Estimation of financial burden due to oversupply of medications for chronic diseases

Given the potential of financial burden due to oversupply of medications for chronic diseases, this study aims to determine the prevalence of oversupply and to estimate the magnitude of financial loss in Thailand. Electronic patient database in a university-affiliated hospital in Thailand was used. Based on the utilization of top 5 high drug expenditure in 2005, the prevalence and the financial loss of oversupply (medication possession ratio [MPR] >1.00) were estimated. In total, 1893 patients were included in this study. The average age was 65.2 years and the majority were female (56%). The prevalence of oversupply ranged from 23.2% to 62.8%, whereas the annual financial loss ranged from US $4108 to US $10 517. The total amount of loss was US $32 903 or 3.77% of total medication costs. In summary, because of the high prevalence and associated high financial loss, oversupply of medication is a significant financial burden on hospitals and society.     

Utilization review of concomitant use of potentially interacting drugs in Thai patients using warfarin therapy

PURPOSE: In Thailand, there has been no study determining the concomitant use of medications, known to potentially interact with warfarin, in patients receiving warfarin therapy. This paper examined the frequency of which specific interacting drugs were concomitantly used in warfarin users. METHODS: We retrospectively examined the database of warfarin outpatient medical records from a regional 756-bed hospital located in the north of Thailand. All patients receiving warfarin from 10 June 1999 to 4 August 2004 were reviewed to identify all drugs possessing interaction potential with warfarin. The potential of significant interactions were divided into high, moderate and low, according to the extent of evidence documented in textbooks and literature. RESULTS: Among 1093 patients receiving warfarin therapy, 914 (84%) patients received at least one potentially interacting drug and half of them (457 patients) received at least one drug with high potential for interaction. The most frequently concomitant drug that increased INR was acetaminophen (63%, 316/457). Propylthiouracil was the most frequently concomitant drug that decreased INR response (4%, 19/457), while diclofenac was the most frequently concomitant drug that increased bleeding risk (16%, 73/457). CONCLUSIONS: About a half of patients receiving warfarin therapy was prescribed concomitant drug(s) that has a high potential of interactions with warfarin. These patients should be closely monitored and counselled to watch for signs and symptoms of bleeding and thrombosis to avoid adverse events associated with drug interactions.     

Consolidated Health Economic Evaluation Reporting Standards 2022 (CHEERS 2022) statement: updated reporting guidance for health economic evaluations

The European Journal of Health Economics - Health economic evaluations are comparative analyses of alternative courses of action in terms of their costs and consequences. The Consolidated Health...