Cost Of Medicines Research Articles

Costs and affordability of psychotropic medicines for patients with schizophrenia in Nigeria

Background: Schizophrenia is a complex illness, in other words, requires certain costs to tackle the challenge. However, the use of psychotropic medicines is paramount for the disease management and the costs of these medications should be considered in the management especially in low- and – middle income countries. There is over-reliance on out-of-pocket payments among the individuals in these countries whereby a large number of the patients purchase the medicines out of pocket, and majority unable to afford the medicines for their illness. Aim: The aim of this study was to assess the costs and affordability of psychotropic medicines for management of Schizophrenia. It specifically evaluated the financial burden of out-of-pocket payment to purchase medicines for patients with Schizophrenia in Nigeria. Method: The study was conducted in a Neuropsychiatric Hospital in Southeastern part of Nigeria using a retrospective, cross-sectional study of the costs of psychotropic medicines for adult patients with Schizophrenia that visited the hospital. Results: All the prescribed oral typical antipsychotics (except chlorpromazine 200mg/day and 300mg/day) gave the patients less than one day wage to pay for medicines, whereas, all the oral atypical antipsychotics gave the patients more than one day wage to pay for the psychotropic medicines. Conclusion: The atypical antipsychotics were unaffordable to the patients. We considered various factors as limitation and recommend interventions for reimbursements or make the psychotropic medicines free for the patients.

Management Of Pest And Disease Control In Sallots (Allium Ascalonicum L) Farm Activities Sub-District Sungai Ulin Banjarbaru City

This research aims to identify management pest and disease control and cost incurred of shallot (Allium ascalonicum L) farmer in Banjarbaru City, This research activity was carried out began on December-January 2024 with research sampling method is case study, data analysis with management implementation and financial analysis. Result of this research Pest control is very important for farmers to reduce the risk of crop failure due to pests, the purpose of pest and disease control management is not to eliminate pests altogether but to reduce the risk of attacks due to pests and diseases in shallot plants. Farmers need to apply management functions in controlling pests and diseases, namely the functions of planning, organizing, implementing and supervising. The application of management function in Bawang Mas Horti Langgeng Farmer Group has not been fully carried out properly and Average total cost incurred by each farmer is Rp.640,720. The average cost of medicines per one harvest period is 4 months amounting to Rp.277,800. The average depreciation cost of tools amounted to Rp.41,670.

An integrated approach for economic evaluation of environmental and health costs of occupational diseases in the oil industry

The health sector is one of the components of development, social welfare and economic growth. The purpose of this study was to develop an economic evaluation model of the environmental and health costs of occupational diseases by hybrid approach. To achieve the study goal, a taxonomy of economic evaluation model of the environmental and health costs of occupational diseases has been developed. The Delphi method was used to identify health and environmental criteria and the analytic network process (ANP) method was used to weigh the sub-criteria. Finally, health and environmental cost were estimated based on the available information. Naft Subspecialty Hospital in Tehran, Iran (NSHT), was selected as the place of case study. In this study, eight and eleven sub-criteria were identified in the health and environmental sector, respectively. The ANP results indicated that the medicine and medical equipment cost criteria with a weight of 0.312 in the Medical sector, and the special and infectious waste cost criteria with a weight of 0.085 in the environmental sector were the most significant cost criteria in NSHT. Furthermore, the parametric model findings indicated that 99.84 and 0.16% of the total costs are associated with health and environmental costs, respectively. The findings indicated that 61.3% of the costs of the health sector were associated with the two sectors of medicine and medical equipment and the cost-of-service personnel, and 91.7% of the costs of the environmental sector are associated with wastewater treatment and the cost of electricity consumption. This study tried to present a quantitative model of the health and environmental costs of NSHT. Implemention of this integrated model can be a practical and effective step in allocating resources and prioritize interventions.

Cost analysis of radical resection of malignant breast tumors under the China Healthcare Security Diagnosis Related Groups payment system.

