CURRENT ECOMOMICAL, SOCIAL ASPECTS OF HEALTH TECHNOLOGIES FOR PRETERM BIRTH AND REAL WORLD DATA OF DRUG PRESCRIPTIONS IN UKRAINE
DOI:
https://doi.org/10.11603/2312-0967.2016.4.7123Keywords:
pregnancy, preterm birth, health technology, real world data, drug prescriptions, progestin.Abstract
Introduction
According to the report "State of the World's Mothers 2014. Saving Mothers and Children in Humanitarian Crises” (was prepared by International Society «Save the Children») state Ukraine has 72 place (total – 178 states) in the world, depending on conditions of motherhood, such as rates of maternal health, educational, economic and political status of women and children).
Preterm birth (PB) is a serious medical, economical and social problem. This pathology is quite common among women in low-income countries, but in countries with high level, for example in the United States, that is also a significant problem. According to the WHO newsletter (2016) the rate of PB is over 60% in Africa and South Asia [27, 28]. The global World Prematurity Network, which includes organizations from Europe, Africa,Australia,China, Latin America,Canada,United States, has the main task to improve care and quality of life of premature infants [25].
Pharmaceutical aspects of pregnant women in the hospital and using ABC- VEN-analysis were studied. Some aspects of pharmacoeconomic analysis "cost-effectiveness" for treatment of threatened abortion was elaborated inUkraine[22].
Research methods
The aim of this article was to analyse the economical, social aspects of PB in the world andUkraine. Also we studied the real world data on prescribing of drugs for pregnant with threatened PB, and determine a financial cost for therapy, using ABC/ VEN - analysis and the effectiveness rates according to evidence data for progestogens for PB treatment. We used content-analysis for recommendations, ABC/VEN analysis for drug prescriptions, systematic review of data.
Results and discussion
Improving the quality of life and health of pregnant women and their rational pharmacotherapy are the main objectives of WHO. Ukraine occupies 72 place in terms of motherhood in the world.
We have analyzed and compared the national and international reports, guidelines on requirements for treatment and prevention of preterm birth. We analyzed the real world data of the frequency of drug prescriptions using ABC / VEN analysis based on medical records about drug prescriptions for pregnant women, diagnosed according to ICD-10 - 047.0. We found that the most common in A group were drugs for 7 INN (14.58 % of total allocations) and the essential drugs was only sodium chloride, which indicated that not enough rational use of funds of patients.
We studied the evidence data about progesterone for effective treatment of PB. Therefore, that is important to optimize pharmaceutical care for pregnant women and rational use of medicines for effective pharmacotherapy of PB according to current health technologies.
Conclusions
1.Preterm birth is a huge economical, medical and social problem in the world, especially in low in-come countries. It was established that current ukranian clinical protocols include the treatment and prevention of PB have a need for a good revision because the WHO, NICE published a new evidence-based recommendations for health technologies of PB in 2015.
2. We determined that treatment for PB threat appointed 75 trade names of drugs, including 46 for INN and 2 supplements. The average number of prescriptions for a pregnant woman shown polypharmacy. The cost of drug therapy is for one patient average 740 UAH.
3.Using ABC / VEN - analysis was showed that the group A included 7 drugs for the INN, the group B and C included 11 and 30 drugs, respectively.
4.Progestines have a good evidence data, but it need to determine the less expensive scheme/drugs for the treatment and prevention of PB using pharmacoeconomic analysis results in Ukraine.References
A randomised controlled double-blind clinical trial of 17-hydroxyprogesterone caproate for the prevention of preterm birth in twin gestation (PROGESTWIN): evidence for reduced neonatal morbidity / Awwad J., Usta I.M., Ghazeeri G. [et al.] // BJOG An International Journal of Obstetrics & Gynaecology. – 2014. – Vol.122, №1. – P. 71–79.
A randomized trial of progesterone in women with recurrent miscarriages / Coomarasamy A., Williams H., Truchanowicz E. [et al.] // N. Engl. J. Med. – 2015. – Vol. 373, №22. – P. 2141–2148.
Analysis of the follow-up results concerning pregnancy, delivery and infants after assisted reproductive technique with GnRH-a for luteal support / W. Zhou, Y. Pan, Y. Zhuang [et al.] // Zhonghua Fu Chan Ke Za Zhi. – 2016. – Vol.51, №1. – P. 31–35.
Born too soon The global action report on preterm birth [Electronic resource] – Access: http://www.who.int/pmnch/media/news/2012/201204_borntoosoon-report.pdf
Centers for Disease Control and Prevention [Electronic resource] – Access: https://www.cdc.gov/reproductivehealth/maternalinfanthealth/pretermbirth.htm
Delnord M. What contributes to disparities in the preterm birth rate in European countries? / M. Delnord, B. Blondel, J. Zeitlin. // Curr Opin Obstet Gynecol. – 2015. – Vol. 27, №2. – P. 133–142.
