Trend analysis of medicine consumption based on therapeutic categories in Iran: 2000–2016
01 Apr 2018-Journal of research in pharmacy practice (Medknow Publications)-Vol. 7, Iss: 2, pp 95-103
TL;DR: Pharmaceutical market trend analysis serves as a reliable tool to gather and analyze market and consumption data to take account of the past policies and forecast the future of the market and disease trends.
Abstract: Objective: Iranian healthcare system cost has been remarkably growing during the recent decades. Drug shortages and the economic effects of the sanctions have also exposed the pitfalls and shortcomings of the pharmaceutical system. Moreover, the pharmaceutical system is a major expenditure source for the health system. Pharmaceutical market trend analysis serves as a reliable tool to gather and analyze market and consumption data to take account of the past policies and forecast the future of the market and disease trends. Methods: The present work tries to quantitatively describe and analyze past 17 years of Iranian pharmaceutical market sales data from 2000 to 2016. The anatomical therapeutic chemical-classified drug utilization data obtained from the Iranian Food and Drug Administration were used to analyze the market trends for each therapeutic class and categorize them. Findings: The size of Iranian pharmaceutical market has grown dramatically during the last 5 years reaching to $5.183 billion in 2016 from $3.847 billion in 2011 with a compound annual growth rate of 6.14%. Antidiabetics and antineoplastic agents were one of the most prominent market growth drivers. Introduction of new drug molecules to the market has also contributed to the trend. However, the noncommunicable diseases are gaining momentum in the national disease burden. Conclusion: The market growth necessitates policies to prevent the overwhelming cost burden on the healthcare system which in turn requires well-informed decision-making. Pharmaceutical market trend analysis tries to supply the evidence feed for informed policy-making to forecast, prioritize, and contain the cost burden imposed on the healthcare system by the pharmaceutical sector.
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TL;DR: In this paper, the effect of inflation and its uncertainty on pharmaceutical prices in Iran was investigated using a generalized autoregressive conditional heteroscedasticity model based on the Hylleberg-Engle-Granger-Yoo test.
Abstract: Pharmaceutical productions are recognized as an essential commodity in the economical literature; therefore, an increase in their prices leads to an increase in the household budget. Currently, about 15-20% of the entire health expenditure in Iran is allocated to the pharmaceutical sector. This study aimed to investigate the effect of inflation and its uncertainty on inflation in pharmaceutical prices in Iran. In this study, the monthly time series of consumer price index from 2001 to 2017 was used to calculate inflation uncertainty based on a generalized autoregressive conditional heteroscedasticity model. Hylleberg-Engle-Granger-Yoo test was performed to determine the stationary of the data. Feasibility tests were also used to explore the application of Autoregressive conditional heteroscedasticity family models to these data. The causal relationship between inflation uncertainty and inflation in the pharmaceutical sector was investigated using the Granger causality test. A causal relationship was found between inflation and inflation uncertainty at the 95% confidence interval for the monthly data during the study. It was revealed that Inflation uncertainty did not affect the inflation in the pharmaceutical prices, but inflation can be a cause of pharmaceutical inflation. Although inflation uncertainty has no association with pharmaceutical inflation, it seems that it could affect pharmaceutical inflation through inflation in other sectors. Therefore, adopting appropriate monetary policies aimed at controlling liquidity and inflation can effectively control pharmaceutical prices.
7 citations
TL;DR: Characteristics and utilization pattern of high-cost patients as well as their predictors are determined, showing female sex, older age, cancer, chronic obstructive pulmonary disease, cardiovascular disease, and diabetes increase the odds of being high cost.
Abstract: The aim of this study is to investigate the concentration of ambulatory health care expenditure in a large Iranian outpatient population. This study used 2013-2016 individual-level claims data of Iranian Health Insurance Organization in East Azerbaijan province. All ambulatory care utilizers were included in the study. We determined characteristics and utilization pattern of high-cost patients as well as their predictors. A total of 1 128 149 patients were included. The top 10% of patients accounted for 62.56% of the total expenditure. This skewed expenditure pattern remained relatively stable over the study period. Female sex, older age, cancer, chronic obstructive pulmonary disease, cardiovascular disease, and diabetes increase the odds of being high cost.
4 citations
Cites background from "Trend analysis of medicine consumpt..."
...In case of cancer diseases, that substantially increase the odds of being high cost, high incremental cost of treatment is a well-documented issue (Mittmann et al., 2012; Wodchis et al., 2016) and requires extra consideration....
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TL;DR: This study uses structural equation modeling to examine the hypotheses on a dataset from 100 Iranian pharmaceutical manufacturers in 2018 and indicates that a firm’s entrepreneurial orientation and desorptive capacity have a positive effect on its open innovation performance.
