The global anti-dyslipidemic market grew by 19% from 2000 to 2001, achieving sales of over $21 billion (Smith, 2004: 2). This market is currently well sewed by a number of effective and well-tolerated treatments. Lipid-lowering drugs are considered as the first choice drugs in control of dyslipidemias and they are well tolerated by most patients. As with many drug therapies, there should be a balance between the benefits of cholesterol lowering agents, increased medication cost and the overall risk of adverse drug reactions. According to Ballesteros (2001: 514), hypolipidemic drugs are consumed on a large scale and most consumers are elderly. This warrants a study of expenditure incurred because of inadequate prescribing of these agents. The general objective of this study was to determine the utilisation and cost of hypolipidemic drugs in the private health care environment in South Africa. A quantitative retrospective drug utilisation review was performed using a medicine claims database. Data for twenty-four consecutive months (May 1, 2001 to April 30, 2003) were used to determine and compare the utilisation patterns and cost of drugs associated with the management of dyslipidemia a year before (1st May 2001 to 30 April 2002) and a year after (1st May 2002 to 30 April 2003) the implementation of a medicine reference price system (MPL). Data analysis was done by calculating the average value, the standard deviation, effect size, and cost-prevalence indices. The results of this study revealed that hypolipidemic drugs constituted 2.70% (n = 21820911) and 2.78% (n =27277825) of the total number of all medicine items for the first and the second study years respectively. On the other hand, the total cost of all hypolipidemic drugs accounted for 6.33% (n= R3 097 604 602) and 6.23 % (n= R 4 053 280 295) of the total cost of all medicine items claimed during the first and the second study years respectively. The prevalence of generic hypolipidemic drugs accounted for 0.89% (n=589036) and 4.88% (n=759675) of the total number of hypolipidemic drugs claimed during the first and second study year respectively. Innovator drugs, on the other hand, constituted 99.1 1% (n=589036) and 95.11% (n=759675) of the total number of hypolipidemic drugs claimed during the first and second study years respectively. It was found that R23 694.5 and R603 277.36 could have been saved for generic bezafibrate and generic simvastatin respectively if they had been sold at ME'L prices. The total cost of generic hypolipidemic drugs accounted for 0.60% and 2.94%. The total cost of innovator hypolipidemic drugs accounted for 99.40% and 97.06% of the total cost of hypolipidemic drugs claimed during the first (n=R 196 076 050) and second (n=R 252 919 285) study year respectively. With respect to the prescribed daily dose, it was found that most prescriptions for individual hypolipidemic drugs did not conform to the defined daily dose. It was, however, found that most prescriptions whose prescribed daily dose was for one tablet once daily and whose strength was similar to the defined daily dose conformed to the defined daily dose. The conclusion is that there was an insignificant difference in both the prevalence and cost of hypolipidemic drugs a year before and after the implementation of MPL. It was further concluded that increased utilisation of generic hypolipidemic medicine items a year after the implementation of the MPL, could have been brought about by the introduction of generic simvastatin into the market as opposed to the implementation of the MPL. Recommendations for further studies will be formulated. / Thesis (M.Pharm. (Pharmacy Practice))--North-West University, Potchefstroom Campus, 2005.

Diss. (sammanfattning) Linköping : Univ., 2004. / Härtill 5 uppsatser.

Diss. (sammanfattning) Stockholm : Karolinska institutet, 2005. / Härtill 5 uppsatser.

Thesis (Ph. D.)--RAND Graduate School, 2005. / Includes bibliographical references.

Thesis (Ph. D.)--Pardee RAND Graduate School, 2005. / Includes bibliographical references (p. 126-135). Also available via the World Wide Web.