Breast cancer is one of the most common malignant tumors in women worldwide and poses a severe threat to their health. Therefore, this study examined patients who underwent breast cancer surgery, analyzed hospitalization costs and structure, and explored the impact of China Healthcare Security Diagnosis Related Groups (CHS-DRG) management on patient costs. It aimed to provide medical institutions with ways to reduce costs, optimize cost structures, reduce patient burden, and improve service efficiency. To study the CHS-DRG payment system's impact on breast cancer surgery costs. Using the CHS-DRG (version 1.1) grouping criteria, 4073 patients, who underwent the radical resection of breast malignant tumors from January to December 2023, were included in the JA29 group; 1028 patients were part of the CHS-DRG payment system, unlike the rest. Through an independent sample t-test, the length of hospital stay as well as total hospitalization, medicine and consumables, medical, nursing, medical technology, and management expenses were compared. Pearson's correlation coefficient was used to test the cost correlation. In terms of hospitalization expenses, patients in the CHS-DRG payment group had lower medical, nursing, and management expenses than those in the diagnosis-related group (DRG) non-payment group. For patients in the DRG payment group, the factors affecting the total hospitalization cost, in descending order of relevance, were medicine and consumable costs, consumable costs, medicine costs, medical costs, medical technology costs, management costs, nursing costs, and length of hospital stay. For patients in the DRG non-payment group, the factors affecting the total hospitalization expenses in descending order of relevance were medicines and consumable expenses, consumable expenses, medical technology expenses, the cost of medicines, medical expenses, nursing expenses, length of hospital stay, and management expenses. The CHS-DRG system can help control and reduce unnecessary medical expenses by controlling medicine costs, medical consumable costs, and the length of hospital stay while ensuring medical safety.

A Comparative Study to assess the Treatment Cost of Ayurvedic Medicine (Ginger and Castor Oil) and Modern Medicine (DMARDs) in Amavata (Rheumatoid Arthritis)

Ama and Vata are the initial elements in the pathophysiology of Tridosha, whereas Amavata is a result of their vitiation. The expense of treatment is a major factor in the economic burden of RA for both the patient and the health and social care systems. Objective: a. To assess the socio-demographic conditions of the patients of Amavata. b. To compare the cost of a one-month treatment of ginger and castor oil with DMARD in the management of Amavata. Methodology: Total 72 patients of RA Fulfilling the inclusion criteria and having symptoms of RA were enrolled for this Interventional study. Patients were treated in two different groups- Group A- 36 clinically diagnosed and registered patients of Amavata were treated by DMARD Group B- 36 clinically diagnosed and registered patients of Amavata were treated with ginger and castor oil. After the completion of the study, total 62 patients came after one month of treatment, so we included 62 patients in this study. 32 patients in group A and 30 patients in group B Results: The average direct cost of treatment of RA patients in 2024 was estimated as Rs. 2669.17 ($31.96)/month in group A (DMARD Group) and Rs. 1386.69 ($16.62) in group B (Ginger and Castor oil). Major part of total direct costs was covered by medicines (Rs. 1583) in group A and Laboratory cost (Rs. 600) in group B. The ratio of one-month cost of DMARD and Ayurvedic medicine (ginger and castor oil) was 12:1. Discussion: The cost of Ayurvedic medicine was very low in comparison to DMARD. Ayurvedic Medicine ginger and castor oil were easily available, safe, effective and cheap.

Indigenous Medicinal Plants Used in the Management of Diabetes in Africa: 5 Years (2019-2024) in Perspective.

