[Prescription drug consumption recovery following the co-payment change: Evidence from a regional health service]. / La recuperación del consumo farmacéutico tras la modificación del copago: evidencia de un servicio regional de salud.

OBJECTIVES: In the past few decades, increasing pharmaceutical expenditures in Spain and other western countries led to the adoption of reforms in order to reduce this trend. The aim of our study was to analyze if reforms concerning the pharmaceutical reimbursement scheme in Spain have been associated with changes in the volume and trend of pharmaceutical consumption. DESIGN: Retrospective observational study. SETTING: Region of Murcia. Prescription drug in primary care and external consultations. PARTICIPANTS: Records of prescribed medicines between January 1, 2008 and December 31, 2013. METHOD: Segmented regression analysis of interrupted time-series of prescription drug consumption. RESULTS: Dispensing of all five therapeutic classes fell immediately after co-payment changes. The segmented regression model suggested that per patient drug consumption in pensioners may have decreased by about 6.76% (95% CI; -8.66% to -5.19%) in the twelve months after the reform, compared with the absence of such a policy. Furthermore the slope of the series of consumption increased from 6.08 (P<.001) to 12.17 (P<.019). CONCLUSIONS: The implementation of copayment policies could be associated with a significant decrease in the level of prescribed drug use in Murcia Region, but this effect seems to have been only temporary in the five therapeutic groups analyzed, since almost simultaneously there has been an increase in the growth trend.

[Analysis of medications dispensed to control the main cardiovascular risks in the Murcia Region: are there gender differences?]. / Análisis de la dispensación de medicamentos para el control de los principales factores de riesgo cardiovascular en la Región de Murcia: ¿existen diferencias de género?

OBJECTIVES: To estimate the use of cardiovascular medicines and its distribution by age and sex. DESIGN: Observational study. SETTING: Region of Murcia. MAIN MEASUREMENTS: Daily doses of cardiovascular drugs prescribed and dispensed in all the pharmacies of the Region per 1,000 inhabitants-day (DHD). A comparison was made of consumption rates (DHD) by age and sex. RESULTS: The probability of receiving antiplatelet drugs increases with age, with the proportion of men being higher. The use of beta-blockers and angiotensin II increases with age up to 79 years, with an increased consumption in men up to 65 years. The probability of receiving treatment with calcium channel blockers, ACE inhibitors, or statins, linearly increases with age, and the proportion of men under treatment exceeds that of women in the early ages, tending to equalize beyond 80 years. CONCLUSIONS: This study shows that the cardiovascular disease prevention focuses on people aged 40 to 74 years. Access by women to cardiovascular therapy occurs with a delay of 3-5 years, depending on the treatment subgroup. Changes should be promoted to encourage rational and equitable access and use of the drugs.

Economic evaluation of colorectal cancer (CRC) screening.

Because of its incidence and mortality colorectal cancer represents a serious public health issue in industrial countries. In order to reduce its social impact a number of screening strategies have been implemented, which allow an early diagnosis and treatment. These basically include faecal tests and studies that directly explore the colon and rectum. No strategy, whether alone or combined, has proven definitively more effective than the rest, but any such strategy is better than no screening at all. Selecting the most efficient strategy for inclusion in a population-wide program is an uncertain choice. Here we review the evidence available on the various economic evaluations, and conclude that no single method has been clearly identified as most cost-effective; further research in this setting is needed once common economic evaluation standards are established in order to alleviate the methodological heterogeneity prevailing in study results.