Políticas públicas são estruturadas com a finalidade de ser uma resposta dada pelo poder público para as diversas demandas, problemas e tensões geradas na sociedade. Devem ter magnitude e relevância social, bem como possuir poder de barganha suficiente para fazer parte da agenda de prioridades de um determinado órgão fomentador de políticas. Desta forma, uma política é constituída pelo seu propósito, diretrizes e definição de responsabilidades das esferas de Governo e dos órgãos envolvidos. Assim, a política de medicamentos brasileira, inserida na Política de Saúde, constitui um dos elementos fundamentais para a implementação de ações capazes de promover melhoria nas condições de saúde. Preconiza a garantia da disponibilidade, do acesso e do uso racional de medicamentos por todos os setores da população, conforme seu perfil de morbimortalidade. Nessa perspectiva, o presente trabalho pretendeu fazer uma análise da Política Nacional de Medicamentos (PNM) para compreender os dados encontrados. Com base na abordagem qualitativa, levando em consideração o que explicita o documento fundador da PNM, além de uma revisão da literatura foram feitos o mapeamento e a análise dos referidos dados, gerando categorias (contexto, conteúdo e processos envolvidos). Este estudo permitiu concluir que a PNM não abrange muitos dos problemas relacionados ao uso do medicamento, como também não conseguiu ferramentas suficientes para dar todas as respostas governamentais necessárias para muitos dos problemas por ela levantados ou até mesmo daqueles existentes e que não foram por ela contemplados. Os governos, tanto o que a formulou quanto os que o sucederam, avançaram em suas diretrizes ou continuam envidando esforços para tal, no sentido de contribuir para a efetivação do direito à assistência terapêutica integral. / Public policies are structured with the objective of being a response given by the public power to the various demands, problems and tensions generated in the society. They must have magnitude and social relevance, as well as having enough bargain power to take part in the agend of priorities of a certain organ that foments the policies. This way, a policy is constituted by its purposes, directrixes and the definition of the responsibilities of the government spheres and the organs that are involved. Therefore, the brazilian policy of drugs, inserted in the Health Policy, constitutes one of the fundamental elements for the implementation of actions capable of promoting improvement in the health conditions. It institutes the guarantee of availability, access and rational use of the drugs by all of the sectors of the population, according to their profile of morbimortality. Within this perspective, the present work intended to make an analysis of the National Drug Policy (NDP) in order to comprehend the data found. Based on the qualitative approach, taking into consideration what the document that has founded the NDP says, besides a review of the literature, the mapping and analyses of such data have been done, generating categories (context, content and involved processes). This study has let us conclude that the NDP does not hold many of the problems related to the use of drugs as well as that it has not obtained the tools to give all the necessary governmental responses to many of the problems arisen by it or even the existing ones that have not been contemplated by it. The governments, both the one which has formulated it and the ones which have succeed it, have advanced in their directrixes or kept on endeavoring for so, to contribute to the effectuation of the right of integral therapeutic assistance.

Políticas públicas são estruturadas com a finalidade de ser uma resposta dada pelo poder público para as diversas demandas, problemas e tensões geradas na sociedade. Devem ter magnitude e relevância social, bem como possuir poder de barganha suficiente para fazer parte da agenda de prioridades de um determinado órgão fomentador de políticas. Desta forma, uma política é constituída pelo seu propósito, diretrizes e definição de responsabilidades das esferas de Governo e dos órgãos envolvidos. Assim, a política de medicamentos brasileira, inserida na Política de Saúde, constitui um dos elementos fundamentais para a implementação de ações capazes de promover melhoria nas condições de saúde. Preconiza a garantia da disponibilidade, do acesso e do uso racional de medicamentos por todos os setores da população, conforme seu perfil de morbimortalidade. Nessa perspectiva, o presente trabalho pretendeu fazer uma análise da Política Nacional de Medicamentos (PNM) para compreender os dados encontrados. Com base na abordagem qualitativa, levando em consideração o que explicita o documento fundador da PNM, além de uma revisão da literatura foram feitos o mapeamento e a análise dos referidos dados, gerando categorias (contexto, conteúdo e processos envolvidos). Este estudo permitiu concluir que a PNM não abrange muitos dos problemas relacionados ao uso do medicamento, como também não conseguiu ferramentas suficientes para dar todas as respostas governamentais necessárias para muitos dos problemas por ela levantados ou até mesmo daqueles existentes e que não foram por ela contemplados. Os governos, tanto o que a formulou quanto os que o sucederam, avançaram em suas diretrizes ou continuam envidando esforços para tal, no sentido de contribuir para a efetivação do direito à assistência terapêutica integral. / Public policies are structured with the objective of being a response given by the public power to the various demands, problems and tensions generated in the society. They must have magnitude and social relevance, as well as having enough bargain power to take part in the agend of priorities of a certain organ that foments the policies. This way, a policy is constituted by its purposes, directrixes and the definition of the responsibilities of the government spheres and the organs that are involved. Therefore, the brazilian policy of drugs, inserted in the Health Policy, constitutes one of the fundamental elements for the implementation of actions capable of promoting improvement in the health conditions. It institutes the guarantee of availability, access and rational use of the drugs by all of the sectors of the population, according to their profile of morbimortality. Within this perspective, the present work intended to make an analysis of the National Drug Policy (NDP) in order to comprehend the data found. Based on the qualitative approach, taking into consideration what the document that has founded the NDP says, besides a review of the literature, the mapping and analyses of such data have been done, generating categories (context, content and involved processes). This study has let us conclude that the NDP does not hold many of the problems related to the use of drugs as well as that it has not obtained the tools to give all the necessary governmental responses to many of the problems arisen by it or even the existing ones that have not been contemplated by it. The governments, both the one which has formulated it and the ones which have succeed it, have advanced in their directrixes or kept on endeavoring for so, to contribute to the effectuation of the right of integral therapeutic assistance.