(1) Background: The utilization of medicinal plants in the management of diabetes is of great importance to the health of the indigenous population on the African continent. The high cost of orthodox conventional medicines coupled with the perceived side effects encourages the high patronage of indigenous medicinal plants in the management of this metabolic disorder. We conducted a review on the indigenous African medicinal plants that could be useful in preclinical and clinical trials in the field of diabetes mellitus research. (2) Methods: Data were mined from research articles published and associated with the use of medicinal plants in the management of diabetes on the African continent (from January 2019 to March 2024). Literature from ethnobotanical studies on the African continent was searched from the Google Scholar, SCOPUS, Medline, Web of Science and PubMed databases. We employed the following keywords: "indigenous plants", "diabetes in Africa" and "antidiabetic effect of medicinal plants". (3) Results: A total of 52 medicinal plants belonging to 31 families were recorded in this study. Amaryllidaceae (14.28%), Fabaceae (9.52%) and Asteraceae (9.52%) were the most cited plant families. The frequently used indigenous medicinal plants on the African continent were Allium sativum L. (n = 6), Olea europaea L. (n = 6), Azadirachta indica A. Juss (n = 5), Allium cepa L. (n = 5) and Moringa oleifera Lam. (n = 5). The highly cited parts of the plant used in the management of diabetes were the leaves (45.55%), bark (14.44%) and bulbs (12.22%). The preferred methods of the preparation of herbal medicines were decoction (45.23%) and infusion (25%). Oral (52.32%) was the preferred route of the administration of herbal medicine on the African continent. (4) Conclusions: The data revealed some similarities in the way countries on the African continent manage diabetes. This interesting observation will assist in our quest towards obtaining a standardized protocol using indigenous medicinal plants to combat diseases on the African continent.

Comparative Cost Analysis of Hypercholesterolemia Treatment: Allopathic Medicine and Ayurveda Medicine

The cost of treatment is very high for CVD and the prevalence of hypercholesterolemia is also very high in developing countries. Many Indian people do not have basic amenities and medical facilities are also not accessible. So alternative medicine can play an important role in the treatment of high cholesterol. Arjuna and Kutki are effective medicines in treating high cholesterol. Methodology: Comparative cross sectional study was planned to determine the socio-economic, and demographic status and comparison of treatment costs of high cholesterol patients in SS Hospital, IMS, BHU, Varanasi. Result: The overall expenditure for Group B is significantly high (3670.06) compared to Group A (1341.10). Medicine costs form the largest portion of expenses in Group B (1:4.8), while laboratory costs are the largest in Group A. Discussion: The economic burden poses a significant challenge in the treatment of any illness. Elevated cholesterol levels pose a significant problem in the current state of affairs in India. Developing countries face significant challenges in managing their financial issues.

A lean approach for improving medicines management in Australia's first cardiac hospital inventory system.

Medicines are the cornerstone of healthcare. Lean methodology approach such as Value Stream Mapping (VSM) is being used in healthcare to manage resources wisely to ensure sustainability of medicines and resources. The aim of this quality improvement study was to evaluate and improve the medication management and hospital imprest supply processes in Australia's first dedicated cardiology hospital using VSM. We conducted a review of our medicine supply processes at a 180-bed cardiology hospital in Australia. We followed a lean methodology approach over a 4-month period from February to May 2023 and evaluated the outcome of our improvements for another 4months from July to October 2023. We used VSM to identify non-value adding activities. Cost of medicines holding was calculated, as well as time taken to complete supply processes, pre and post. Pharmacy department stockholdings reduced by 51%; p=0.000121 (from $539,662 to $275,406). Time taken to manage the inventory system also reduced by 42%; p=0.025762 (from 148h/month to 62h/month). Lean methodology such as VSM can facilitate cost-effective and sustainable system improvements for pharmacy procurement systems.

Curative care expenditure of outpatient anxiety disorder in Liaoning Province, 2015-2020-based on "System of Health Accounts 2011".

Anxiety disorders are the most common mental disorder, experienced by more than a quarter of the population. This study examines total outpatient curative care expenditures (CCE) for anxiety disorders and changes in their composition based on the System of Health Accounts 2011 (SHA 2011). This study used multi-stage stratified random from a total of 9,318,513 outpatient sample data by 920 healthcare organizations, a total of 109,703 cases of anxiety disorders from 53 sample organizations (5.76%) from 2015 to 2020. Univariate analysis, multifactor analysis and structural equation modeling (SEM) were used to explore the influential factors affecting outpatient CCE for anxiety disorders. Anxiety disorder outpatient CCE from 2015 to 2020 continued to increase from CNY 99.39million in 2015 to CNY 233.84 million in 2020, mainly concentrated in western medicine costs, 15-64 years, general hospital, generalized anxiety disorder and public financing. The results of univariate analysis showed statistically significant differences in all subgroups, and the results of multivariate analysis and SEM showed that the choice to purchase western drugs, purchase prepared Chinese drugs, choice to have a checkup, urban employees' basic medical insurance, and 0-14 years old were associated with high anxiety disorder outpatient CCE. Initiatives to improve the essential drug system, reduce the out-of-pocket (OOP) ratio, and strengthen primary health care to effectively reduce the medical burden on patients.

