Butt, H.

Khan, H.M.S.

Shah, N.H.

Elsevier - Publisher Connector 

PHP124 Exposure To Potential Drug-Drug Interactions in Teaching Hospital Of South Punjab, Pakistan 

 VA L U E  I N  H E A LT H  1 7  ( 2 0 1 4 )  A 3 2 3 – A 6 8 6  A425
productivity, and generational accounting, which accounts for a range of other gov-
ernment fiscal transfers to citizens. The possible produced value for a life-time term 
was assumed as calculating the total NPV depending on the life expectancy. CPD 
was assumed as the difference between NPV on the year of life expectancy and each 
decades as life years 50, 40, 30, 20, 10 and new born. The economic values for the 
model were derived from World Bank, OECD, UNESCO or WHO. Results: Possible 
produced value for a life-time term for Turkey was calculated as US$ 483.298. Cost 
of pre-mature death per person was calculated as US$ - 102.064, US$ - 271.716, US$ 
-441.679, US$ -583.726, US$ - 518.753,14 and US$ - 483.986 for the life years new born, 
10, 20, 30, 40 and 50 respectively. ConClusions: However the study was based 
on a hypothetical model that calculated the NPV with the taxes and spending in a 
life-time term, cost of premature death was calculated as the highest in early ages 
and was decreasing up to the retirement age. The results may be reference for the 
decision makers. Health policy makers may improve the access to the treatments 
in the early life years for the possible increased cost of premature deaths in Turkey.
PHP124
ExPosurE To PoTEnTial Drug-Drug inTEracTions in TEacHing HosPiTal 
of souTH Punjab, PakisTan
Khan H.M.S.1, Butt H.1, Shah N.H.2
1Islamia University Bahawalpur, The Islamia University of Bahawalpur, Pakistan, 2Bahauddin 
Zakarya University, Multan, Pakistan
objeCtives: Drug-drug interaction is a common error in poly-medication and con-
tributes a major part in adverse drug reactions. The aim of the present study was to 
evaluate the percentage of potential drug-drug interactions in the prescription in the 
region of South Punjab Pakistan prescribed by the medical practitioner Methods: A 
total of 100 prescriptions were included in this study. Institution based retrospective 
study was performed in Nishter Hospital Multan, Pakistan, the 3rd oldest medical 
institution of Pakistan, which has a capacity of 1800 beds and having a best facil-
ity to hold a large number of emergencies at a time. Prescriptions were collected 
to see the Drug - Drug interactions and compared with the standard reference of 
important DDI’s. The potential drug-drug interactions were categorized according 
to their severity, effect and mechanism. Results: The study showed that among 
100 prescriptions (543 medicines), 41% of prescriptions have potential DDI’s. Mostly 
prescribed drugs were the antibiotics (38%), and the drugs belonging to class analge-
sic were found to contribute mostly in drug-drug interactions (26.50%). The survey 
showed the total of 71 interactions and their severity level accounting as major 
(20.10%), moderate (63.4%) and minor (15.90). The mechanism by which the drugs 
interact with one another showed that there were pharmacokinetic (60.5%), pharma-
codynamic (38.6%) and few of them interact by the mechanism which was not speci-
fied in the available literature (0.9%). ConClusions: Drug-drug interactions occur 
in poly-medication and need to be evaluated and monitored for the positive impact 
on the medication use system and improvement of quality of patient care. A clini-
cal pharmacist with its accurate knowledge of drug, their effect on human organs 
and their interaction with other can monitor and manage these drug interactions.
PHP125
ValuE of lifE anD cosT of PrE-MaTurE DEaTHs WiTH THE PErsPEcTiVE of 
ProDucTiViTy as nET Tax rEVEnuE: a coMParison in argEnTina, brazil 
anD MExico
Atikeler K.1, Tuna E.1, Yenilmez F.B.1, Tatar M.1, Kockaya G.2
1Hacettepe University, Ankara, Turkey, 2Health Economics and Policy Association, Ankra, Turkey
objeCtives: The Human Capital Theory emphasizes investments to the health care 
sector as an important element in achieving and sustaining economic development. 
Investments to health care sector improves macro and micro economic outcomes 
for the whole society. The aim of this study is to calculate the possible produced 
value for a life-time term (VLT) and cost of pre-mature deaths (CPD) from the pro-
ductivity for Argentina, Brazil and Mexico. Methods: Net present value (NPV) of 