Orientador: Heloisa Andre Pontes / Dissertação (mestrado) - Universidade Estadual de Campinas, Instituto de Filosofia e Ciencias Humanas / Made available in DSpace on 2018-08-10T10:14:49Z (GMT). No. of bitstreams: 1 Rui_Taniele_M.pdf: 933087 bytes, checksum: 08d2389cc9b44c01cdda857bef58b7dd (MD5) Previous issue date: 2007 / Resumo: Esta pesquisa pretende descrever e apreender distintas concepções e práticas do uso de "drogas". Para tanto, são descritos e analisados três grupos: ex-usuários que passam por tratamento de recuperação de "drogas", "meninos de rua" e estudantes universitários. Proponho que as diferenças entre os modos de conceber esses usos podem nos indicar caminhos para complexificar a questão das "drogas" na contemporaneidade; para o entendimento das classificações sociais e dos processos sociais envolvidos no consumo de "drogas" e na relação entre os grupos consumidores, bem como para o modo que o tema é abordado pelas ciências sociais. Temáticas essas que ganham em profundidade quando a materialidade do corpo e das "drogas" adquirem lugar nesta discussão / Abstract: This researchs aims to describe and to apprehend distinct practical and conceptions of the "drugs"s uses. For this, they are analyzing three groups: former-users who pass for treatment of recovery of "drugs", "street boys" and students. I propose that the differences between the ways to conceive these uses can place in question the drugs's problems nowadays. Also can help us for the establishment of social classifications that involve the consumption of "drugs" and the relation between the consuming groups. We can also analyze the way that the subject is worked by social sciences. Those thematic earn in depth when the body ant the "drugs" (while materia) is taken how the point in the quarrel / Mestrado / Antropologia / Mestre em Antropologia