Engagement in Care, Awareness, and Interest in Long-Acting Injectable Anti-Retroviral Therapy

Long Acting Injectable (LAI) therapy to treat HIV is an alternative to daily oral medications. The success of early roll-out of LAI to eligible patients requires a better understanding of patients’ awareness and interest in this novel therapy. We administered an electronic survey to patients attending an urban HIV clinic in the US South. Eligible participants were 18 + years old with a most recent HIV-1 viral load < 200 copies/ml, without any evidence of genotypic resistance to LAI components or chronic hepatitis B. Survey recipients were asked about current treatment, engagement in care, and knowledge of LAI. Between January-April 2023, 480 patients were screened; 319 were eligible, and 155 (49%) completed the survey. The majority (119, 77%) were aware of, and 87 (56%) were interested in LAI. In regression analysis, only age was associated with interest in LAI (OR 0.95, 95% CI 0.92,0.99). Among proposed benefits of injectables, ease of travel without pills, lack of daily pill-taking, and fewer medication interactions were most appealing. Among proposed concerns with injectables, higher cost and insurance coverage of the new medicine were most worrisome. A large majority of people with HIV (PWH) are aware of the newest treatment available, and just over half of our sample expressed interest in LAI. Older age was associated with lower interest in LAI. LAI is appealing for its convenience, privacy, and avoidance of drug interactions, while the increased costs associated with LAI need to be addressed.

Counselling with a focus on product and price transparency for over-the-counter headache medicines: A simulated patient study in community pharmacies in Munich, Germany.

In Germany, over-the-counter (OTC) medicines may only be dispensed by community pharmacies (CPs). German CPs must ensure 'adequate' counselling, including the cost of medicines. Along with information gathering and advice giving as classic aspects of counselling, the aim was also to investigate counselling indicators of product and price transparency. The cross-sectional study was based on the covert simulated patient (SP) methodology and was conducted in a random sample of CPs stratified by districts in the major German city of Munich. Each of the 178 selected CPs was visited once by one of five trained female students. They simulated a symptom-based sub-scenario 1 with a request for an OTC medicine for a headache and a sub-scenario 2 with standardised information regarding product and price transparency. The assessment, completed immediately postvisit by the SPs, included a total of 23 items. All 178 scheduled visits were completed successfully. The median counselling score with the classic items was 3.0 out of 12 points (interquartile range [IQR] 4.25) and when expanded by items for product and price transparency the score was 4.0 out of 14 points (IQR 4.00). A selection of medicines was offered unsolicited in 38.2% of the visits and in 5.6% of the visits voluntary price information was provided before the transaction. A request for a cheaper medicine led to a significant price reduction (Wilcoxon signed-rank test; p<0.001, r=0.869). Due to the below-average level of counselling, the regional chambers of pharmacists are recommended to initiate measures for improvement. There is also potential for optimisation with regard to product and price transparency as an important extension of the classic counselling aspects. It is therefore recommended that the government raise customers' awareness of the cost of medicines.

