Systematic review of cross-national drug utilization studies in Latin America: methods and comparability

Durán, Carlos E.; Christiaens, Thierry; Acosta, Ángela; Stichele, Robert Vander

doi:10.1002/pds.3896

Cited by 14 publications

(22 citation statements)

References 26 publications

(53 reference statements)

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“…The hospitals are located in the three largest Ecuadorian cities (Quito, Guayaquil and Cuenca). The hospitals’ catchment area is estimated at 60%–70% of the Ecuadorian population (14.4 million in 2010 and 15.6 million in 2014) . Two hospitals per city were included, one belonging to IESS (public social security) and one to SOLCA (private non‐profit).…”

Section: Methodsmentioning

confidence: 99%

“…The hospitals' catchment area is estimated at 60%-70% of the Ecuadorian population (14.4 million in 2010 and 15.6 million in 2014). [17] Two hospitals per city were included, one belonging to IESS (public social security) and one to SOLCA (private non-profit). IESS hospitals are general hospitals that provide oncologic care as part of their offer.…”

Section: Methodsmentioning

confidence: 99%

“…This poses a special challenge to collect valid data on drug utilization (DU). Often in this region, the only sources of DU are data from the private sector . This study collects DU data from both, the public and the private sectors; the aim was to comprehensively describe 5‐year (2010–2014) hospital consumption of oncologic drugs in Ecuador, in terms of proportion of patients using oncologic drugs and of expenditures.…”

Section: Introductionmentioning

confidence: 99%

“…Often in this region, the only sources of DU are data from the private sector. [17] This study collects DU data from both, the public and the private sectors; the aim was to comprehensively describe 5-year (2010-2014) hospital consumption of oncologic drugs in Ecuador, in terms of proportion of patients using oncologic drugs and of expenditures. The analysis is split into therapeutic groups: targeted drugs, chemotherapy and antihormonal drugs.…”

Section: Introductionmentioning

confidence: 99%

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Sharp rise in the expenditures of targeted drugs in Ecuador: five-year (2010-2014) consumption of oncologic drugs in public and private hospitals

Durán

Elseviers

Stichele

et al. 2018

J Pharm Health Serv Res

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Objective In Ecuador, a new constitutional mandate (2008) allowed the government to implement free universal access to health care, including oncologic drugs. As most Latin American countries, Ecuadorian healthcare system is fragmented between public and private providers, posing a special challenge to collect valid drug utilization data. Data from the public and the private healthcare sectors were collected to examine the utilization of oncologic drugs in Ecuador over a 5‐year period (2010–2014). Methods Oncologic drugs were extracted from individual dispensing data collected in the six largest Ecuadorian cancer hospitals. Drug utilization indicators include the yearly proportion of patients using selected therapeutic groups (targeted drugs, chemotherapy and hormonal drugs), and the mean and total expenditures, by healthcare sector. Key findings Total number of patients ranged from 12 060 in 2010 to 12 769 in 2014. Median age was 56 years; 60.3% were women. Twenty‐three drugs were classified as targeted (monoclonal antibodies, protein kinase inhibitor, vismodegib, vorinostat and abiraterone), 43 as chemotherapy and 11 as hormonal. Patients using chemotherapy decreased from 56% to 52%. Proportion of patients using chemotherapy drugs was 30% lower in the public than in the private sector. Total expenditures on cancer drugs showed a constant increase from USD 17 912 865 in 2010 to USD 40 514 947 in 2014. Patients using targeted drugs doubled from 8% to 14% in 5 years. Targeted drugs accounted for 76% of total expenditures in 2014. Conclusion Although only a small, but increasing proportion of patients used targeted drugs, it leads to a sharp rise in expenditures. In 2014, it represented three‐quarters of the total oncologic drugs expenditures. Differences in chemotherapy consumption between public and private sectors could reflect difficulties in public procurement, shortages and a faster, poorly controlled adoption of new drugs. If unmanaged, this is a possible threat to the health budget in the coming years.

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Sharp rise in the expenditures of targeted drugs in Ecuador: five-year (2010-2014) consumption of oncologic drugs in public and private hospitals

Durán

Elseviers

Stichele

et al. 2018

J Pharm Health Serv Res

Self Cite

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“…[12][13][14] In addition, the utilization of NRD for the treatment of CI increases polypharmacy in this vulnerable population, with the evidence-based negative clinical consequences. 19 It is highly relevant to obtain good quality local data, allowing health authorities to perform appropriate regional health policies. [15][16][17][18] Comparative studies on the prescription of pharmacological treatment for CI are scarce in Latin America due to the lack of official data from public health systems.…”

mentioning

confidence: 99%

What is happening with not recommended drugs for dementia in Argentina? Prescription patterns and direct costs analysis

Bustín

Rojas

O'Neill

et al. 2019

Int J Geriat Psychiatry

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Objectives: The only recommended pharmacological treatments for specific dementias are donepezil, galantamine, rivastigmine, and memantine (recommended drugs, RD). However, other drugs without recommendations (not recommended drugs, NRD) are often used to treat patients with cognitive impairment (CI) in Argentina. The INSSJyP is the largest health insurance in Argentina. The objective of this study is to analyze the prescription pattern, cost, and implications of NRD used for the treatment of CI in the INSSJyP. Materials: This is a retrospective, population-based study of the INSSJyP outpatients' prescriptions database for drugs usually prescribed for CI during 2015. These data were compared with the same database in 2009. The number of "prescriptions" always refers to dispensed packages. Results: A total of 3 255 438 packages of drugs usually indicated for CI were prescribed during 2015: 1 912 476 packages of RD (59%) and 1 342 962 packages of NRD (41%).Comparing the results with those obtained in 2009, there is a 148% gross increase in the prescription of both RD and NRD for CI, although the rates/1000 affiliates/year show a lesser rise for NRD (70.1%) compared to RD (103.9 %).The expenditure on CI drugs prescribed during 2015 was 77 million USD. NRD cost represented approximately 20 million USD. Conclusion: Inappropriate drug use increases health costs in developing countries.We found a high number of patients with a probable diagnosis of CI treated with NRD. It is extremely relevant that all the healthcare professionals can update their knowledge and modify behavioral insights about appropriate prescription for specific dementias.

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Studies of Drug Utilization

Wettermark

Vlahović‐Palčevski

Lee

et al. 2019

Pharmacoepidemiology

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Systematic review of cross-national drug utilization studies in Latin America: methods and comparability

Cited by 14 publications

References 26 publications

Sharp rise in the expenditures of targeted drugs in Ecuador: five-year (2010-2014) consumption of oncologic drugs in public and private hospitals

Sharp rise in the expenditures of targeted drugs in Ecuador: five-year (2010-2014) consumption of oncologic drugs in public and private hospitals

What is happening with not recommended drugs for dementia in Argentina? Prescription patterns and direct costs analysis

Studies of Drug Utilization

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