capital, recurrent and total
expenditure involved for implementing each SOP in the two
pharmacies were calculated and compared.
Key findings: The average Gunning Fog Index
was 14.73 years. This index gives an indication of number
of years of education that a person needs to be able
to understand the text easily on the first reading. Total
expenditure for implementing the SOPs was expected to
be higher in the larger pharmacy (pharmacy B) than in the
smaller pharmacy (pharmacy A). This was confirmed for 3 of
the 5 SOPs compiled.
Conclusion: The cost for implementing the majority of
the SOPs for both pharmacies was negligible and most probably
their implementation would have a minimal financial impact on
the profit of pharmacy.peer-reviewe
Cost evaluation of collagenase clostridium histolyticum versus surgery for dupuytren's contracture
Objective: To evaluate whether collagenase injections
would be a cost-effective alternative to surgery for
Dupuytren’s contracture in Malta.
Method: An average of fifty patients per year requires
surgery to correct Dupuytren’s contracture in Malta. The
price of collagenase injections was obtained from published
pharmacoeconomic studies in Spain, United Kingdom and
United States. The cost to treat multiple affected joints
using collagenase injections at the different prices was
compared to the costs associated with surgery in both
the government and private hospital setting. A proposed
price at which collagenase injections would be more costeffective
than surgery to treat two affected joints in Malta
was calculated.
Key findings: The cost of surgery in the private
hospital setting is significantly higher than that in the
government hospital setting. The price of collagenase in the
United States is significantly higher than in Europe. At the
prices available in Europe, collagenase use in Malta would
not confer significantly increased costs when treating one,
two or three affected joints, both in the government and
private hospital setting. Treating two affected joints rather
than one affected joint does not significantly increase
costs, however treating three affected joints significantly
increases costs, in both hospital settings. For collagenase
injections to be cost-effective in Malta, they would need to
be priced at 77 Euro per vial or less.
Conclusion: If all patients were to be administered
the injection instead of undergoing surgery, the hospital
would be able to accommodate 20 additional total knee
replacements each year. With surgery costs in Malta being
much less than in other European countries, there could
be a possibility for Malta to attract patients from other
countries. Collagenase injections would offer a less invasive
treatment for the patients, and if priced at 77 Euro per vial
or less, would provide a more cost-effective option to the
government hospital.peer-reviewe
The financial impact of the Pharmacy of Your Choice scheme on community pharmacies
Objective: To give an insight into the financial
impact of the Pharmacy Of Your Choice (POYC ) scheme on
community pharmacies.
Method: A time and motion study was carried out in
three community pharmacies that are enrolled in the POYC
scheme to provide information on the time allocated to the
various activities pertaining to the scheme. Two different
methods were used to calculate the costs incurred to
implement the system in the three pharmacies.
Key findings: The direct costs that are related to
the implementation of the POYC scheme are reasonably
close to the government’s remuneration.
Conclusion: Expenses incurred due to the POYC
scheme run into thousands of Euro every year. Consequently,
the POYC scheme does not seem to be very profitable for the
community pharmacies where it has been implemented.
It is highly recommended that the remuneration by the
government ought to be revised.peer-reviewe
Generic medicine prices and their distribution in Malta
Objectives: To analyse the composition of the
private pharmaceutical retail market in Malta on the basis
of the originator or generic status of available medicines
and to observe the change in prices of generics and
originators over time.
Method: The prices of a sample (n=435) of medicines
in Malta were analysed for an eight year period (2002 to
2009). The variation in price in the generic and originator
segments was calculated. Thirty-one active ingredients
with generics available were identified and the Average
Retail Price Per Unit (ARPPU) and the Lowest Retail Price
Per Unit (LRPPU) were calculated. The average discount
from the originator price was calculated, per compound
and also by drug class.
Key Findings: The sample population contained
17.2% generic products. The mean drop in the ARPPU was
of 10.87% and for the LRPPU of 21.42% for the LRPU. The
average discount was 14.59% in 2002 and 37.19% in 2009.
Conclusion: The number of generic medicines
in Malta has increased in the last eight years, with a
consequent decrease in the lowest prices available for the
set of medicinal compounds.peer-reviewe
Generic medicine prices and their distribution in Malta
Objectives: To analyse the composition of the
private pharmaceutical retail market in Malta on the basis
of the originator or generic status of available medicines
and to observe the change in prices of generics and
originators over time.
Method: The prices of a sample (n=435) of medicines
in Malta were analysed for an eight year period (2002 to
2009). The variation in price in the generic and originator
segments was calculated. Thirty-one active ingredients
with generics available were identified and the Average
Retail Price Per Unit (ARPPU) and the Lowest Retail Price
Per Unit (LRPPU) were calculated. The average discount
from the originator price was calculated, per compound
and also by drug class.
Key Findings: The sample population contained
17.2% generic products. The mean drop in the ARPPU was
of 10.87% and for the LRPPU of 21.42% for the LRPU. The
average discount was 14.59% in 2002 and 37.19% in 2009.
Conclusion: The number of generic medicines
in Malta has increased in the last eight years, with a
consequent decrease in the lowest prices available for the
set of medicinal compounds.peer-reviewe
Public perception of generic pharmaceuticals in Malta
Objective: To evaluate the perception of the Maltese
general public on generic medicinal products.
Method: A self-administered questionnaire was
compiled and distributed to a sample of the general public.
Data collected from the questionnaires was analysed using
SPSS ® version 19.
Key findings: Five hundred and forty four
questionnaires were completed. Fifty one percent of the
respondents did not know the meaning of the term ‘generic
medicinal product’ and 47% of the respondents became
familiar with the term through the questionnaire.
Conclusion: Improved communication amongst
patients and healthcare professionals on the correct
meaning of generic medicinal products and their medical
and financial implications is required.peer-reviewe
Reference pricing for pharmaceuticals : a policy perspective
Objective: To analyse the introduction of reference
pricing systems for pharmaceuticals in Malta, their
effectiveness and adequacy to-date, and to propose
possible improvements.
Method: A study on 18 interviewees associated
with pharmaceutical and economical pricing policies
was performed. A literature review analysis of the local
published media regarding the subject was also undertaken
to confirm personal interpretations given and to bridge
information gaps.
Key Findings: There are two separate reference
pricing systems in place; one for the private and another for
the public health sector, operating via different economic
mechanisms. Reasons for resorting to such systems centred
around the lack of access and affordability of medicines.
This situation had emanated from an inefficient business
environment, lack of proper government regulation
and management and an imbalance of power between
medicines’ suppliers, consumers and patients. A total of
18 respondents participated in the study. Two out of the 18
respondents considered the system successful, 6 deemed it
unsuccessful and 7 thought the system had limited success.
Results show that reference pricing may be regarded as a
fair and simple means of monitoring and comparing local
medicine prices with those of other countries. Reference
pricing systems do not cater for many of the problems
associated with such pricing.
Conclusions: Reference pricing cannot be taken
out of context in an integrated pharmaceutical system.
The situation must be tackled holistically to address the
real issues hindering the establishment of fair prices of
medicines for Maltese consumers. Policy systems should be
constructed in accordance with Malta’s particular political,
economic and cultural requirements in line with local and
European Union (EU) legislation.peer-reviewe