POSSIBLE SOLUTION FOR THE GLOBAL PROBLEM OF THE HIGH COST OF MEDICINES

A new range of threats arose at the beginning of the 21st century, and the current global and national security systems could not respond effectively. Climate change threatens human health and well-being. Extreme weather events, food and water shortages, and the growth of infectious diseases increase the burden on healthcare systems. Progress in international health partnerships in 2022 has stalled and, in some cases, is reversing. The constant increase in the cost of medical services and medicines has a negative impact on the effectiveness of the functioning of national healthcare systems. Out-of-pocket healthcare costs cause financial hardship for more than 930 million people and push about 90 million into extreme poverty each year. If current trends continue, the World Health Organization predicts that by 2030, up to 5 billion people will be unable to access or afford health services. For further advancement in global health security and to ensure better health for all in a changing world, reducing the cost and guaranteeing access for indigent patients to innovative medicines for treating a wide range of life-threatening diseases is essential. To minimize the cost and ensure access to medicines, it is proposed to create international research centers for developing innovative medicines without patent protection with centralized funding and appropriate planning for high-level interdisciplinary fundamental and applied research based on the needs of healthcare systems worldwide.

Barriers and Enablers Affecting the Uptake of Biosimilar Medicines Viewed Through the Lens of Actor Network Theory: A Systematic Review.

Biosimilars represent an opportunity to realise savings against the costs of innovative medicines. Despite efforts made by stakeholders, there are numerous barriers to the uptake of biosimilars. To realise the promise of biosimilars reducing costs, barriers must be identified, understood, and overcome, and enablers magnified. The aim of this systematic reviewis to summarise the enablers and barriers affecting uptake of biosimilars through the application of a classification system to organise them into healthcare professional (HCP), patient, or systemic categories. A systematic literature search was performed in PubMed, Scopus, CINAHL, eConlit, and Embase. Included were primary research studies published in English between Jan 2017 through June 2023 focused on enablers and barriers affecting uptake of biosimilars. Excluded studies comprised comparisons of biosimilar efficacy and safety versus the reference biologic. One reviewer extracted data that included classification of barriers or enablers, the sub-classification, and the identification of the degree of agency associated with the actor through their role and associations as a mediator within their network, through the application of Actor Network Theory. The data were validated by a second reviewer(PV). Of the 94 studies included, 59 were cross-sectional, 20 were qualitative research, 12 were cohort studies, and three were economic evaluations. Within the review, 51 of the studies included HCP populations and 35 included patients. Policies and guidelines were the most cited group of enablers, overall. Systemic enablers were addressed in 29 studies. For patients, the most frequently cited enabler was positive framing of a biosimilar, while for HCPs, cost benefit was the most frequently noted enabler. The most frequently discussed systemic barrier to biosimilar acceptance was lack of effective policies or guidelines, followed by lack of financial incentives, while the most significant barriers for HCPs and patients, respectively, were their lack of general knowledge about biosimilars and concerns about safety and efficacy. Systemic actors and HCPs most frequently acted with broad degree of agency as mediators, while patient most frequently acted with a narrow degree of agency as mediators within their networks. Barriers and enablers affecting uptake of biosimilars are interconnected within networks, and can be divided into systemic, HCP, and patient categories. Understanding the agency of actors within networks may allow for more comprehensive and effective approaches. Systemic enablers in the form of policies appear to be the most effective overall levers in affecting uptake of biosimilars, with policy makers advised to give careful consideration to appropriately educating HCPs and positively framing biosimilars for patients.

Sustaining competition for biosimilars on the pharmacy benefit: Use it or lose it.

Congress passed the Biologic Price Competition and Innovation Act of 2009, specifically to offer market competition as a counterweight to the rising costs of biologic medicines. As of April 15, 2024, 49 biosimilars have been approved by the US Food and Drug Administration in 15 biologic categories. Biosimilar competition has been undeniably successful: Through 2022, biosimilars have saved the US health system $23.6 billion, without significant care disruption or reduced quality. Through 2023, adalimumab biosimilar competition has added an additional $6.5 billion to this total, primarily through greater rebates from the reference manufacturer. Despite launching at discounts as great as 85%, adalimumab biosimilars have not been given preferred formulary positioning in the vast majority of cases and have thus gained only 3% of market share through 2023, largely because of payers' and pharmacy benefit managers' preference for rebates over discounts. This situation may negatively influence future biosimilar development, posing a threat to a biosimilar pipeline that represents hundreds of billions in savings over the next 10 years.

