Întotdeauna mi-au plăcut cifrele. Au o “muzică“ a lor, cu totul particulară.
Am considerat adecvat să realizez o minimă analiză a consumului de medicamente.
Datele privind consumul de medicamente sunt preluate de pe site-ul CNAS din tabelele cu date necesare pt calculul referitor la clawback (contribuție trimestrială datorată de DAPP -deținători de autorizații de punere pe piață-, în special producătorii de medicamente; vedeți art. 1, cu modificările si completările ulterioare, din OUG 77/2011).
Datele sunt din anul 2019 pentru că n-am putut face analizele necesare pentru anul 2020 întrucât la data scrierii articolului lipsea un trimestru de date (trim. 3/2020) .
Din punctul meu de vedere, chiar dacă anul trecut au apărut modificări legislative importante privind calculul referitor la clawback, consumul trimestrial de medicamente este nevoie să fie publicat în continuare pe site-ul CNAS și am văzut ca așa se întâmplă. Ca să pricepem evoluția și tendințele consumului de medicamente de pe piața farmaceutică. Aș milita pentru o cât mai mare transparență privind anumite date farmaceutice care să fie publicate pe site ori în raportul anual.
Este nevoie de mai multe date publicate pentru a înțelege cum se cheltuiesc banii asiguraților precum și să poți face conexiunile adecvate.
Fraza de mai jos (valabilă pentru trim. 1/2021) însoțește tabelele publicate trimestrial:
“Consum medicamente suportate din FNUASS şi Buget MS
(NU este inclusa:
‐ valoarea consumului pentru medicamentele eliberate în trimestrul I 2021 care fac obiectul contractelor cost‐volum/cost‐volum‐rezultat, conform prevederilor legale in vigoare,
‐ valoarea consumului pentru medicamentele eliberate în trimestrul I 2021 care fac obiectul prevederilor Ordinului Ministrului Sănătății nr. 402/28.03.2018 privind aprobarea listei medicamentelor derivate din sânge uman sau plasmă umană, cu completările ulterioare),
‐ valoarea consumului pentru medicamentele eliberate în trimestrul I 2021 care fac obiectul prevederilor Ordinului Ministrului Sănătă ții nr. 607/22.04.2019 privind aprobarea listei vaccinurilor achiziţionate în cadrul programelor naţionale de sănătate pentru care nu se datorează contribuţii trimestriale calculate conform Ordonanţei de urgenţă a Guvernului nr. 77/2011 privind stabilirea unor contribuţii pentru finanţarea unor cheltuieli în domeniul sănătăţii, cu modificările și completările ulterioare.”
Deci, medicamentele care fac obiectul contractelor cost‐volum/cost‐volum‐rezultat, medicamentele derivate din sânge uman sau plasmă umană și vaccinurile nu fac parte din analiza valorică de mai jos referitoare la anul 2019.
Sintetic, tabelul privind consumul de medicamente în anul 2019 arată astfel:
Grupă terapeutică |
Valori absolute inclusiv TVA (mii lei) |
Valori procentuale (%) |
A (ALIMENTARY TRACT AND METABOLISM) |
1,997,428.58
|
21 |
B (BLOOD AND BLOOD FORMING ORGANS) |
613,776.50
|
6 |
C (CARDIOVASCULAR SYSTEM)
|
1,231,652.05
|
13 |
D (DERMATOLOGICALS) |
33,849.60 |
0 |
G (GENITO URINARY SYSTEM AND SEX HORMONES) |
72,996.25
|
1
|
H (SYSTEMIC HORMONAL PREPARATIONS, EXCL. SEX HORMONES AND INSULINS) |
163,087.87
|
2 |
J (ANTIINFECTIVES FOR SYSTEMIC USE) |
762,942.19
|
8 |
L (ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS) |
2,750,494.74
|
29 |
M (MUSCULO-SKELETAL SYSTEM) |
257,585.40 |
3 |
N (NERVOUS SYSTEM) |
1,083,805.42 |
11 |
P (ANTIPARASITIC PRODUCTS, INSECTICIDES AND REPELLENTS) |
8,889.94
|
0 |
R (RESPIRATORY SYSTEM) |
325,011.66 |
3 |
S (SENSORY ORGANS) |
121,337.84 |
1 |
V (VARIOUS) |
87,512.24 |
1 |
X |
21.86 |
0 |
TOTAL |
9,510,392 |
100 |
Evident, grupa X nu există.
Bineînțeles, valorile procentuale sunt rotunjite la întreg.
Există o corespondență rezonabilă între grupele terapeutice care consumă mult, din punct de vedere valoric, și principalele cauze de deces din țara noastră.
Ce remarcăm din punct de vedere valoric? Facem eforturi semnificative pentru medicamentele din grupa L(Antineoplastic and Immunomodulating Agents). În anul 2019 aceste medicamente reprezintă 29% din total, iar în anul 2020 s-a depășit, probabil, valoarea de 30% din totalul valoric al consumului de medicamente.
Dacă ne-am referi strict la medicamentele oncologice și am adăuga și pe cele din contracele cost-volum ajungem la 31-32% din totalul valoric al consumului de medicamente din România în anul 2020.
