The economic burden attributable to asthmatic inpatients and outpatients in a military hospital, Vietnam: A retrospective 5-year analysis.

OBJECTIVES: Asthma is a disease that causes significant health and economic burdens worldwide. The prevalence and incidence of asthma have been rising around the world over recent decades. The current study is to capture the direct medical costs of inpatient and outpatient asthma treatment for the period from 2013 to 2017. METHODS: This study was conducted at Military Hospital 175 in Vietnam. The study was performed from the patient and social insurance perspective, which means all types of costs were identified and measured based on patients' healthcare insurance. Cost analysis was measured using the medical records for estimating the economic burden of asthma. The study adopted descriptive statistics and bootstrap techniques to calculate asthma-related costs as well as analyze the background characteristics of asthma patients. RESULTS: The average outpatient and inpatient costs were US$64.90 and US$141.20, respectively, over the period from 2013 to 2017, for which out-of-pocket payments accounted for 10-12%. Medications, specifically asthma controller drugs, were the key driver leading to the substantial burden of direct medical costs for treating asthma. The cost burden was also significantly higher for adult patients compared to children. CONCLUSIONS: Asthma continues to be a concerning problem in Vietnam. The economic impact of either preventive or promotive health interventions that can reduce the prevalence of asthma can be predicted from the statistics found in this research. Moreover, this data will help policymakers plan and allocate national expenditures for asthma treatment in a more rational way.

The economic impact of asthma treatment on patients, 2014-2017: The Vietnamese experience from a public hospital.

OBJECTIVES: To estimate the economic burden of asthma treatment by quantifying direct medical expenditures at one of Southern Vietnam's public hospitals base on the hospital perspective. METHODS: A retrospective, prevalence-based, cost-of-illness analysis was developed using the hospital's electronic medical record data to calculate the economic burden of asthma (ICD-10 code J45, J46) through direct medical costs from January 2014 to December 2017. All costs were converted to US dollars and to the year 2018. Data were analyzed using descriptive statistics. The potential correlations between variables were evaluated using the chisquare test and bootstrap difference. RESULTS: The average direct medical cost of asthma was estimated to range from $34.7 to $55.3 per - outpatient and $45.1 to $107.2 per - inpatient annually. The total economic burdens for 4 years from 2014 to 2017 were $110,387.4 from outpatients and $13,413.8 from inpatients. The most influential component was medication cost. CONCLUSIONS: Asthma places a high economic burden on individuals and the healthcare system in Vietnam. The findings of this study provide health administrators with important evidence to enhance surveillance of the disease and to allow suitable drafting of national health policy.

Simultaneous determination of 14 oral antihyperglycaemic drugs in human urine by liquid chromatography-tandem mass spectrometry.

A simple, sensitive, and rapid assay based on hydrophilic interaction liquid chromatography (HILIC) with tandem mass spectrometry was developed and validated for the simultaneous determination of metformin and 13 other oral antihyperglycaemic drugs in human urine using metoprolol as an internal standard. A simple sample clean-up procedure using the "dilute and shoot" approach enabled fast and reliable analysis. Chromatographic separation was performed on a HILIC column using an elution gradient of mobile phase A, composed of 1 mM ammonium formate (pH 5), and mobile phase B, composed of acetonitrile, at a flow rate of 0.35 mL/min. Quantitation was performed on a triple quadrupole mass spectrometer operated in multiple reaction monitoring mode by using electrospray ionization in positive ion mode. The total chromatographic run time was 20 min. Calibration curves for each analyte were linear over concentration ranges of 2-300, 5-400, or 20-500 ng/mL, with a coefficient of determination above 0.99. The method was validated for selectivity, sensitivity, recovery, linearity, accuracy and precision, system suitability, robustness, and stability. Inter-batch and intra-batch coefficients of variation across four validation runs were ≤ 13.62%. The present method was successfully applied for the analysis of metformin and nateglinide in urine samples after their oral administration to healthy human subjects under fasted conditions.

Determination of S-(-)-lansoprazole in dexlansoprazole preparation by capillary zone electrophoresis.

Capillary zone electrophoresis was successfully applied to the enantiomeric purity determination of dexlansoprazole using sulfobutyl ether-ß-cyclodextrin and methyl-ß-cyclodextrin as chiral selectors. Separations were carried out in a 50 µm, 64/56 cm fused-silica capillary. The optimized conditions included 90 mM phosphate buffer, pH 6.0, containing 30 mM sulfobutyl ether-ß-cyclodextrin, 20 mM methyl-ß-cyclodextrin as background electrolyte, an applied voltage of 25 kV and a temperature of 16 °C, detection was at 280 nm. The assay was validated for the S-(-)-lansoprazole in the range of 0.2-1.0%. The limit of detection was 0.07%, the limit of quantitation was 0.20%, relative to a total concentration of 4.0 mg mL-1. Intra-day precision varied between 1.72 and 2.07%. Relative standard deviations of inter-day precision ranged between 1.62 and 1.96% for peak area ratio. The assay was applied for the determination of the chiral purity of dexlansoprazole capsules. Recovery in capsules was ranged between 101.7 and 103.1%.

Determination of urazamide in pharmaceutical preparation with room temperature ionic liquid.

A high performance liquid chromatographic method was developed and validated for the determination of urazamide in pharmaceutical preparation with novel green aqueous mobile phase modified with room temperature ionic liquids (RTILs). 1-Ethyl-3-methyl-imidazolium tetrafluoroborate ([EMIM][BF4]) was selected as a mobile phase additive to improve retention and avoid baseline disturbances at t0. Various mobile phase parameters such as cation moiety, chaotropic anion moiety, pH and concentration of RTILs were optimized to determine urazamide at the proper retention time. The assay was validated according to International Conference on Harmonization guidelines. The linearity of the calibration curve was good (r2 > 0.999). Intra-day precision varied between 0.50 and 1.23%. Relative standard deviations of inter-day precision ranged between 1.07 and 1.66%. Recoveries in tablets ranged between 99.7 and 101.2% and it was successfully applied to determine urazamide in pharmaceutical preparations.

Determination of rabeprazole enantiomers in commercial tablets using immobilized cellulose-based stationary phase.

Rabeprazole is one of the latest proton-pump inhibitors used for treatment of several gastrointestinal disorders. For therapeutic applications, rabeprazole has been administered as a mixture of R-(+) and S-(-) enantiomers. Owing to pharmacological and toxicological differences between stereoisomers, chiral recognition has now become an integral part of drug research and development. A simple and rapid liquid chromatographic method for enantioselective separation and determination of R-(+) and S-(-) enantiomers of rabeprazole in bulk drug and pharmaceutical formulations was developed. Chiralpak IC (150 × 4.6 mm, 5 µm) column and µmobile phase containing hexane:ethanol:ethylenediamine (30:70:0.05 v/v) in an isocratic mode yielded baseline separation with resolution greater than 6.0 at 35 °C. Effects of additives and n-hexane were evaluated. Optimized condition was validated as per ICH guidelines. The method has good linearity, high sensitivity with LOD was 0.01 µg/mL and LOQ was 0.03 µg/mL for both enantiomers. Intra-day precision varied between 0.44 and 1.79% for S-(-) enantiomer, 0.65 and 1.97% for R-(+) enantiomer. Relative standard deviations of inter-day precision were less than 1.81% for both enantiomers. The percentage recovery for both enantiomers of rabeprazole ranged between 99.81 and 101.95%, 98.82 and 101.36% in material and tablets, respectively. The method was successfully applied to determine content of each enantiomer in commercial tablets.