O Diabetes mellitus é uma das doenças crônicas não-transmissíveis mais prevalentes do mundo, com prevalência estimada para 2025 de 7,1% e 14,0% da população mundial e brasileira, respectivamente. Atualmente existe a necessidade de desenvolvimento de programas com ênfase na prevenção primária, controle da incidência e complicações do diabetes devido ao elevado índice de morbi-mortalidade, associação com comorbidades e custo social-econômico. Para isso, uma das possíveis estratégias seria avaliar a utilização de medicamentos antidiabéticos orais e insulina prescritos aos portadores de DM atendidos pelo Sistema Único de Saúde. No presente trabalho, os usuários diabéticos pertencentes à rede municipal de saúde do Distrito Sanitário Oeste de Ribeirão Preto-SP foram identificados pela retirada de medicamentos antidiabéticos orais ou insulina nas farmácias das Unidades de Saúde do Distrito através da base de dados da prefeitura, denominado sistema Hygia de informação. Dessa forma, foi possível avaliar a terapia farmacológica para o tratamento do diabetes, a freqüência de retirada dos antidiabéticos orais e insulina, análise da outras classes medicamentosas prescritas para o controle das outras enfermidades e acesso aos diversos níveis de atenção à saúde. Por meio do banco de dados Hygia foram identificados 3927 usuários portadores de diabetes pertencentes ao Distrito Oeste de Ribeirão Preto-SP no período de mar/2006 a fev/2007, sendo a média de idade de 60,4 anos e 60,8% dos usuários identificados pertencerem ao gênero feminino. A monoterapia (60,0%) foi o esquema terapêutico mais prescrito, sendo a metformina o medicamento mais utilizado (31,8%). Apenas 3,3% dos usuários utilizaram insulina de forma isolada. No geral, as doses dos medicamentos antidiabéticos orais foram mais elevadas em politerapia do que em monoterapia, sendo que a freqüência média de retirada foi superior a 70,0%. Aproximadamente 34,0% dos indivíduos apresentaram insucesso no tratamento farmacológico do diabetes, com adição de medicamentos e/ou aumento da dose. Medicamentos como hidroclorotiazida, cimetidina, diclofenaco, entre outros, devem ser administrados com cautela em pacientes portadores de diabetes devido à possibilidade de elevar o risco de alteração da glicemia. Em relação às comorbidades, 73,5% dos usuários identificados são hipertensos e 25,9% dislipidêmicos. O número médio de consultas durante o período de estudo foi de 7,0 para todos os Grupos Terapêuticos. Portanto, através do estudo do perfil epidemiológico do Diabetes mellitus, foi possível verificar que existe a necessidade de se conhecer a situação real do consumo de medicamentos e do perfil epidemiológico das populações, além de constatar que os estudos de utilização de medicamentos são uma ferramenta útil neste processo, contribuindo para o uso racional dos medicamentos, direcionamento da prática médica e formulação de políticas de saúde. / The Diabetes mellitus is one of the non-transmissible chronic diseases most prevalent in the world. It is estimated that diabetes affect more than 7.1% people worldwide and 14.0% people in Brazil by 2025. Currently, it is necessary to develop programs with emphasis in the primary prevention, incidence and complications diabetes control due to the high mortality and comorbities rate. Therefore, one of the possible strategies would be to evaluate the use of oral antidiabetic agents and insulin prescribed to the people with DM attends by brazilian public health system. In the present study, the diabetic patients belonging to the public health system of the West Sanitary District of Ribeirão Preto-SP were identified to receive orals agents or insulin from pharmacy of the units of public health system of the West District through the Hygia database record. So, it was possible to evaluate the pharmacological therapy for the treatment of the diabetes, the frequency of oral agents and insulin received, analysis of the other medicines classes prescribed to control comorbities and access at the public health system. In this study was identified 3927 patient with diabetes attend to the West District of Ribeirão Preto-SP in the period from March 2006 to February 2007. The mean age of the patient population was 60.4 years and 60.8% of patients were females. The most frequent treatment prescribed was monotherapy (60.0%) and the metformin was drug more prescribed (31.8%). Only 3.3% of the patients were treated with insulin in monotherapy. In general, the doses of the oral antidiabetic agents were higher in politherapy than monotherapy, and the mean frequency of drugs received was higher to 70.0%. Approximately 34.0% of the patients showed failure in the pharmacological treatment of the diabetes, with addition of drugs and/or dose increase. Medicines such as hydrochlorothiazide, cimetidine, diclofenac, and others, should be administered with caution in patient with diabetes due to the possibility of increasing the risk of glycemic alteration. In relation to comorbities, 73.5% of the identified patients are hypertensive and 25.9% dyslipidemic. The mean of consultations was 7.0 in all Therapeutic Groups. Therefore, through of the study of the epidemic Diabetes mellitus profile, it was possible to verify that it is necessary to know the real situation of the consumption of medicines and the epidemic population profile, besides to verify that the drug utilization studies are a useful tool in this process, contributing to the rational use of the medicines, direction of the medical practice and politics health formulation.

Nesta pesquisa foram avaliados 186 idosos hospitalizados quanto ao aparecimento de reações adversas a medicamentos (RAM). Encontrou-se 199 RAM (1,07 por paciente). Para 11,3% dos idosos a RAM constituiu a causa da internação, para 17,2% estava presente à internação mas não como causa e 46,2% apresentaram RAM durante a hospitalização. As RAM sérias mais comuns foram a insuficiência renal aguda, a hipercalemia e a hipotensão postural. Concluiu-se que houve uma prevalência importante de RAM nesses pacientes, encontrando-se como fatores de risco significativos o número de diagnósticos, o número de medicamentos e o uso de medicamento inapropriado para idosos / The present study evaluated the prevalence of adverse drug reactions (ADR) among 186 hospitalized elderly. A total of 199 ADR were founded (1.07 per patient). For 11.3% of the patients the ADR was the cause of hospitalization, for 17.2% the ADR was present at hospitalization but not as the cause and for 46.2% it was presented during hospitalization. The most common serious ADR were acute renal insufficiency, hyperkalemia and postural hypotension. We concluded that a significant prevalence of ADR was found among that patients, with the number of diagnosis, the number of drugs and the use of a drug considered to be inappropriate as risk factors