Suntem în acord cu Planul European pentru Cancer, ne străduim în această direcție, dar resursele financiare vor fi insuficiente în cinci ani.
La fel se va întâmpla si pentru bolile rare.
Am construit un tabel, pe baza datelor existente pe site-ul CNAS privind consumul de medicamente, pe grupe terapeutice (ATC nivel 3), în anul 2019:
An 2019 - consum valoric: valoare cu TVA (mii lei) | ||||||
Cod ATC* - nivel 3 | Definiție** | Trim. 1* | Trim. 2* | Trim. 3* | Trim. 4* | Total an 2019 |
A | ALIMENTARY TRACT AND METABOLISM | 1,997,428.58 | ||||
A01A | STOMATOLOGICAL PREPARATIONS | 86.32 | 89.85 | 91.36 | 107.16 | 374.69 |
A02A | ANTACIDS | 328.30 | 288.42 | 110.87 | 121.05 | 848.64 |
A02B | DRUGS FOR PEPTIC ULCER AND GASTRO-OESOPHAGEAL REFLUX DISEASE (GORD) | 43,478.43 | 43,267.62 | 40,983.11 | 39,564.67 | 167,293.83 |
A03A | DRUGS FOR FUNCTIONAL GASTROINTESTINAL DISORDERS | 6,855.63 | 6,433.89 | 6,873.36 | 6,999.98 | 27,162.86 |
A03B | BELLADONNA AND DERIVATIVES, PLAIN | 174.79 | 177.68 | 182.02 | 187.95 | 722.44 |
A03D | ANTISPASMODICS IN COMBINATION WITH ANALGESICS | 1,177.22 | 1,156.32 | 1,172.29 | 1,163.49 | 4,669.32 |
A03F | PROPULSIVES | 2,177.08 | 2,169.15 | 2,228.26 | 1,502.49 | 8,076.98 |
A04A | ANTIEMETICS AND ANTINAUSEANTS | 10,003.42 | 10,358.05 | 10,711.44 | 11,107.11 | 42,180.02 |
A05A | BILE THERAPY | 9,785.22 | 9,775.88 | 9,774.96 | 10,415.49 | 39,751.55 |
A05B | LIVER THERAPY, LIPOTROPICS | 3,352.07 | 3,611.47 | 3,682.22 | 3,681.99 | 14,327.75 |
A06A | DRUGS FOR CONSTIPATION | 778.88 | 780.77 | 729.06 | 607.84 | 2,896.55 |
A07A | INTESTINAL ANTIINFECTIVES | 7,277.48 | 7,459.31 | 7,636.84 | 8,227.18 | 30,600.81 |
A07B | INTESTINAL ADSORBENTS | 89.06 | 80.68 | 80.19 | 63.00 | 312.93 |
A07D | ANTIPROPULSIVES | 26.45 | 29.10 | 31.09 | 28.51 | 115.15 |
A07E | INTESTINAL ANTIINFLAMMATORY AGENTS | 4,188.32 | 4,265.37 | 4,295.64 | 4,478.66 | 17,227.99 |
A07F | ANTIDIARRHEAL MICROORGANISMS | 235.04 | 267.29 | 283.74 | 253.96 | 1,040.03 |
A07X | OTHER ANTIDIARRHEALS | 451.82 | 644.93 | 647.76 | 576.62 | 2,321.13 |
A08A | ANTIOBESITY PREPARATIONS, EXCL. DIET PRODUCTS | 4.96 | 7.84 | 8.76 | 5.12 | 26.68 |
A09A | DIGESTIVES, INCL. ENZYMES | 294.11 | 283.80 | 296.13 | 305.03 | 1,179.07 |
A10A | INSULINS AND ANALOGUES | 158,862.47 | 158,710.48 | 162,315.43 | 167,134.08 | 647,022.46 |
A10B | BLOOD GLUCOSE LOWERING DRUGS, EXCL. INSULINS | 131,613.27 | 142,122.83 | 153,078.54 | 167,828.07 | 594,642.71 |
A11A | 0.36 | 0.36 | ||||
A11C | VITAMIN A AND D, INCL. COMBINATIONS OF THE TWO | 15,776.46 | 15,349.97 | 15,430.35 | 16,954.20 | 63,510.98 |
A11D | VITAMIN B1, PLAIN AND IN COMBINATION WITH VITAMIN B6 AND B12 | 32,404.56 | 31,977.78 | 33,335.23 | 35,779.20 | 133,496.77 |
A11E | VITAMIN B-COMPLEX, INCL. COMBINATIONS | 7.03 | 6.03 | 5.20 | 5.14 | 23.40 |
A11G | ASCORBIC ACID (VITAMIN C), INCL. COMBINATIONS | 1,613.93 | 1,152.96 | 1,144.37 | 1,235.06 | 5,146.32 |
A11H | OTHER PLAIN VITAMIN PREPARATIONS | 1,503.86 | 1,521.39 | 1,561.68 | 1,600.43 | 6,187.36 |
A11J | OTHER VITAMIN PRODUCTS, COMBINATIONS | 1.00 | 1.07 | 0.44 | 0.15 | 2.66 |