Abstract: Open innovation is a young arena in research that is fascinating the attention of a growing number of scholars. However, there are not enough studies that investigate open innovation performance. The pharmaceutical industry with the most Research and Development (R&D) intensity has been targeted by this new paradigm. This study explores the effect of entrepreneurial orientation on open innovation performance, considering the mediating role of desorptive capacity, which is defined as the firm’s capability to recognize outward technology transfer opportunities and to facilitate it. We use structural equation modeling to examine the hypotheses on a dataset from 100 Iranian pharmaceutical manufacturers in 2018. The results of the study support our conceptual model. Our findings indicate that a firm’s entrepreneurial orientation and desorptive capacity have a positive effect on its open innovation performance. Moreover, desorptive capacity has a mediating effect in the relation of entrepreneurial orientation and open innovation performance. This denotes that our new model contributes to the concept of desorptive capacity in the context of open innovation.
4 citations
12 Dec 2018
TL;DR: In this paper, the authors used ABC, VED, and ABC-VED matrix analysis to determine the categories of medicines, which necessitate strict control and the annual consumption and cost of each item of medicine for the year 2016 were analyzed.
Abstract: The ABC and VED (i.e. vital, essential, desirable) analysis of the pharmacy of Imam Reza Educational Hospital was carried out to determine the categories of medicines, which necessitate strict control. The annual consumption and cost of each item of medicine for the year 2016 were analyzed and cost control programs, i.e. ABC, VED, and ABC-VED matrix analysis, were used. The drug formulary of the pharmacy included 597 items. The annual drug expenditure on items issued was 13 108,365,188 Rials. The ABC analysis showed that 5.7%, 11.2%, and 83.1% of items belonged to category A, B, and C, respectively, conforming 74.873%, 20.089%, and 5.038% of ADE of the pharmacy. The VED analysis revealed 10.55%, 19.43%, and 70.02% of items as V, E, and D category items, respectively, conforming 23.20%, 47.91%, and 28.89% of ADE of the pharmacy. On ABC-VED matrix analysis, 15.24%, 20.44%, and 63.32% of items were defined to be category I, II, and III items, respectively, conforming 83.76%, 13.54%, and 2.70% of ADE of the pharmacy. In conclusion, scientific inventory management tools are needed to be applied on a routine basis for efficient management of pharmacy stores, as they contribute improvement in patient care and judicious use of resources.
4 citations
TL;DR: In this paper, the authors aim to elicit the public preferences to develop an evidence-based decision-making framework for entering a drug into the list of subsidies in Iran, which is regarded as a challenging issue for healthcare policymakers in Iran in most times.
Abstract: Deciding on pharmaceutical subsidy is regarded as a challenging issue for healthcare policymakers in Iran in most times. Public preferences, rarely attended in Iran, could be invaluable for including a particular drug in the list of subsidized medications. The current study aims to elicit the public preferences to develop an evidence-based decision-making framework for entering a drug into the list of subsidies in Iran. Discrete Choice Experiment (DCE) was employed to elicit the public preferences. Around 34 attributes were identified based on the systematic review and interview with 51 experts. By holding an expert panel, 7 attributes were finalized, namely: the survival after treatment, quality of life after treatment (QoL), alternative treatment, age group of the target population, cost burden for the government, disease severity, and drug manufacturer country. Next, 1224 households were selected for the survey in the city of Tehran, using random cluster sampling. Data were analyzed using conditional logit model. The survival after treatment (β = 1.245; SE = 0.053) and cost burden for the government (β = − 0.140; SE = 0.050) had the highest and lowest priority, respectively, in the preferences for allocating subsidy to a drug. In developed region, unlike the other two regions, the level of domestic drug production (β =− 0.302; SE = 0.073) was inversely associated with preferences toward allocating subsidy to a drug. In contrast to other districts, those living in district number one (β = 2.053; SE = 0.138) gave the highest value to promoting the QoL after treatment. It is suggested that policymakers pay more attention to attributes such as effectiveness and alternative treatment when developing an evidence-based framework for entering a drug into the list of subsidies. This study highlighted the public belief in the government’s subsidy for medicines, provided that, this results in an increased survival and QoL.
2 citations
References
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TL;DR: Results indicate that the magnitude of the health impact estimated for the city of Tehran underscores the need for urgent action to reduce the health burden of air pollution.
