Pharmacoepidemiologic and cost evaluation of asthma management in Universiti Sains Malaysia Health Center
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Date
2007
Authors
Bashir Ahmed, Abdalla Gorashi
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Abstract
Asthma is a chronic disease that affects about 5% to 20% of the world's
population causing significant morbidity and mortality, affecting the quality of
life, and resulting in considerable economic burden. The first objective of the
study is to evaluate the pharmacoepidemiology of asthma management by
evaluating the pattern of anti-asthma drugs utilization and secondly, to estimate
the direct medical costs of asthma in the main campus of Universiti Sains
Malaysia. Data of outpatients in 2003 and 2004 with their prescription records
were collected retrospectively from electronic medical records. The drug
utilization research and cost of illness methods were used in this study. The
appropriate inferential statistics used include the Chi-square test, the KruskaiWallis
test, the Mann-Whitney test, Wilcoxon test, and the student-t test. The
significance level was 0.05 with a confidence interval of 95%. There were 205
and 237 asthmatic patients in 2003 and 2004, respectively. The findings from
this study showed that the majority of patients were Malays, USM's staff
members and dependants. Most of the patients were in the 1-12 and 26-45 age
groups. In terms of drugs utilization, the mean drug per prescription was 2.1 in
2003 and 2.2 in 2004. The study showed that 132-agonists, the use of which
increased with age, were the most prescribed and consumed drug in 2003 and
2004. The inhaled corticosteroid (ICS) was the second most frequently
prescribed drug. 23.0% and 26.6 % of asthmatic patients in 2003 and 2004
'respectively took ICS. The most commonly anti-asthma combination prescribed
was ~ragonist + ICS. The mean and median cost of prescription in 2003 was
RM20.44±12.85 and RM18.29, while in 2004, the mean cost was
RM20.13±13.63 with a median of RM16.89. The cost of prescriptions and the
cost of drugs per patient per year increased with age. There were variations in
the cost of prescription with regard to category of patients and prescribers. The
study found that the consumption of anti-asthma drugs increased from 1.305
DID in 2003 to 1.514 DID in 2004. In terms of direct medical cost, drugs
constituted about 75% of total direct medical costs in 2003 and 2004, while the
cost of health personnel constituted 25% of total direct medical costs. Antiasthma
medications accounted for 90% of total drug costs in 2003 and 2004.
With regard to anti-asthma drugs, inhaled ~ 2-agonist accounted for 63% of total
anti-asthma drugs cost in 2003 followed by ICS (18%). In 2004, inhaled ~2-
agonist accounted for 61% while ICS accounted for ~3% of total anti-asthma
drug costs. The total direct medical cost of asthma management in 2003 was
RM12,929.17 and the cost per patient per year was RM 63.07. In 2004, the total
direct medical cost increased to RM15,475.00 and the cost per patient per year
increased to RM65.30. A comparison of the data for 2003 and 2004 revealed
that there was no significant difference in terms of demographic profile,
prescribing patterns, the average cost of prescriptions, the average visit per
patient, the average number of drugs per prescription, the consumption of drugs
per prescription, the prescription of drugs per patient, and direct cost per patient
per year.
Keywords: Asthma, cost evaluation, drug utilization, Health Center, outpatient,
pharmacoepidemiology, Universiti Sains Malaysia, university.
Description
Keywords
Asthma management , Health center