A12A | CALCIUM - MINERAL SUPPLEMENTS | 732.95 | 719.72 | 731.64 | 751.60 | 2,935.91 |
A12B | POTASSIUM - MINERAL SUPPLEMENTS | 105.56 | 97.61 | 101.06 | 104.72 | 408.95 |
A12C | OTHER MINERAL SUPPLEMENTS | 16.77 | 20.39 | 17.04 | 21.25 | 75.45 |
A13A | TONICS | 197.67 | 205.79 | 210.21 | 174.96 | 788.63 |
A16A | OTHER ALIMENTARY TRACT AND METABOLISM PRODUCTS | 43,629.47 | 44,900.65 | 45,794.86 | 47,733.22 | 182,058.20 |
B | BLOOD AND BLOOD FORMING ORGANS | 613,776.50 | ||||
B01A | ANTITHROMBOTIC AGENTS | 59,658.26 | 61,603.90 | 62,084.67 | 65,975.12 | 249,321.95 |
B02A | ANTIFIBRINOLYTICS | 70.20 | 56.37 | 91.90 | 115.34 | 333.81 |
B02B | VITAMIN K AND OTHER HEMOSTATICS | 27,838.15 | 28,394.79 | 31,764.33 | 33,583.53 | 121,580.80 |
B03A | IRON PREPARATIONS | 8,542.73 | 9,130.59 | 9,475.30 | 9,512.95 | 36,661.57 |
B03B | VITAMIN B12 AND FOLIC ACID | 445.35 | 449.65 | 461.69 | 480.20 | 1,836.89 |
B03X | OTHER ANTIANEMIC PREPARATIONS | 17,950.79 | 19,499.30 | 20,692.03 | 20,794.04 | 78,936.16 |
B05A | BLOOD AND RELATED PRODUCTS | 1,336.00 | 1,209.64 | 1,204.86 | 1,382.16 | 5,132.66 |
B05B | I.V. SOLUTIONS | 22,825.43 | 23,749.85 | 23,933.29 | 23,994.07 | 94,502.64 |
B05D | PERITONEAL DIALYTICS | 2,220.35 | 2,297.60 | 2,272.77 | 2,210.62 | 9,001.34 |
B05X | I.V. SOLUTION ADDITIVES | 840.85 | 899.49 | 935.55 | 989.51 | 3,665.40 |
B05Z | HEMODIALYTICS AND HEMOFILTRATES | 668.49 | 704.35 | 673.68 | 755.51 | 2,802.03 |
B06A | OTHER HEMATOLOGICAL AGENTS | 1,909.12 | 2,477.77 | 2,513.62 | 3,100.74 | 10,001.25 |
C | CARDIOVASCULAR SYSTEM | 1,231,652.05 | ||||
C01A | CARDIAC GLYCOSIDES | 866.82 | 840.75 | 810.11 | 811.68 | 3,329.36 |
C01B | ANTIARRHYTHMICS, CLASS I AND III | 3,499.23 | 3,486.78 | 3,586.97 | 3,734.07 | 14,307.05 |
C01C | CARDIAC STIMULANTS EXCL. CARDIAC GLYCOSIDES | 4,676.63 | 4,539.27 | 4,571.88 | 5,050.99 | 18,838.77 |
C01D | VASODILATORS USED IN CARDIAC DISEASES | 5,663.60 | 5,585.19 | 5,456.80 | 5,534.35 | 22,239.94 |
C01E | OTHER CARDIAC PREPARATIONS | 15,412.43 | 15,541.38 | 14,997.05 | 16,187.45 | 62,138.31 |
C02A | ANTIADRENERGIC AGENTS, CENTRALLY ACTING | 10,052.01 | 10,675.51 | 10,782.67 | 11,527.46 | 43,037.65 |
C02C | ANTIADRENERGIC AGENTS, PERIPHERALLY ACTING | 310.36 | 319.02 | 309.39 | 478.50 | 1,417.27 |
C02K | OTHER ANTIHYPERTENSIVES | 6,917.84 | 6,256.35 | 6,379.05 | 6,449.56 | 26,002.80 |
C03A | LOW-CEILING DIURETICS, THIAZIDES | 145.23 | 142.56 | 140.70 | 144.21 | 572.70 |
C03B | LOW-CEILING DIURETICS, EXCL. THIAZIDES | 20,765.53 | 20,393.40 | 20,084.62 | 20,322.30 | 81,565.85 |
C03C | HIGH-CEILING DIURETICS | 2,779.32 | 2,838.47 | 2,774.35 | 2,944.48 | 11,336.62 |
C03D | POTASSIUM-SPARING AGENTS | 2,876.63 | 2,891.17 | 2,919.28 | 3,034.94 | 11,722.02 |
C03E | DIURETICS AND POTASSIUM-SPARING AGENTS IN COMBINATION | 13,008.95 | 13,254.18 | 13,214.56 | 13,193.69 | 52,671.38 |
C04A | PERIPHERAL VASODILATORS | 16,674.48 | 16,508.32 | 16,652.02 | 16,707.91 | 66,542.73 |
C05A | AGENTS FOR TREATMENT OF HEMORRHOIDS AND ANAL FISSURES FOR TOPICAL USE | 36.30 | 34.49 | 34.39 | 33.20 | 138.38 |
