Pharmacoepidemiologic and direct medical cost evaluations of type 2 diabetes mellitus in Universiti Sains Malaysia
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Date
2005-10
Authors
Abd Alaziz Mousnad, Mohamed Awad
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Abstract
Diabetes mellitus (OM) is a worldwide health problem. Generally, the
increasing cost of diabetic care is due to the increase in the cost of management
and the costs of control and prevention, which makes this disease a long term
cost disease. A high rate of medical utilization, especially in treatment of chronic
diseases such as OM was observed in the USM main campus. This has had an
affect on the health services as there are limited allocations to meet the
increasing costs. The aims of this study were to estimate direct medical costs of
type 2 OM in the USM Health Centre and to conduct a drug utilization study with
specific emphasis on economic aspects of the medical utilization. Retrospective
data for 2002 and 2003, respectively was collected from the Research and
Development (R & D) and Innovation Section which is under purview of the USM
Centre for Knowledge, Communication and Technology. This study is a
population and prevalence cost based study. The "bottom-up" approach was
used to estimate the direct medical cost of type 2 OM on the USM Health Centre
from a management perspective. A drug utilization study using the Anatomical
Therapeutic Chemical classification and defined daily doses (ATC/DDD)
methods was conducted. Selected drug use indicators as suggested by
WHO/INRUD were also determined. A total of 300 patients' medical records
were analyzed. During the period of study, 1289 and 1565 prescription data were
collated from the database for 2002 and 2003, respectively. The utilization of
antidiabetic drugs was expressed as the number of defined daily doses per 1000
inhabitants per day (OOD/1 000/day). A high prevalence of OM was observed in
" males (65.3%), among staff member (57.7%) and in Malays (77.0%), within the
45-64 years age group (56.8%). The total number of visits per year among
diabetic patients to the USM Health Centre in 2002 and 2003 was 1395 (1289
with drugs and 106 without drugs) and 1718 (1565 with drugs and 153 without
drugs), respectively. The total number of different drugs prescribed in 2002 and
2003 were 2982 and 3345 respectively.1997 (67.0%) of drugs prescribed in
2002 and 2389 (71.4%) of drugs prescribed in 2003 were antidiabetics while 985
(33.0%) of drugs prescribed in 2002 and 956 (28.6%) of drugs prescribed in
2003 were from other classes. In general, the consumption of antidiabetics in
USM Heath Centre increased from 3.4 DID in 2002 to 4.7 DID in 2003.
Antidiabetic prescribing trends towards Metformin and Gliclazide was observed
in this study. The total direct medical cost was estimated at RM 61311.08 and
RM 62882.42 for 2002 and 2003, respectively. Medication accounted for 67.0%
and 60.0%; laboratory tests accounted for 8.0 % and 10.0%; medical personnel
accounted for 25.0% and 30.0% for 2002 and 2003, respectively. It is reasonable
to conclude that diabetic medical utilization is on increase. Much attention and
effort should be directed towards establishing the burden of diabetes in USM in
economic terms i.e. being more cost effective in relation to available resources.
Intensive intervention strategies should be conducted overtime to create
awareness among the general population about diabetes and it is complications.
Key Words:
Direct medical costs, WHO drug use indicators, ATC/DDD methodology,
Universiti Sanis Malaysia, Pharmacoepidemiology
Description
Keywords
Direct medical costs , Type 2 diabetes mellitus , Universiti Sains Malaysia , Pharmacoepidemiologic