Kaminsky V. The tocolytic therapy opportunities / V. V. Kaminsky, S. Zhuk. – Women’s Doctor. F – 2008. – №6. – 2008. – P. 3.
Premature birth has long-term effects [Electronic resource] – Access: https://www.theguardian.com/science/2008/mar/26/medicalresearch.children
Martinez de Tejada B. Prevention of preterm birth with vaginal progesterone in women with preterm labor: which are the evidences? [Electronic resource] / B. Martinez de Tejada, V. Othenin-Girard, O. Irion – Access: – https://www.ncbi.nlm.nih.gov/pubmed/26672179
MOH on 31.12.2004 number 676 "On approval of clinical protocols for obstetric and gynecological care" [Electronic resource] – Access: http://www.moz.gov.ua/ua/portal/dn_20140324_0205.html
Mohamad Razi Z. Review on role of progestogen (dydrogesterone) in the prevention of gestational hypertension / Z. Mohamad Razi, A. Schindler // Horm Mol Biol Clin Investig. – 2016. – Vol.27, №2. – P. 73–76.
National List of Essential Medicines First Edition (November 2016) adapted from the basic list of essential medicines WHO 19th edition, 2015 [Electronic resource] – Access: https://drive.google.com/file / d / 0BwMIN7nHqX2LdlBSY3hRcXQzT1k / view
National, regional, and worldwide estimates of preterm birth rates in the year 2010 with time trends since 1990 for selected countries: a systematic analysis and implications / Blencowe H., Cousens S., Oestergaard M. Z. [et al.] // Lancet. – 2012. – №379. – P. 2162–2172.
Brien J. M. Prevention of preterm birth with vaginal progesterone or 17-alpha-hydroxyprogesterone caproate: a critical examination of efficacy and safety / J. M. O 'Brien, D. F. Lewis. // Am J Obstet Gynecol. – 2016. –Vol. 214, №1. – P. 45–56.
Order of MOH dated 14. 03. 2016 p. № 183 "On Approval of the eighth issue state form of medicines and ensuring its availability" [Electronic resource]. – Access: http://www.moz.gov.ua/ua/portal/dn_20160314_0183.html
Order of MOH dated 03.11.2008 №624 «On approval of clinical protocols on obstetrical and gynecological care" [Electronic resource] – Access: http://www.moz.gov.ua/ua/portal/dn_20081103_624.html
Order of MOH dated 29.12.2005 N 782 "On approval of clinical protocols for obstetric and gynecological care" [Electronic resource] – Access: http://www.moz.gov.ua/ua/portal/dn_20051229_782.html
Paddock C. Progesterone supplements do not help women with recurrent miscarriages. [Electronic resource] / C. Paddock // Medical News Today. – 2015. – Access: http://www.medicalnewstoday.com/303214.php.
Preterm Birth International Collaborative [Electronic resource] – Access: www.prebic.org/
Preterm birth time trends in Europe: a study of 19 countries / Zeitlin J., Szamotulska K., Drewniak N. [et al.] // BJOG. – 2013. – Vol.120. – P. 1356–1365.
Preterm labour and birth [Електронний ресурс] // NICE. – 2015. – Режим доступу: https://www.nice.org.uk/guidance/ng25/resources/preterm-labour-and-birth-1837333576645.
Shunko E. E. Strategic areas of care to newborns in Ukraine / E. E. Shunko / Neonatology, perinatal medicine and surgery. – T. IV. – №3 (13). – 2014. – P. 11–14.
Socioeconomic inequalities in very preterm birth rates / L. K. Smith, E. S. Draper, B. N. Manktelow [et al.] // Arch. Dis. Child. Fetal. Neonatal. Ed. – 2007. – Vol. 92. – P. 11–14.
State of the World’s Mothers 2014 Saving Mothers and Children in Humanitarian Crises [Electronic resource] – Access: http://www.savethechildren.org/atf/cf/%7B9def2ebe-10ae-432c-9bd0-df91d2eba74a%7D/SOWM_2014.PDF
The World Prematurity Network [Electronic resource] – Access: http://prembaby.org.au/worldprematurityday/
Tskhay V. B. Successful prevention of preeclampsia in a high-risk pregnancy using progestogen dydrogesterone: a clinical case. / V. B. Tskhay, N. M. Kovtun, A. E. Schindler // Horm Mol Biol Clin Investig. – 2016. – Vol. 27, №2. – P. 85–88.
WHO recommendations on interventions to improve preterm birth outcomes [Electronic resource] - Access: http://apps.who.int/iris/bitstream/10665/183037/1/9789241508988_eng.pdf?ua=1
World Health Organization Preterm birth [Electronic resource] // Fact sheet Reviewed November 2016 – Access: http://www.who.int/mediacentre/factsheets/fs363/en
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