C05B | ANTIVARICOSE THERAPY | 260.74 | 299.81 | 325.52 | 285.99 | 1,172.06 |
C05C | CAPILLARY STABILIZING AGENTS | 11,978.74 | 12,423.36 | 13,122.22 | 13,059.55 | 50,583.87 |
C07A | BETA BLOCKING AGENTS | 30,709.52 | 30,994.16 | 30,978.04 | 31,812.91 | 124,494.63 |
C07B | BETA BLOCKING AGENTS AND THIAZIDES | 63.81 | 67.06 | 65.82 | 70.11 | 266.80 |
C07F | BETA BLOCKING AGENTS, OTHER COMBINATIONS | 1,025.55 | 1,084.99 | 1,113.20 | 1,179.21 | 4,402.95 |
C08C | SELECTIVE CALCIUM CHANNEL BLOCKERS WITH MAINLY VASCULAR EFFECTS | 9,862.55 | 9,906.61 | 9,877.80 | 10,256.52 | 39,903.48 |
C08D | SELECTIVE CALCIUM CHANNEL BLOCKERS WITH DIRECT CARDIAC EFFECTS | 1,568.57 | 1,590.33 | 1,572.93 | 1,593.15 | 6,324.98 |
C09A | ACE INHIBITORS, PLAIN | 21,929.52 | 21,479.59 | 21,291.62 | 21,614.26 | 86,314.99 |
C09B | ACE INHIBITORS, COMBINATIONS | 29,066.23 | 29,976.41 | 29,710.21 | 31,520.87 | 120,273.72 |
C09C | ANGIOTENSIN II RECEPTOR BLOCKERS (ARBs), PLAIN | 29,625.60 | 30,368.97 | 30,537.16 | 31,785.74 | 122,317.47 |
C09D | ANGIOTENSIN II RECEPTOR BLOCKERS (ARBs), COMBINATIONS | 12,603.12 | 13,072.43 | 13,090.88 | 12,495.26 | 51,261.69 |
C10A | LIPID MODIFYING AGENTS, PLAIN | 47,434.44 | 47,539.81 | 48,793.74 | 49,415.06 | 193,183.05 |
C10B | LIPID MODIFYING AGENTS, COMBINATIONS | 3,519.79 | 3,787.09 | 3,764.60 | 4,220.05 | 15,291.53 |
D | DERMATOLOGICALS | 33,849.60 | ||||
D01A | ANTIFUNGALS FOR TOPICAL USE | 151.04 | 173.82 | 186.38 | 159.39 | 670.63 |
D01B | ANTIFUNGALS FOR SYSTEMIC USE | 79.42 | 97.30 | 117.24 | 109.74 | 403.70 |
D03A | CICATRIZANTS - PREPARATIONS FOR TREATMENT OF WOUNDS AND ULCERS | 0.12 | 0.26 | 0.84 | 4.66 | 5.88 |
D03B | ENZYMES - PREPARATIONS FOR TREATMENT OF WOUNDS AND ULCERS | 118.18 | 120.58 | 113.18 | 201.81 | 553.75 |
D04A | ANTIPRURITICS, INCL. ANTIHISTAMINES, ANESTHETICS, ETC. | 0.86 | 3.31 | 4.09 | 1.47 | 9.73 |
D05A | ANTIPSORIATICS FOR TOPICAL USE | 1,004.60 | 1,028.35 | 989.25 | 1,119.38 | 4,141.58 |
D05B | ANTIPSORIATICS FOR SYSTEMIC USE | 83.67 | 55.64 | 1.81 | 0.41 | 141.53 |
D06A | ANTIBIOTICS FOR TOPICAL USE | 301.32 | 341.23 | 290.67 | 192.96 | 1,126.18 |
D06B | CHEMOTHERAPEUTICS FOR TOPICAL USE | 554.82 | 555.22 | 568.86 | 667.20 | 2,346.10 |
D07A | CORTICOSTEROIDS, PLAIN | 1,970.84 | 2,416.06 | 2,381.28 | 1,922.21 | 8,690.39 |
D07C | CORTICOSTEROIDS, COMBINATIONS WITH ANTIBIOTICS | 999.65 | 1,056.59 | 1,176.62 | 1,100.27 | 4,333.13 |
D07X | CORTICOSTEROIDS, OTHER COMBINATIONS | 133.87 | 111.39 | 109.03 | 115.28 | 469.57 |
D08A | ANTISEPTICS AND DISINFECTANTS | 924.16 | 1,062.15 | 1,274.29 | 1,345.42 | 4,606.02 |
D10A | ANTI-ACNE PREPARATIONS FOR TOPICAL USE | 986.87 | 927.38 | 979.18 | 913.66 | 3,807.09 |
D10B | ANTI-ACNE PREPARATIONS FOR SYSTEMIC USE | 389.93 | 333.32 | 219.18 | 295.52 | 1,237.95 |
D11A | OTHER DERMATOLOGICAL PREPARATIONS | 327.60 | 349.90 | 318.71 | 310.16 | 1,306.37 |
G | GENITO URINARY SYSTEM AND SEX HORMONES | 72,996.25 | ||||
G01A | ANTIINFECTIVES AND ANTISEPTICS, EXCL. COMBINATIONS WITH CORTICOSTEROIDS | 330.34 | 319.81 | 306.42 | 309.60 | 1,266.17 |