Abstract: The aims of the present study were to provide quantitative data on the impact of air pollution on the health of people living in Tehran city, the most populated city of Iran. The approach proposed by the World Health Organization (WHO) was applied using the AirQ 2.2.3 software developed by the WHO European Centre for Environment and Health, Bilthoven Division. Concentrations of ozone, nitrogen dioxide, sulfur dioxide and particulate matter of aerodynamic diameter ≤ 10 μm (PM10) were used to assess human exposure and health impacts in terms of attributable proportion of the health outcome, annual number of excess cases of mortality for all causes, and cardiovascular and respiratory diseases. The annual average of PM10, SO2, NO2 and O3 in Tehran were 90.58, 89.16, 85 and 68.82 μg/m3, respectively. Considering short-term effects, PM10 had the highest health impact on the 8,700,000 inhabitants of Tehran city, causing an excess of total mortality of 2194 out of 47284 in a year. Sulfur dioxide, nitrogen dioxide and ozone caused about, respectively, 1458, 1050 and 819 excess cases of total mortality. Results indicate that the magnitude of the health impact estimated for the city of Tehran underscores the need for urgent action to reduce the health burden of air pollution.
254 citations
"Trend analysis of medicine consumpt..." refers background in this paper
...The market growth signals the need for policies to implement evidence-based medicine, sustainable price control policies, optimized cost reimbursement, and efficient and timely diagnostic and preventive measures for NCDs as evidenced by the epidemiologic shift in burden of diseases.[26,27] With such policies and plan of action in place, the pharmaceutical sector expenditure imposed on the healthcare system could be contained....
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TL;DR: There appears to have been a generally downward trend in the incidence of intestinal helminthiases in Iran over the last decade, and problems in accurate diagnosis have prevented good estimates of the general prevalence of this nematode infection.
Abstract: Over the last few decades there have been several marked changes in the human helminthiases found in Iran. Fascioliasis is emerging as an important chronic disease of humans, especially in the northern province of Gilan (where outbreaks in 1989 and 1999 involved >7000 and >10,000 cases, respectively) and, more recently, in the western province of Kermanshah. In contrast, no cases of urinary schistosomiasis, a disease that once affected thousands of individuals in south-western Khuzestan province, have been reported in Iran in recent years, and no cases of dracunculiasis have been seen in the country since the mid-1970s. Approximately 1% of all admissions to surgical wards are attributable to cystic echinococcosis, which is still considered endemic, but only a few cases of alveolar echinococcosis have been recorded. Over the last decade, there appears to have been a generally downward trend in the incidence of intestinal helminthiases in Iran. Recent estimates of the prevalences of ascariasis and strongyloidiasis, for example, lie between just 0.1% and 0.3%, and <1% of the population now appears to be infected with hookworm. In contrast, human infection with Hymenolepis and Enterobius remains relatively common. There have been a few case reports of toxocariasis and a few sero-epidemiological investigations of this disease but problems in accurate diagnosis have prevented good estimates of the general prevalence of this nematode infection. Just nine cases of pentastomiasis (all caused by Linguatula), 12 of dirofilariasis, one of gongylonemiasis, and three of moniliformiasis have been formally recorded in Iran.
232 citations
"Trend analysis of medicine consumpt..." refers background in this paper
...For example, respiratory system drugs annual growth rate has been lower than the market average which could imply that the prevalence of respiratory tract diseases had remained steady while the possibility of the market expansion due to active and passive smoking and air pollution crisis in the major cities has faded away.[25]...
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Journal Article•
TL;DR: Although non-communicable diseases had the greatest burden in 2010, the challenge of communicable and maternal diseases for health system is not over yet and Iranians would greatly benefit from effective strategies to prevent injury and musculoskeletal disorders and expand mental care.
Abstract: BACKGROUND: we aimed to recap and highlight the major results of the Global Burden of Diseases, Injuries, and Risk Factors Study 2010 by mortality and morbidity to clarify the current health priorities and challenges in Iran. METHODS: We estimated Iran's mortality and burden of 289 diseases with 67 risk factors and 1160 sequelae, which were used to clinically present each disease and its disability or cause of death. We produced several measures to report health loss and status: all-cause mortality, cause-specific mortality, years of life lost due to death (YLL), healthy years of life lost due to disability (YLD), disability-adjusted life years (DALYs), life expectancy, and healthy life expectancy, for three time periods: 1990, 2005, and 2010. RESULTS: We found out that life expectancy at birth was 71.6 years in men and 77.8 years in women. Almost 350 thousand deaths occurred in both sexes and all age groups in 2010. In both males and females and all age groups, ischemic heart disease was the main cause of death, claiming about 90 thousand lives. The main contributors to DALYs were: ischemic heart disease (9.1%), low back pain (9.0%), road injuries (7.3%), and unipolar depressive disorders (6.3%). The main causes of death under 5 years of age included: congenital anomalies (22.4%), preterm birth complications (18.3%), and other neonatal disorders (13.5%). The main causes of death among 15 - 49 year olds in both sexes included: injuries (23.6%) and ischemic heart disease (12.7%) The highest rates of YLDs were observed among 70+ year olds for both sexes (27,365 per 100,000), mainly due to low back pain, osteoarthritis, diabetes, falls, and major depressive disorder. The main risk factors to which deaths were attributable among children under 5 years included: suboptimal breast feeding, ambient PM pollution, tobacco smoking, and underweight. The most important risk factors among 15 to 49 year olds were: dietary risks, high blood pressure, high body mass index, physical inactivity, smoking, and ambient PM pollution. The pattern was similar among 50+ year olds. CONCLUSION: Although non-communicable diseases had the greatest burden in 2010, the challenge of communicable and maternal diseases for health system is not over yet. Diet and physiological risk factors appear to be the most important targets for public health policy in Iran. Moreover, Iranians would greatly benefit from effective strategies to prevent injury and musculoskeletal disorders and expand mental care. Persistent improvement is possible by strengthening the health information system to monitor the population health and evaluate current programs. Language: en
186 citations
"Trend analysis of medicine consumpt..." refers result in this paper
...This trend is consistent with the fact that the prevalence of parasitic and insect-borne diseases has decreased with the enforcement of the public hygiene measures through environmental and health protection programs which constitute a national initiative along with the social determinants of health program.[23]...
