Aim. Study of multi-year sales statistics in pharmacy market segment to assess the volume and structure of consumed cardiovascular and antithrombotic drugs under COVID-19 pandemic conditions.
Material and methods. Data on nomenclature and sales volumes of drugs in pharmacy segment of Samara region in 20152020.
Results. It is shown that the share of basic cardiovascular drugs in physical terms is insignificant (5.2-3%). The largest volume of sales are drugs of angiotensin-converting enzyme inhibitor group (28%) and b-adrenoblockers (23.5%). Fixed combinations of hypotensive drugs account for only 13% of the volume of sold basic cardiovascular drugs, and the share of statins is 7.6%, which does not correspond to their role as the most effective drugs in primary and secondary cardiac prevention. The share of antithrombotic drugs in total sales in volume terms was 0.45% in 20152019. In absolute terms, sales of anticoagulants and disaggregants increased in 20182020, which was accompanied by an average 15% increase in the cost per daily dose. Among disaggregants, acetylsalicylic acid (66.6%), clopidogrel (21.6%), and dipyridamole (10.2%) are most frequently sold. The share of disaggregants in sales fell from 74.8 to 57.6% at the expense of acetylsalicylic acid drugs. In 2020, consumption of dipyridamole increased significantly to 16.6% due to inclusion of the drug in protocols for managing patients with COVID-19. Among anticoagulants, the proportion of new oral medications is characterized by a progressive increase from 7.8% in 2015 to 27% in 2020. During the COVID-19 pandemic, the most demanded group of Xa factor blockers is dominated by apixaban (63.8%), which can be explained by the lower cost (by 16%) of a daily equivalent dose compared to rivaroxaban.
Conclusion. Low consumption of basic cardiovascular drugs among the population of Samara region, especially statins and combined hypotensive drugs was observed. During COVID-19 pandemic there was an increase in consumption of antithrombotic drugs, due to dipyridamole and new oral anticoagulants.
Environmental contamination is still a pressing issue, in particular, contaminated drinking water sources and contaminated drinking water from centralized communal water supply systems, since it produces negative effects on human health. Our research goal was to estimate probable impacts exerted on overall morbidity in Samara by quality of drinking water taken from centralized communal water supply systems as a most significant environmental factor. Our research tasks included taking and analyzing drinking water samples from centralized communal water supply systems; calculating carcinogenic and non-carcinogenic health risks caused by analyzed chemicals. To fulfill the tasks and achieve the goals, in 2018–2019 we performed sanitary-chemical analysis of drinking water quality as per 20 sanitary-chemical parameters; our research object was drinking water taken from centralized communal water supply systems in 7 districts in Samara. Obtained actual data on contamination of water taken from centralized water supply networks in Samara were used as primary basis for calculating hazard indexes and carcinogenic risk coefficients using conventional exposure scenarios. In our research we revealed that maximum total non-carcinogenic hazard quotient was determined by arsenic and petroleum products introduction. Assessment of carcinogenic risks caused by contaminants in drinking water revealed that total health risk for children younger than 18 was within the second range as per its median; total carcinogenic risks for adults, within the third range. At the same time, arsenic contents did not exceed hygienic standards in all examined samples. So, we assessed carcinogenic and non-carcinogenic risks, basing on actual data on quality of drinking water taken from centralized communal water supply systems. It seems vital to perform a wider-scale controlled study in several regions in order to assess significance of revealed factors for morbidity among population.
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