the taxes and spending for each year were calculated. For calculating NPV in the 
government perspectives, two modelling approaches were combined, human capital 
modelling based on lives saved and lost productivity, and generational accounting, 
which accounts for a range of other government fiscal transfers to citizens. The 
possible produced value for a life-time term for each country were assumed as cal-
culating the total NPV for each country depending on the countries life expectancy. 
CPD for each countries were assumed as the difference between NPV on the year 
of life expectancy and each decades as life years 60, 50, 40, 30, 20, 10. The economic 
values for the model of each country derived from World Bank, OECD, UNESCO or 
WHO. Discount rate and inflation for wages were taken as 3% per year for all coun-
tries. Results: Possible produced VLT for each country were calculated as US $ 
716.945, US$ 663.129 and US$ 653.598 for Argentina, Brazil and Mexico, respectively. 
CPD per person for Argentina were calculated as US$ -666.234, US$ -657.861, US$ 
-512.554, US$ -338.675, US$ - 164.722 and US$ -24.615 for the life years 10, 20, 30, 40, 
50 and 60 respectively. The trend was same for Brazil and Mexico. ConClusions: 
However the study was based on a hypothetical model that calculated the NPV with 
the taxes and spending in a life-time term, the results of each country were parallel.
PHP126
coMMuniTy PHarMacisT PErcEPTions of gEnEric MEDicinEs: a surVEy 
in TEHran
Mehralian G.1, Noee F.2, Yousefi N.1, Peiravian F.1
1Shahid Beheshti University of Medical Sciences, School of Pharmacy, Tehran, Iran, 2Azad 
University, Tehran, Iran
Pharmaceutical expenditure as has been increasingly grown during the last decades 
so that policy makers have paid more and more attention to develop strategies 
to deal with this challenging issue. Pharmacists play an important role in health 
continuum to implement such strategies through dispensing and delivering generic 
medicines to consumers. So, the main objective of this study was to explore the per-
ception of Iranian pharmacists regarding generic substitution, and also to explore 
how Iranian pharmacists think about patients’ role, physicians’ role and government 
role in generic substitution. A cross sectional descriptive study involving the entire 
population of Tehran community pharmacies (n = 2000) was performed using a 
self-administrated anonymous questionnaire. A total of 1205 questionnaires were 
returned indicating a response rate of 60%. Regarding to the first section, 62% of 
participants agreed that pharmacists should be given right to generic substitu-
tion, and 45% viewed that the generic medicine are bioequivalent with brand ones. 
Majority of the respondents (73.6%) stated that, they do substitution once generic 
medicine is available. However, they think that patients, physicians and government 
have important role in generic substitution. More than half (75.5%) of pharmacists 
believed physicians’ prescription behavior highly influenced by the marketing 
and promotion activities of foreign companies. 93% of respondents pointed to full 
coverage of generic medicines by providers as a strategy to generic substitution. 
Summary, evidences indicated that Iranian pharmacists have good insights regard-
ing implementation and promotion of generic substitution strategy.
PHP127
builDing a “HigH-alErT/HigH risk MEDicaTions rEMinDEr sysTEM” To 
iMProVE PaTiEnT safETy
Kao L.C.
Mackay Memorial Hospital, Taipei, Taiwan
objeCtives: This paper was aimed to introduce how we developed a “high-alert/
high risk medications reminder system” operated in the computer system to 
improve medication safety in our hospital. Methods: This reminder system was 
designed in a 2,400-bed health institute with 2,000 nurses, consisting of 12 nursing 
divisions and 75 units. The new module was added to the current BCMA system with 
VB. net. The functions of this computer system include seven steps. Results: A 
satisfaction and cognition survey on the application of the new, computerized “high-
alert/ high risk medications reminder system” was done to MICU nurses (N= 36). The 
survey response rate was 100%. The results showed high rate of positive support 
on the new system due to easy to access and easy to learn. The satisfactory rate 
comparing the old paper form system and the new computer system was 62.8% vs. 