G01B | ANTIINFECTIVES/ANTISEPTICS IN COMBINATION WITH CORTICOSTEROIDS | 13.16 | 11.26 | 10.31 | 11.56 | 46.29 |
G02A | UTEROTONICS | 164.57 | 183.91 | 157.34 | 124.17 | 629.99 |
G02B | CONTRACEPTIVES FOR TOPICAL USE | 112.96 | 128.62 | 130.53 | 158.94 | 531.05 |
G02C | OTHER GYNECOLOGICALS | 610.25 | 660.78 | 681.34 | 708.21 | 2,660.58 |
G03A | HORMONAL CONTRACEPTIVES FOR SYSTEMIC USE | 17.51 | 15.75 | 9.71 | 9.12 | 52.09 |
G03B | ANDROGENS | 1,025.64 | 1,038.74 | 1,053.05 | 1,108.47 | 4,225.90 |
G03C | ESTROGENS | 26.40 | 29.53 | 30.06 | 32.80 | 118.79 |
G03D | PROGESTOGENS | 495.27 | 470.19 | 431.58 | 391.44 | 1,788.48 |
G03F | PROGESTOGENS AND ESTROGENS IN COMBINATION | 5.45 | 4.73 | 4.42 | 5.25 | 19.85 |
G03G | GONADOTROPINS AND OTHER OVULATION STIMULANTS | 29.79 | 46.06 | 38.29 | 37.08 | 151.22 |
G03H | ANTIANDROGENS | 81.02 | 82.49 | 84.84 | 92.32 | 340.67 |
G03X | OTHER SEX HORMONES AND MODULATORS OF THE GENITAL SYSTEM | 84.91 | 54.07 | 36.05 | 22.46 | 197.49 |
G04B | UROLOGICALS | 2,410.08 | 2,425.07 | 2,263.05 | 2,411.60 | 9,509.80 |
G04C | DRUGS USED IN BENIGN PROSTATIC HYPERTROPHY | 12,532.54 | 12,637.16 | 12,765.79 | 13,522.39 | 51,457.88 |
H | SYSTEMIC HORMONAL PREPARATIONS, EXCL. SEX HORMONES AND INSULINS | 163,087.87 | ||||
H01A | ANTERIOR PITUITARY LOBE HORMONES AND ANALOGUES | 14,086.03 | 13,607.85 | 13,778.59 | 14,183.89 | 55,656.36 |
H01B | POSTERIOR PITUITARY LOBE HORMONES | 3,192.93 | 3,381.86 | 3,571.67 | 3,738.12 | 13,884.58 |
H01C | HYPOTHALAMIC HORMONES | 7,725.98 | 8,301.68 | 8,516.59 | 8,904.74 | 33,448.99 |
H02A | CORTICOSTEROIDS FOR SYSTEMIC USE, PLAIN | 7,420.13 | 6,909.73 | 7,435.84 | 8,677.02 | 30,442.72 |
H03A | THYROID PREPARATIONS | 805.21 | 785.12 | 773.01 | 784.63 | 3,147.97 |
H03B | ANTITHYROID PREPARATIONS | 206.40 | 206.69 | 209.14 | 202.76 | 824.99 |
H03C | IODINE THERAPY | 9.22 | 8.60 | 5.76 | 0.21 | 23.79 |
H04A | GLYCOGENOLYTIC HORMONES | 3.19 | 17.11 | 137.15 | 206.50 | 363.95 |
H05A | PARATHYROID HORMONES AND ANALOGUES | 4,392.97 | 4,451.00 | 4,639.43 | 4,198.17 | 17,681.57 |
H05B | ANTI-PARATHYROID AGENTS | 1,876.12 | 1,892.50 | 1,934.72 | 1,909.61 | 7,612.95 |
J | ANTIINFECTIVES FOR SYSTEMIC USE | 762,942.19 | ||||
J01A | TETRACYCLINES | 2,197.71 | 2,178.55 | 1,867.41 | 1,949.54 | 8,193.21 |
J01B | AMPHENICOLS | 0.23 | 0.43 | 0.34 | 0.41 | 1.41 |
J01C | BETA-LACTAM ANTIBACTERIALS, PENICILLINS | 26,438.64 | 21,835.10 | 20,028.95 | 25,179.88 | 93,482.57 |
J01D | OTHER BETA-LACTAM ANTIBACTERIALS | 37,026.01 | 29,205.66 | 27,536.84 | 33,795.73 | 127,564.24 |
J01E | SULFONAMIDES AND TRIMETHOPRIM | 1,016.85 | 750.98 | 741.23 | 920.23 | 3,429.29 |
J01F | MACROLIDES, LINCOSAMIDES AND STREPTOGRAMINS | 10,204.27 | 7,378.13 | 6,412.48 | 9,010.73 | 33,005.61 |
J01G | AMINOGLYCOSIDE ANTIBACTERIALS | 1,382.44 | 1,374.16 | 1,405.22 | 1,451.11 | 5,612.93 |
J01M | QUINOLONE ANTIBACTERIALS | 7,792.31 | 6,062.56 | 5,917.47 | 6,750.87 | 26,523.21 |
J01X | OTHER ANTIBACTERIALS | 10,027.90 | 10,146.43 | 10,550.06 | 11,441.02 | 42,165.41 |
