Towards the rational use of medicines

Rational use of medicines remains to be one of the most challenging problems in health systems worldwide. Kazan Federal University researchers conducted a practical study to assess the impact of introducing evidence-based principles to the practice of medicine procurement in order to manage budget expenditures on medicines of a multidisciplinary health facility for the period of 2011-2014.

ABC/VEN-analysis used for the investigation represents the simple and effective method of analysis of medicine expenditures, identifying priority groups of medicines, the use of which, when improved, may provide the greatest clinical and economic impact. ABC analysis provides an accurate and objective picture of budget expenditures on medicines. VEN-analysis helps to prioritize between various medicines in their selection for procurement and use within a drug supply system.

"When assigning VEN categories of medicines we used expert method", comments Lilia Ziganshina, Head of the Department of Basic and Clinical Pharmacology at Kazan Federal University", "the assignment of categories was carried out by clinical pharmacologists after reviewing all available evidence on effectiveness, safety and cost-effectiveness compared to other drugs in this group".

The case-study was performed on a multidisciplinary health facility with over 1000 beds (an average number of beds for three years), which is responsible for provision of care to the population of about 1.4 million people.

Through educational intervention, including detailed discussion of the results of the ABC/VEN-analysis for the years 2011-2012 from the standpoint of evidence-based pharmacology and recommendations for medicine procurement and training workshop for the heads of clinical departments on evidence-based principles in clinical pharmacology and rational use of medicines some significant results were achieved. Medicines expenditures of the studied health facility for the year 2014 were less than for the year 2013, which was the important decrease reversing the trend of increasing medicines expenditures of the last three years: 2011 – 59,868,963 roubles; 2012 – 85,324,084 roubles, 2013 – 107 303 390 roubles, and 2014 – 74,416,692 roubles. However, adds Prof. Ziganshina, "Regular educational interventions for practicing physicians and heads of clinical departments of health facilities that promote rational prescribing are needed".

This work was partly funded by the subsidy allocated to Kazan Federal University for the state assignment in the sphere of scientific activities.