Gamification of emergency medicine cost awareness education.

Despite rising costs of health care, physician awareness of costs remains poor. Educational initiatives to remedy this have shown promise, with gamification specifically having success, but actual improvements in physician estimation capabilities have yet to be evaluated. The objective of the study was to assess a gamified educational session for emergency medicine residents that improved their ability to estimate the costs of tests or services commonly performed in their department. Participants completed an anonymous presession survey consisting of demographic data, self-analysis on cost awareness, and a 10-item cost estimation list. This was followed by a 1-h interactive gamified education session utilizing rules from the television show The Price is Right. During this session, only three of the survey items had their cost directly discussed such that the remaining seven were able to be assessed solely on estimation improvement instead of short-term knowledge retention. Participants then completed the same survey to assess for improvement in cost awareness. Sixteen residents at the PGY-2 or PGY-3 level completed the surveys and education session. All self-analysis questions showed significant improvement in the postsession survey. Eight out of the 10 items had significant differences in cost estimation. A gamified teaching session using The Price is Right rules can improve a resident's estimation capabilities, even on items not directly taught during the session.

Challenges in the distribution of antimicrobial medications in community dispensaries in Accra, Ghana.

The dispensation of medicines in some low- and middle-income countries is often carried out by private vendors operating under constrained conditions. The aim of this study was to understand the challenges reported by employees of dispensaries, specifically, chemical and herbal shops and pharmacies in Accra, Ghana. Our objectives were twofold: (1) to assess challenges faced by medicine vendors related to dispensing antimicrobials (antibiotic and antimalarial medications), and (2) to identify opportunities for improving their stewardship of antimicrobials. Data were collected in 79 dispensaries throughout Accra, in 2021, using a survey questionnaire. We used open-ended questions, grounded on an adapted socioecological model of public health, to analyze these data and determine challenges faced by respondents. We identified multiple, interlocking challenges faced by medicine vendors. Many of these relate to challenges of antimicrobial stewardship (following evidence-based practices when dispensing medicines). Overall, medicine vendors frequently reported challenges at the Customer and Community levels. These included strained interactions with customers and the prohibitive costs of medications. The consequences of these challenges reverberated and manifested through all levels of the socioecological model of public health (Entity, Customer, Community, Global). The safe and effective distribution of medications was truncated by strained interactions, often related to the cost of medicines and gaps in knowledge. While addressing these challenges requires multifaceted approaches, we identified several areas that, if intervened upon, could unlock the great potential of antimicrobal stewardship. The effective and efficient implementation of key interventions could facilitate efforts spearheaded by medicine vendors and leverage the benefits of their role as health educators and service providers. Addressing barriers faced by medicine vendors would provide an opportunity to significantly improve the provision of medications, and ultimately population health. Such efforts will likely expand access to populations who may otherwise be unable to access medications and treatment in formal institutions of care such as hospitals. Our findings also highlight the broad range of care provided by shopkeepers and vendors at dispensaries. These findings suggest that the meaningful engagement of dispensaries as valued conduits of community health is a promising pathway for interventions aiming to improve antimicrobial stewardship.

Pradhan Mantri Bharatiya Jan Aushadi Pariyojana – An Evaluation of Jan Aushadhi Kendra in Mumbai Metropolitan Region

Affordable healthcare remains a significant challenge for many low and middle-income countries, with the cost of medicines constituting a substantial portion of patients' expenses. Despite the implementation of various policy changes aimed at addressing this issue, the expenditure on drugs continues to represent a significant proportion of out-of-pocket healthcare costs. In a country like India, where both state and central governments have implemented policies to mitigate this burden, the uptake of generic drugs, which could significantly reduce spending, has not been effectively promoted. The Pradhan Mantri Bharatiya Jan Aushadhi Pariyojana (PMBJP) is the initiative taken by the Government of India to provide the quality medicines at affordable prices to the poor people. There are very limited studies at present done on the topic of effective implementation of PMBP. So this study is conducted as a Pilot study to to evaluate the effectiveness of Jan Aushadhi Kendras in Mumbai region. Objectives of this study to know the awareness of the PMBJP, viability of kendras, challenges and opportunities in running these kendras and know the employment opportunities under the scheme.

