ASSESSMENT OF THE REGISTRATION STATUS, AVAILABILITY, UTILIZATION PATTERN AND RATIONALITY OF FIXED DOSE DRUG COMBINATIONS IN NEPAL

ASSESSMENT OF THE REGISTRATION STATUS, AVAILABILITY, UTILIZATION PATTERN AND RATIONALITY OF FIXED DOSE DRUG COMBINATIONS IN NEPAL

Simple item page

dc.contributor.author	ARJUN, POUDEL
dc.date.accessioned	2016-01-18T08:41:08Z
dc.date.available	2016-01-18T08:41:08Z
dc.date.issued	2010-04
dc.description.abstract	Fixed dose drug combinations (FDCs), though offer certain advantage in terms of patient compliance, their use is highly debatable. There is a widespread use of FDCs in Nepal. However, there are no extensive studies on FDCs. The present study evaluated the registration status, availability, utilization pattern and rationality of FDCs in Nepal. Firstly, registration status of FDCs in the national drug list was assessed and their availability in the Nepalese National Formulary (NNF) 1997, the WHO Model List of Essential medicines (15th Edition) 2007 and the Essential Drug List (EDL) of Nepal (third revision) 2002 were analyzed. Secondly, the availability of un-registered FDCs in five major cities of Nepal was carried out using a snowball sampling method with a visit of 20 retail pharmacies from each city. Thirdly, the toolkit developed by Health Action International-Asia Pacific (HAI-AP) was used to justify the rationality of the FDCs obtained from the five cities of Nepal. Fourthly, the utilization pattern of FDCs in primary health care (PHC), secondary health care (SHC) and tertiary health care (THC) centers from western Nepal was evaluated using systematic random sampling method involving 100 prescriptions from each health care center. A total of 81 FDCs were registered in Nepal. Higher percent (66.7%) of FDCs were·from India. Among the total 81 FDCs only, 7.0% were present in the NNF, 6.0% in the EDL of Nepal and 11.0% in the WHO Model List. Only three combinations were present in all the formularies and drug lists. Altogether, 41 un-registered FDCs were obtained from the five cities. None of the FDCs fulfilled all the fundamental requirements as stated in the toolkit, thus categorizing them to be 'irrational'. In the PHC center, 206 drugs were prescribed among which 20.0% were FDCs. Antimicrobials were the highly prescribed FDCs (57.1%). The unit price costs of all FDCs were below 100 NRs (USD1=NRs 80). In the SHC center, 309 drugs were prescribed out of which 30% were FDCs. Vitamins, minerals and dietary supplements were highly prescribed FDCs (25.8%). The costs of 63.5% of FDCs were below 100 NRs. In case of THC center, 33.5% were FDCs out of total 270 drugs prescribed. As in SHC center, vitamins, minerals and dietary supplements were highly prescribed FDCs (40.6%). The costs of 50.5% of FDCs were below 100 NRs. In conclusion, considerable amount of FDCs are registered in Nepal with extensive utilization in different levels of health care centers along with the availability of unregistered and irrational FDCs in Nepalese pharmaceutical market which needs to be weeded out.	en_US
dc.identifier.uri	http://hdl.handle.net/123456789/1675
dc.subject	FIXED DOSE DRUG	en_US
dc.title	ASSESSMENT OF THE REGISTRATION STATUS, AVAILABILITY, UTILIZATION PATTERN AND RATIONALITY OF FIXED DOSE DRUG COMBINATIONS IN NEPAL	en_US
dc.type	Thesis	en_US

Files

License bundle

Now showing 1 - 1 of 1

Name:: license.txt
Size:: 1.71 KB
Format:: Item-specific license agreed upon to submission
Description:

Collections

Pusat Pengajian Sains Farmasi - Tesis