J02A | ANTIMYCOTICS FOR SYSTEMIC USE | 9,853.09 | 9,720.31 | 9,985.68 | 10,010.19 | 39,569.27 |
J04A | DRUGS FOR TREATMENT OF TUBERCULOSIS | 1,053.72 | 1,132.95 | 1,359.46 | 2,377.98 | 5,924.11 |
J04B | DRUGS FOR TREATMENT OF LEPRA | 0.15 | 0.15 | 0.17 | 0.03 | 0.50 |
J05A | DIRECT ACTING ANTIVIRALS | 92,388.79 | 90,055.69 | 88,373.14 | 90,618.08 | 361,435.70 |
J06A | IMMUNE SERA AND IMMUNOGLOBULINS | 7.81 | 13.67 | 251.06 | 272.54 | |
J06B | IMMUNOGLOBULINS | 34.17 | 14.68 | 81.41 | 63.93 | 194.19 |
J07A | BACTERIAL VACCINES | 829.61 | 1,276.03 | 1,552.31 | 1,069.68 | 4,727.63 |
J07B | VIRAL VACCINES | 1,549.15 | 3,107.67 | 3,566.52 | 2,612.63 | 10,835.97 |
J07C | BACTERIAL AND VIRAL VACCINES, COMBINED | 0.05 | 0.36 | 3.66 | 4.07 | |
J07X | OTHER VACCINES | 0.05 | 0.04 | 0.24 | 0.33 | |
L | ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS | 2,750,494.74 | ||||
L01A | ALKYLATING AGENTS | 3,523.17 | 3,727.57 | 3,435.96 | 3,640.10 | 14,326.80 |
L01B | ANTIMETABOLITES | 34,796.96 | 38,426.02 | 40,433.84 | 42,740.71 | 156,397.53 |
L01C | PLANT ALKALOIDS AND OTHER NATURAL PRODUCTS | 12,562.00 | 12,716.67 | 13,576.22 | 12,626.61 | 51,481.50 |
L01D | CYTOTOXIC ANTIBIOTICS AND RELATED SUBSTANCES | 7,025.44 | 7,116.76 | 7,178.25 | 7,397.84 | 28,718.29 |
L01X | OTHER ANTINEOPLASTIC AGENTS | 362,382.58 | 389,418.13 | 406,523.54 | 442,041.28 | 1,600,365.53 |
L02A | HORMONES AND RELATED AGENTS - ENDOCRINE THERAPY | 10,275.74 | 10,720.07 | 11,012.86 | 11,382.15 | 43,390.82 |
L02B | HORMONE ANTAGONISTS AND RELATED AGENTS - ENDOCRINE THERAPY | 11,351.48 | 11,547.74 | 12,127.16 | 12,986.97 | 48,013.35 |
L03A | IMMUNOSTIMULANTS | 41,624.15 | 45,924.45 | 45,662.66 | 46,306.94 | 179,518.20 |
L04A | IMMUNOSUPPRESSANTS | 155,486.02 | 152,806.84 | 153,855.76 | 166,134.10 | 628,282.72 |
M | MUSCULO-SKELETAL SYSTEM | 257,585.40 | ||||
M01A | ANTIINFLAMMATORY AND ANTIRHEUMATIC PRODUCTS, NON-STEROIDS | 22,829.26 | 20,425.04 | 20,773.87 | 23,265.65 | 87,293.82 |
M01C | SPECIFIC ANTIRHEUMATIC AGENTS | 120.47 | 126.46 | 78.87 | 162.76 | 488.56 |
M02A | TOPICAL PRODUCTS FOR JOINT AND MUSCULAR PAIN | 319.90 | 316.54 | 343.08 | 286.55 | 1,266.07 |
M03A | MUSCLE RELAXANTS, PERIPHERALLY ACTING AGENTS | 1,416.65 | 1,326.05 | 1,365.97 | 1,391.48 | 5,500.15 |
M03B | MUSCLE RELAXANTS, CENTRALLY ACTING AGENTS | 740.15 | 613.31 | 543.30 | 529.89 | 2,426.65 |
M04A | ANTIGOUT PREPARATIONS | 1,878.01 | 1,892.91 | 1,922.49 | 1,948.35 | 7,641.76 |
M05B | DRUGS AFFECTING BONE STRUCTURE AND MINERALIZATION | 5,388.18 | 5,216.86 | 5,269.23 | 5,468.31 | 21,342.58 |
M09A | OTHER DRUGS FOR DISORDERS OF THE MUSCULO-SKELETAL SYSTEM | 34,882.71 | 28,739.15 | 28,977.57 | 39,026.38 | 131,625.81 |
N | NERVOUS SYSTEM | 1,083,805.42 | ||||
N01A | ANESTHETICS, GENERAL | 5,515.65 | 5,378.66 | 5,300.60 | 5,562.49 | 21,757.40 |
N01B | ANESTHETICS, LOCAL | 1,770.38 | 1,704.89 | 1,705.29 | 1,838.71 | 7,019.27 |
N02A | OPIOIDS | 11,096.90 | 11,996.13 | 12,380.29 | 12,338.17 | 47,811.49 |
