Cross-section Study Of Essential Medicines And Pharmacoeconomics Analysis Of Proton Pump Inhibitors In Healthcare Facilities

Objective To analysis the drugs utilization for the essential medicines in a topthree hospital using some statistics and investigations of essential medicines, wecompared the cost-effect with proton pump inhibitors, so as to provide the scientificevidence for clinical rational use of drug and a platform to improve the hospitalutilization of essential medicines.Methods Firstly, data of essential medicines in this hospital from2010to2012were retrieved in the hospital’s HIS database system. The records included drugname, strength, pharmaceutical form, retail price, dose and other specific indicators.The essential medicines in hospital were marked by2009edition of "NationalEssential Medicines List (chemical drugs and biological products)" and the2010edition of "Shanxi supplement catalog". Defined daily dose (DDD) was determinedin seventeenth edition of "New Pharmacology" and "National Essential medicinesClinical Application Guide".Secondly, the proportion of the essential medicines was separately calculatedusing Excel2010in National EML and Shanxi supplement catalog. The annual salessort of essential medicines and amount sort of all drugs were conducted. Accordingto the formula, we sort the top ten injections on DDDs, DDDc. Statistical data weretabulated, plotted in Fig.Thirdly, proton pump inhibitors as research subjects were cost-effect analysisusing pharmacoeconomics. Non-acute upper gastrointestinal bleeding patients weredivided into four groups according to different dosing regimens. Patients in a group A, B, C were respectively injected of intravenous omeprazole sodium, esomeprazoleand lansoprazole for seven days. Patients in group D were injected with intravenousesomeprazole at first5days and then administrated with esomeprazoleenteric-coated tablets at last two days. Therapeutic effect and drug costs were takeninto account and the method of Pharmacoeconomic analysis were used to analysisthe economic value of four treatment regimens.Results The percentage of national essential medicines was54.6%,63.8%and81.08%from2010to2012, respectively. Proportions of essential medicines inall drugs were19.69%in2010,18.36%in2011and18.77%in2012. The varies ofessential medicines in the top three were anti-microbial drugs, digestive systemdrugs and cardiovascular system drugs. Among them, omeprazole sodium’s rank wasfirst place in2010and2011, as well as in the first ten places of all drugs. The DDDsof the national essential medicines was in the top three: compound glycyrrhizinglucoside, compound amino acid ammonia, bromine cable injection; The DDDc ofthe national essential medicines was in the top three: omeprazole sodium,mezlocillin sodium and sulbactam sodium, cephalosporins and sulbactam sodium.The results of economic evaluation showed that the best dosing regimen wasintravenous injection of esomeprazole sodium for7days, which effective rate was87.5%and the cost-effectiveness ratio was2224. The second dosing regimen wasintravenous injection of lansoprazole for7days and after intravenous injection ofesomeprazole sodium for five and then oral administration of esomeprazole sodiumenteric-coated tablets for2days, which effective rates were the same84.34%and thecost-effectiveness ratio was1598.53and1539.70, respectively. The third dosingregimen was intravenous injection of intravenous omeprazole sodium for7days,which effective rate was81.25and the cost-effectiveness ratio was1723.08.However, there was no significant difference among these four treatment regimens. The results showed that sequential therapy was the most economic value bycost-effectiveness analysis which had the lowest cost-effectiveness.Conclusion The usage of essential medicines in this hospital was more than80%in National Essential Drugs List meeting the requirements of national ministryof health in2010and the usage of essential medicines must be accounted for morethan15%.The results of economic evaluation of proton pump inhibitors showed that thesequential therapy (intravenous injection of esomeprazole sodium and then oraladministration) was the most economic value which had the lowestcost-effectiveness.