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DOI•
01 Jan 2015TL;DR: It seems that cardiovascular diseases, motor vehicle accidents, cancers, intentional and unintentional injuries are the major causes of death in Iranian population.
Abstract: Introduction: Health care providers and health policy managers need updated and valid information regarding causes of death (COD) for development the health care facilities, directing primary prevention, assigning funds, and promoting public health. The major causes of death and its burden have not been yet appropriately identified in Iran. Although several studies had been carried out in this area, most of them were local or performed in the past years and need to be update. Thus, the present study aimed to address the major causes of death and its burden in Iran. Methods: The present cross-sectional study was performed on graduate students and their families from February to March 2014. Through a two-stage random sampling procedure, data on 11315 subjects were obtained. The corresponding age of death, gender, and calendar year of death were inquired. All causes of death were categorized in nine groups including major cardiovascular disease, cancers, motor vehicle accidents, unintentional injuries, intentional injuries, stroke, lower respiratory infections, diabetes, and other reasons. Years of life lost (YLL) and person years of life lost were computed as the burden of diseases. Results: Totally, 11315 (50.4% male) subjects were studied. The results regarding death of relatives revealed that 360 deaths occurred (66.9% male). COD in 95 cases (26.4%) was cardiovascular diseases, 64 (17.8%) motor vehicle accidents, 41 (11.4%) cancers, 23 (6.4%) unintentional injuries, 22 (6.1%) intentional injuries, 10 (2.8%) stroke, 8 (2.2%) lower respiratory infections, 6 (1.8%) diabetes, and 91 (25.3%) other reasons. The average YLL due to all COD was 34.4±18.5. YLL for motor vehicle accidents and injuries (unintentional and intentional) were higher than cardiovascular diseases (p<0.001). In addition, person years of life lost for motor vehicle accidents were 2613.1 years. Cardiovascular diseases (2159.4 years), cancers (1321.0 years), and unintentional injuries (990.4 years) were in the next ranks. Conclusion: Based on the findings, it seems that cardiovascular diseases, motor vehicle accidents, cancers, intentional and unintentional injuries are the major causes of death in Iranian population. Most of years of life lost were due to motor vehicle accidents, cardiovascular diseases and cancers, intentional and unintentional injuries, respec
124 citations
TL;DR: In this paper, the authors examined the relationship between organisational innovation capability, product platform development and performance in pharmaceutical small and medium enterprises (SMEs) in Iran, an area which has remained unexplored.
Abstract: This study examines the relationship between organisational innovation capability, product platform development and performance in pharmaceutical small and medium enterprises (SMEs) in Iran, an area which has remained unexplored. The intensive literature review has led us to suggest an empirically tested conceptual model consisting of innovation capability, product platform and performance as well as factors/enablers shaping innovation capability in the pharmaceutical firms. Combinations of quantitative and qualitative methods were used for data collection and analysis. Eight Active Pharmaceutical Ingredients (API) companies that produce about 80% of local manufactured API were studied. The results show that the Iranian firms have chosen an imitative strategy in technology and product development. The common pattern for technology sourcing was external. However, although all companies purchased technologies from well-known suppliers, they demonstrated significant differences in the variety of products produced and performance. The failure firms lacked sound absorptive capability. Furthermore, the firms with high performance used a combination of internal and external sources for technology and product development. The empirical analysis showed a positive relationship between innovation capabilities, technology platform, product platform and performance. The pre-requisite to this relationship was found to be effective innovation management and strength/abilities in strategy, organisational structure, learning, processes and linkage (relationship) with the customers, suppliers and alliances.
83 citations
"Trend analysis of medicine consumpt..." refers result in this paper
...This observation coincides with the vast public health awareness and introduction of new generic antidiabetics.[13-15]...
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