N02B | OTHER ANALGESICS AND ANTIPYRETICS | 9,255.01 | 7,312.32 | 7,771.82 | 7,495.72 | 31,834.87 |
N02C | ANTIMIGRAINE PREPARATIONS | 437.71 | 455.86 | 469.35 | 516.12 | 1,879.04 |
N03A | ANTIEPILEPTICS | 21,328.77 | 21,516.32 | 20,824.66 | 20,539.16 | 84,208.91 |
N04A | ANTICHOLINERGIC AGENTS - ANTI-PARKINSON DRUGS | 1,992.09 | 1,969.13 | 2,001.21 | 2,058.84 | 8,021.27 |
N04B | DOPAMINERGIC AGENTS - ANTI-PARKINSON DRUGS | 48,332.58 | 48,924.38 | 50,064.23 | 53,352.18 | 200,673.37 |
N05A | ANTIPSYCHOTICS | 52,670.78 | 53,118.49 | 53,002.03 | 55,572.78 | 214,364.08 |
N05B | ANXIOLYTICS | 2,705.84 | 2,668.67 | 2,563.72 | 2,606.39 | 10,544.62 |
N05C | HYPNOTICS AND SEDATIVES | 2,314.83 | 2,554.96 | 2,763.84 | 2,863.29 | 10,496.92 |
N06A | ANTIDEPRESSANTS | 22,048.89 | 22,341.16 | 22,399.22 | 23,891.41 | 90,680.68 |
N06B | PSYCHOSTIMULANTS, AGENTS USED FOR ADHD AND NOOTROPICS | 32,338.14 | 32,562.10 | 31,749.38 | 32,113.76 | 128,763.38 |
N06D | ANTI-DEMENTIA DRUGS | 22,425.16 | 22,757.29 | 23,269.37 | 24,352.99 | 92,804.81 |
N07A | PARASYMPATHOMIMETICS | 647.44 | 638.26 | 615.95 | 700.67 | 2,602.32 |
N07B | DRUGS USED IN ADDICTIVE DISORDERS | 498.71 | 483.76 | 366.63 | 544.75 | 1,893.85 |
N07C | ANTIVERTIGO PREPARATIONS | 14,843.74 | 15,259.44 | 15,823.31 | 16,198.96 | 62,125.45 |
N07X | OTHER NERVOUS SYSTEM DRUGS | 16,195.12 | 16,491.62 | 16,792.09 | 16,844.16 | 66,322.99 |
NEAL | 0.20 | 0.50 | 0.70 | |||
P | ANTIPARASITIC PRODUCTS, INSECTICIDES AND REPELLENTS | 8,889.94 | ||||
P01A | AGENTS AGAINST AMOEBIASIS AND OTHER PROTOZOAL DISEASES | 33.84 | 40.88 | 43.72 | 40.05 | 158.49 |
P01B | ANTIMALARIALS | 652.86 | 664.15 | 653.85 | 738.49 | 2,709.35 |
P02C | ANTINEMATODAL AGENTS - ANTHELMINTICS | 1,550.72 | 1,376.59 | 1,549.57 | 1,539.26 | 6,016.14 |
P03A | ECTOPARASITICIDES, INCL. SCABICIDES | 1.87 | 1.39 | 1.86 | 0.84 | 5.96 |
R | RESPIRATORY SYSTEM | 325,011.66 | ||||
R01A | DECONGESTANTS AND OTHER NASAL PREPARATIONS FOR TOPICAL USE | 7,426.96 | 6,443.72 | 6,688.06 | 10,098.12 | 30,656.86 |
R01B | NASAL DECONGESTANTS FOR SYSTEMIC USE | 109.69 | 82.52 | 86.44 | 105.37 | 384.02 |
R02A | THROAT PREPARATIONS | 66.00 | 39.84 | 33.28 | 54.84 | 193.96 |
R03A | ADRENERGICS, INHALANTS | 34,004.53 | 34,245.02 | 33,441.93 | 33,792.28 | 135,483.76 |
R03B | OTHER DRUGS FOR OBSTRUCTIVE AIRWAY DISEASES, INHALANTS | 9,318.40 | 9,303.03 | 9,042.00 | 9,772.20 | 37,435.63 |
R03C | ADRENERGICS FOR SYSTEMIC USE | 163.02 | 115.81 | 99.92 | 104.58 | 483.33 |
R03D | OTHER SYSTEMIC DRUGS FOR OBSTRUCTIVE AIRWAY DISEASES | 14,136.01 | 8,292.37 | 9,036.35 | 9,466.61 | 40,931.34 |
R05C | EXPECTORANTS, EXCL. COMBINATIONS WITH COUGH SUPPRESSANTS | 11,888.51 | 9,314.20 | 8,123.03 | 12,222.45 | 41,548.19 |
R05D | COUGH SUPPRESSANTS, EXCL. COMBINATIONS WITH EXPECTORANTS | 2,391.03 | 1,687.52 | 1,363.62 | 2,458.63 | 7,900.80 |
R05F | COUGH SUPPRESSANTS AND EXPECTORANTS, COMBINATIONS | 39.63 | 27.66 | 18.79 | 41.53 | 127.61 |
R05X | OTHER COLD PREPARATIONS | 0.02 | 0.63 | 0.65 | ||
R06A | ANTIHISTAMINES FOR SYSTEMIC USE | 7,013.22 | 6,798.65 | 6,215.33 | 7,338.38 | 27,365.58 |