The usage and costs of national drug price-negotiated anticancer medicines in a first-tier city in Northeast China: a study based on health insurance data

BackgroundThe National Drug Price Negotiation (NDPN) policy has entered a normalisation stage, aiming to alleviate, to some extent, the disease-related and economic burdens experienced by cancer patients. This study analysed the use and subsequent burden of anticancer medicines among cancer patients in a first-tier city in northeast China.MethodsWe assessed the usage of 64 negotiated anticancer medicines using the data on the actual drug deployment situation, the frequency of medical insurance claims and actual medication costs. The affordability of these medicines was measured using the catastrophic health expenditure (CHE) incidence and intensity of occurrence. Finally, we used the defined daily doses (DDDs) and defined daily doses cost (DDDc) as indicators to evaluate the actual use of these medicines in the region.ResultsDuring the study period, 63 of the 64 medicines were readily available. From the perspective of drug usage, the frequency of medical insurance claims for negotiated anticancer medicines and medication costs showed an increasing trend from 2018 to 2021. Cancer patients typically sought medical treatment at tertiary hospitals and purchased medicines at community pharmacies. The overall quantity and cost of medications for patients covered by the Urban Employee Basic Medical Insurance (UEBMI) were five times higher than those covered by the Urban and Rural Resident Medical Insurance (URRMI). The frequency of medical insurance claims and medication costs were highest for lung and breast cancer patients. Furthermore, from 2018 to 2021, CHE incidence showed a decreasing trend (2.85–1.60%) under urban patients’ payment capability level, but an increasing trend (11.94%–18.42) under rural patients’ payment capability level. The average occurrence intensities for urban (0.55–1.26 times) and rural (1.27–1.74 times) patients showed an increasing trend. From the perspective of drug utilisation, the overall DDD of negotiated anticancer medicines showed an increasing trend, while the DDDc exhibited a decreasing trend.ConclusionThis study demonstrates that access to drugs for urban cancer patients has improved. However, patients’ medical behaviours are affected by some factors such as hospital level and type of medical insurance. In the future, the Chinese Department of Health Insurance Management should further improve its work in promoting the fairness of medical resource distribution and strengthen its supervision of the nation’s health insurance funds.

Management of Dushta Vrana with an Ethnomedicine Theepana (Allophylus Cobbe (L.) Raeuch Leaves Choorna

“Ethno” (derived from “ethnic”) is a custom of a particular race or religion and ethnomedicine is a custom of medicine. The discovery of new crude drugs from indigenous reported medicinal plants can be done from ethnomedicinal studies. There is a persistent increasing demand of medicines in the market which makes them costlier. Because of which the use of other substitutes and adulterants is increasing; questioning the efficacy of the actual medicine. Theepana could help to overcome the cost and adulteration of other Vranaropan medicines like Arjun. It is from Sapindaceous family; (soapberry family). Genus is Allophylus. Sanskrit name- Triputa (only according to some viewers. No textual reference available for Triputa as Sanskrit name). Marathi name- Theepana, Thivana, Tipin. Theepana (Allophylus cobbe (L.) Raeuch” leaves Choorna was used as an ethnomedicine in Dushta vrana. The leaves Choorna shows Shothagna (anti-inflammatory), Krimigna (antimicrobial), Vranashodhana and Vrana ropan effects. Dushta vrana (chronic ulcer), manifested in any part of the body, may be caused either by the Doshas or trauma. When caused due to the Doshas, it is called Nija vrana and when caused because of trauma; it is called Aagantuja vrana. According to Madhav Nidan-Vrana having Durgandhit - more Gandha, Vedana, Puyayukta Strava, Chirsthithi and Strava, Varna is known as Dushta Vrana.

The comparative analysis of the economic availability of antihypertensives from the group of beta-blockers in Ukraine

The comparative analysis of the economic availability of antihypertensives from the group of beta-blockers in Ukraine