REG U LATORY & HEALTHCARE NEW!!'

Drug use and expenditure in Italy (1992-1994) v_

"" "" ,-Nlmber of G'uglin CIua A '" '" '" ~01 chogIln Class S' , ... " .. '19 Drug eocts 10 Ihe NHS (ta:In lire) 14491 12818 10379

"'ndIer' paid by palien!s"C*!n lire) 2833 "" '339

-~ -- '" 330 276

• ~ for daM B drugs _ 30-40"lIo In 1~ ancI5O% In

'''' . •• for daM A G1.Ig pr9SCflpllona. 2fIOO lire • £1

However. according to Silvio Garattini. additional improvements in the Italian drug policy are needed. • Physicians must be better informed. • There need to be better prescription controls to

prevent abuse and overuse of expensive medicines. • Drug packaging needs to account for lherapeutic

schedules so as to prevent drug wastage. • Drug indications must be reviewed as they are

often too general. • The prices of 'me-loo' drugs need to be revised as

the current price differentials within therapeutic categorises are unwarranted.

• Patients pay a small 'ticket '; i.e. around £Ilitem.

Gmonini S. CuhW'l.l Win in ltaly's drug polic y. Lanoe! 346: 5·6, I luI 1995

GI disease management programme - cost savings predicted

VaJueRx' gastrointestinal (GI) disease management programme could reduce drug expenditure by 30% for one of the pharmaceutical benefit management company's biggest clients, according to company projections.

ValueRx selected GJ illnesses as the focus for its disease management programme as claims data can be used to monitor patients, and innovations in gastro­oesophageal reflux disease and peptic ulcer disease may lead to the introduction of new and costly agents. Furthermore, a substantial number of patients with GI conditions are not receiving appropriate therapy. according to ValueRx.

Examine GI prescribing patterns The company's GI disease management programme

comprises 5 treatment guidelines: dyspepsia; the association between Hr antagonist dosing and renal function and age; GI complications in recipients of NSAlDs; Helicobacler pylori infection; and gastro­oesophageal reflux disease.

In order to assess GI drug prescribing patterns, patients are identified by drug dosage. age. duration of lreatment, concurrent diseases, drug interactions and drug-related adverse effects. The pharmaceutical benefit management company disseminates the appropriate treatment guidelines to particular physicians; high prescribers of GJ drugs receive all 5 guidelines.

ValueRx GI disease ....... gement drug $pend <:OU.1d (all 30'1>. FOe Rq:uu _ Pink Sheet; TelG 13-14. 26 Jun 1995 ...."...

New South African NHS to improve access to care

A new national health service (NHS) has been proposed for South Africa, which will guarantee 'permanent residents' universal and largely free access 10 primary healthcare, reports the 8Ml.1 The new health plan aims to address the inequity in health and access to care attributable to years of apartheid in South Africa.

According to Nick Lee, a writer for the Lancet, the repon on South Africa's new healthcare system 'is a model of clear thinking that shows appropriate recognition o/where the main priorities are '.2

Healthcare recommendations The repon was produced by a committee of inquiry

set up by the Minister of Health, Dr NC Dlamini Zuma The committee made the following proposals for the new NHS.l • Healthcare should be accessible to aJl permanent

residents of South Africa. • Public sector primary healthcare needs to be

strengthened. • The healthcare system should be compatible with

and support the emerging district-based healthcare system and other levels of the health sector.

• The healthcare system needs to be based on the primary care struCfUre and use population-based planning and delivery mechanisms.

• The healthcare system needs to optimise the public and private healthcare mix, and ensure appropriale allocation of healthcare resources between the 2 sectors.

• The healthcare syslem should enable individuals to use both thc public and the private settings. and insure themselves for the use of privale healthcare services.

Essential drugs list to reduce spending An essential drugs list will also be introduced in

South Africa in an attempl to reduce the huge expenditure on the 2700 drugs that are currently used. reports the BM). t All South Africans will have access (0 medicines on the essential drugs list at stale prices plus a dispensing fee. Also. employers will need to provide a basic form of healthcare 10 their employees.

Overall, the new South African NHS will promote competition between state and private facilities. and help contain healthcare costs. says co-chairperson of the committee of inquiry, Dr Jonathan Broomberg. t

The committee has faced 'formidable challenges', comments Nick Lee, as current healthcare delivery in South Africa is in complete disarray.2 In 1992-93. the country's healthcare expenditure totalled RJO billion (£5.5 billion) - 8.6% of gross national product.

The repon on the new NHS is open for review for 2 months. and the government intends to implement the system over a 5-year period. !

1. Sidley P. South AfricIo to get national health ~ British Medical Journal 311; 8·9. I Jul 1995 2.1...cc N. South Africa·s proposed national health plan. LanccI346; 45. I Jul 1995 ........

PHI\RMACORESOURCES 22 Julli85

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