R07A | OTHER RESPIRATORY SYSTEM PRODUCTS | 575.36 | 606.42 | 717.28 | 600.87 | 2,499.93 |
S | SENSORY ORGANS | 121,337.84 | ||||
S01A | ANTIINFECTIVES | 378.39 | 382.80 | 329.91 | 380.14 | 1,471.24 |
S01B | ANTIINFLAMMATORY AGENTS | 58.87 | 54.81 | 54.12 | 56.80 | 224.60 |
S01C | ANTIINFLAMMATORY AGENTS AND ANTIINFECTIVES IN COMBINATION | 1,584.84 | 1,375.23 | 1,244.43 | 1,636.92 | 5,841.42 |
S01E | ANTIGLAUCOMA PREPARATIONS AND MIOTICS | 28,597.13 | 28,424.49 | 27,980.27 | 27,656.16 | 112,658.05 |
S01F | MYDRIATICS AND CYCLOPLEGICS | 53.09 | 52.60 | 52.41 | 63.50 | 221.60 |
S01G | DECONGESTANTS AND ANTIALLERGICS | 65.92 | 97.22 | 118.88 | 56.77 | 338.79 |
S01H | LOCAL ANESTHETICS | 23.00 | 21.88 | 23.14 | 28.84 | 96.86 |
S01L | OCULAR VASCULAR DISORDER AGENTS | 21.62 | 8.18 | 7.91 | 2.73 | 40.44 |
S01X | OTHER OPHTHALMOLOGICALS | 30.77 | 30.59 | 22.65 | 29.05 | 113.06 |
S02C | CORTICOSTEROIDS AND ANTIINFECTIVES IN COMBINATION | 79.56 | 70.64 | 56.41 | 66.54 | 273.15 |
S02D | OTHER OTOLOGICALS | 2.55 | 1.74 | 1.48 | 3.06 | 8.83 |
S03A | ANTIINFECTIVES - OPHTHALMOLOGICAL AND OTOLOGICAL PREPARATIONS | 13.16 | 12.47 | 11.93 | 12.24 | 49.80 |
V | VARIOUS | 87,512.24 | ||||
V01A | ALLERGENS | 0.03 | 0.01 | 0.04 | ||
V03A | ALL OTHER THERAPEUTIC PRODUCTS | 8,131.01 | 7,332.18 | 8,050.82 | 9,139.57 | 32,653.58 |
V04C | OTHER DIAGNOSTIC AGENTS | 85.79 | 45.99 | 71.83 | 121.85 | 325.46 |
V06D | OTHER NUTRIENTS | 4,740.40 | 4,780.78 | 4,931.84 | 5,236.48 | 19,689.50 |
V07A | ALL OTHER NON-THERAPEUTIC PRODUCTS | 213.14 | 230.87 | 217.22 | 237.70 | 898.93 |
V08A | X-RAY CONTRAST MEDIA, IODINATED | 6,507.39 | 6,984.70 | 6,820.60 | 7,419.17 | 27,731.86 |
V08B | X-RAY CONTRAST MEDIA, NON-IODINATED | 39.92 | 31.47 | 32.44 | 32.82 | 136.65 |
V08C | MAGNETIC RESONANCE IMAGING CONTRAST MEDIA | 776.63 | 866.78 | 871.69 | 1,067.97 | 3,583.07 |
V08D | ULTRASOUND CONTRAST MEDIA | 124.95 | 148.18 | 130.87 | 174.14 | 578.14 |
V09F | THYROID - DIAGNOSTIC RADIOPHARMACEUTICALS | 8.39 | 7.83 | 6.73 | 0.34 | 23.29 |
V10X | OTHER THERAPEUTIC RADIOPHARMACEUTICALS | 475.39 | 478.79 | 327.15 | 610.39 | 1,891.72 |
X | 21.86 | |||||
XNMC | 0.00 | |||||
XRNI | 6.48 | 0.01 | 0.01 | 5.83 | 12.33 | |
Y03V | 0.84 | 4.18 | 4.51 | 9.53 | ||
* site CNAS | ** site WHO Collaborating Centre for Drug Statistics Methodology: https://www.whocc.no/atc_ddd_index - (marcat in albastru - cod ATC, nivel 2) |
Studiind acest tabel, putem trage concluzia că am realizat progrese semnificative în ultimii 25 de ani, dar mai sunt multe de făcut. Sunt destule de comentat pe câteva dimensiuni de analiză, dar înțelegi prioritățile adoptate de statul român pentru tratamentul medicamentos al bolilor.
Să fim sănătoși!
Mă concentrez pe farmacistul de comunitate, respectiv farmacia de comunitate. Nu trebuie să reinventăm roata. Doar sa ne uităm mai la Vest de noi și să înțelegem ce au făcut alții în ultima sută de ani. O să-mi permit să enumăr câteva probleme la care trebuie găsită o rezolvare cât mai rapidă.
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