96.1%. More importantly, the “high-alert/high risk medications reminder system” 
appeared to reduce the administration error rate from 5 cases in 2011 to 0 cases 
in 2012. ConClusions: Our early experience showed that an efficient and user-
friendly “High-Alert/High Risk Medications Reminder System” could be helpful for 
medical staffs to improve medication safety although a longer follow-up time to 
evaluate the efficacy of the computerized system is still needed before a final con-
clusion can be established. In addition, we are also keen to investigate whether this 
system could reduce the waste of time, expenditure, and manpower in a medical 
center in our future study.
PHP128
cosT-EffEcTiVEnEss of TElEMEDicinE: lEssons To lEarn froM an 
inTErnaTional rEViEW
Bongiovanni-Delarozière I.1, Le Goff-Pronost M.2, Rapp T.3
1French National Authority of Health (HAS), Saint Denis La Plaine, France, 2Telecom Bretagne, 
Brest, Brittany, France, 3University of Paris Descartes, Paris, France
objeCtives: At the global level the large deployment of telemedicine raises needs 
for cost-effectiveness evaluations. The objective of this literature review is to explore 
to what extend telemedicine innovations that were implemented in many countries 
were cost-effective. Specifically, we explore whether the model used to evaluate the 
cost-effectiveness can be adapted to the evaluation of telemedicine technologies. 
So, what answers can a review of the international literature relating to the med-
ico-economic evaluation of telemedicine provide? Methods: Following analytical 
reading of 286 articles published between 2000 and 2013, 74 studies that imple-
mented economic evaluation of telemedicine are analysed. Three axis of analysis 
are considered: the act concerned by the telemedicine intervention, the medical 
speciality, the economic evaluation method implemented. Results: The descrip-
tive analysis showed significant heterogeneity in studies characteristics: economic 
analysis method, telemedicine applications, medical specialities, and organisational 
practices. The qualitative analysis underlines that most studies face methodological 
issues and provide reduced evidence of the economic impact of the telemedicine 
interventions. The telemedicine technologies are too individualised (by the context 
and the organisation) to be evaluated using the standards of cost-effectiveness 
analysis. ConClusions: This literature review did not allow proposing a classifica-
tion for telemedicine practices identified as efficient, depending on the strategies 
compared, field of application or speciality, types of telemedicine or an organisation 
of care model. Despite all this, one focus can be the management of chronic diseases 
that remains a central topic at the international level. The increase in the number 
of medical specialities or fields of application concerned with telemedicine and 
the increased volume of activity necessitate the dissemination of methodological 
recommendations to promote the coherent development of economic evaluations. 
Our literature review shows that there is need to develop innovative methods to 
assess the cost-effectiveness of telemedicine technologies.
PHP129
assEssMEnT of ValiDiTy of an inDicaTor MoDulE in iDEnTificaTion of 
aDVErsE Drug EVEnTs in PaTiEnTs of MEDicinE DEParTMEnT
Mallayasamy S., Shravya J., Mehta A., Vilakkathala R.
Manipal University, Manipal, India
objeCtives: An indicator is a clue that helps a health care organization to iden-
tify adverse drug events and assess the overall harm that occurs from medical 
care within that organization. The main aim of the study was to investigate use 
of an indicator list for identification of adverse events in the health care setting 
studied. Methods: The study was a prospective observational study in a tertiary 
care teaching hospital. The study mainly involves the review of medical records of 
patients in general medicine department who were admitted due to drug related 
problems with the help of trigger tool. When the presence of indicator is identified, 
those cases were thoroughly scrutinized to identify adverse drug events and confirm 


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PHP124 Exposure To Potential Drug-Drug Interactions in Teaching Hospital Of South Punjab, Pakistan

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