Eficiencia en la prescripción de medicamentos. Impacto de sustituir la prescripción de marca por el principio activo / Efficiency in the prescription of drugs. Impact of a health policy: automatic change to prescription by active ingredient

En la Comunidad Autónoma del País Vasco (CAPV), en junio de 2010, se sustituyeron en la historia clínica informatizada los tratamientos prescritos por marca comercial por la prescripción por principio activo a los pacientes que tenían pautadas estas moléculas: atorvastatina, clopidogrel, risedronato semanal y losartan-hidroclorotiazida. El objetivo fue evaluar el impacto económico de la sustitución informática automatizada de las moléculas seleccionadas. El uso de medicamentos genéricos de las cuatro moléculas, desde mayo hasta diciembre de 2010, creció entre 64 puntos hasta 87. Así, clopidogrel pasó de un 6,25% en envases genéricos hasta un 93,76%, losartan+hidroclorotiazida de 11,94% a 93,83%, atorvastatina de 18,92% a 96,03% y ácido risedrónico de 1,76% a 65,97%. Si realizamos el cálculo del importe por principio activo de los envases de genéricos que se han dispensado en el período mencionado y de lo que hubiera supuesto si se hubiese tratado de medicamentos de marca, se obtiene esta cifra de ahorro total: 8 104 762,22€. Este trabajo induce a pensar que un programa de promoción de uso de genéricos incrementa la eficiencia en la utilización de medicamentos. Promover la utilización de medicamentos genéricos es una medida de eficiencia implantada en el SNS y en los países de nuestro entorno; en estos últimos se alcanzan cifras del 40% en valores de envases y en Estados Unidos alrededor del 65%; en la CAPV el consumo, a comienzos de 2010, era muy inferior a estas cifras situándose en el 20% y a finales de año reflejaba un 27% gracias a la medida adoptada

The Basque Country in June 2010 were changed in the electronic prescription system the treatments prescribed by a brand by active ingredients, all the patients who had prescribed these molecules: atorvastatin, clopidogrel, weekly risedronate and losartan-hydrochlorothiazide. The aim of this study was to evaluate the economic impact of this change automated done in June 2010. Retrospective study of the prescriptions made in the Basque Country of the selected active ingredients. The use of generics of these molecules from May to December 2010 increased from 64 points to 87. Particularly clopidogrel increased from 6.25% in generic prescriptions to 93.76%, losartan + hydrochlorothiazide from 11.94% to 93.83%, 18.92% for atorvastatin acid and 96.03% risedronic 1.76% to 65.97%. If we make the estimation of the amount of active ingredient in generic containers that have been dispensed from June to December 2010. If they had dispensed brand drugs you get this quantity of total savings: 8 104 762.22 €. This work suggests that a program to promote use of generics increased efficiency in the use of drugs. To promote the use of generic drugs is an efficiency measure implemented in the NHS and in the neighboring countries, in recent figures are reached 40% in securities of U.S.A packaging and around 65% in the Basque Country the consume in early 2010 was much lower than these figures stand at 20% and at the end of the year stood at 27% thanks to the measures taken

[HIV/AIDS screening program in community pharmacies in the Basque Country (Spain)]. / Programa de cribado de VIH/sida en las oficinas de farmacia en la Comunidad Autónoma del País Vasco.

OBJECTIVES: To describe the outcomes of the pilot program of a rapid HIV antibody screening test offered at Basque pharmacies, the socio-demographic characteristics of users and their acceptance of the test. METHODS: Users of a rapid HIV antibody screening test (20 pharmacies) were surveyed. A random sample of 3514 tests (N = 806) performed in 1 year was taken. Statistical analyses included exact tests. RESULTS: There were 806 valid questionnaires. Seven tests were positive (0.85%; 95% confidence interval: 0.34-1.75); five of the users with positive tests were men. The mean age was 36.2 years (standard deviation = 11.0; range: 16-82 years; 70.7% men). Users' risk behavior was predominantly heterosexual and half of the users (58.6%) had no previous HIV tests. The main reasons for choosing this test were its speed, and the convenience and accessibility of community pharmacies. CONCLUSIONS: This new rapid HIV antibody screening test in community pharmacies could supplement other HIV screening programs currently in operation.

[Paracetamol prescriptions, are we using the correct doses?]. / Prescripción de paracetamol. Estamos usando dosis adecuadas?

The authors report on an analysis regarding prescriptions for the main active ingredient in paracetamol in the Basque Country Autonomous Region, by means of data gathered from medical prescription records. Greater doses of paracetamol are being used all the time in spite of the fact that the recommendations and posology for its use have not varied. This increase warns about a possible safety problem.

Prescripción de paracetamol ¿Estamos usando dosis adecuadas? / Paracetamol prescriptions, are we using the correct doses?

Análisis de la prescripción del principio activo paracetamol en la Comunidad Autónoma del País Vasco, a través de datos de facturación de receta médica. Cada vez se usan dosis mayores de paracetamol, a pesar de que las recomendaciones y posología de uso no han variado. Este aumento alerta sobre un posible problema de seguridad(AU)

The authors report on an analysis regarding prescriptions for the main active ingredient in paracetamol in the Basque Country Auto-nomous Region, by means of data gathered from medical prescription records. Greater doses of paracetamol are being used all the time in spite of the fact that the recommendations and posology for its use have not varied. This increase warns about a possible safety problem(AU)