Consumul de medicamente în anul 2019

Data: 09/06/2021
cogito

Farm. pr. Marian Pană
 

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 costvolum/costvolumrezultat, 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!

Asist. univ. dr. Georgiana Nițulescu
amfiteatru

Obiective

Parcurgerea acestui material vă va răspunde următoarelor întrebări:

- Ce sunt nutricosmeticele?
- Cum acționează acestea? Există studii care să dovedească acțiunea lor?
- Au nutricosmeticele reacții adverse și/sau contraindicații?

permițându-vă astfel să oferiți o consiliere optimă pacienților.

...
univers farmaceutic
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