scholarly journals Prices of medicines for the management of pain, diabetes and cardiovascular diseases in private pharmacies and the national health insurance in Tanzania

2020 ◽  
Vol 19 (1) ◽  
Author(s):  
Rashid Bakari Kirua ◽  
Mary Justin Temu ◽  
Amani Thomas Mori
Keyword(s):  
Health Insurance ◽  
Cardiovascular Diseases ◽  
National Health Insurance ◽  
National Health ◽  
Essential Medicines ◽  
High Price ◽  
Sign Test ◽  
Insurance Fund ◽  
Reference Prices ◽  
Significant Difference

Abstract Background High price is a major challenge limiting access to essential medicines especially among the poorest families in developing countries. The study aims to compare the prices of medicines used in the management of pain, diabetes, and cardiovascular diseases in private pharmacies and the National Health Insurance Fund (NHIF) in Tanzania. Pharmacy prices were also compared with the prices of medicines surveyed nationally by WHO/HAI in 2012. Method This cross-sectional study was conducted in Dar es Salaam, Morogoro, Dodoma, and Kilimanjaro regions from February to April 2015. Data were collected from 33 private pharmacies, NHIF and, the HAI database. The study used the WHO/HAI methodology. The analysis was done using non-parametric Kruskal-Wallis and post-hoc pair-wise comparison Dunn test, while a possible change in prices between our survey and 2012 WHO/HAI national survey data was tested using a Sign test in Stata version 16.1. Results Twenty-eight essential medicines, of which 9 are used for management of pain, 7 for diabetes, and 12 for cardiovascular diseases were analyzed. There was a significant difference in the mean pharmacy prices of some medicines between the regions and between the pharmacies and NHIF reference prices. NHIF reference prices were higher than the pharmacy prices for 16 of the 28 medicines. There was a significant increase in the prices of 5 out of the 8 medicines that were also nationally surveyed by the WHO/HAI in 2012. Conclusion The study found that medicine prices in private pharmacies vary a lot between the study regions, which raises equity concerns. Also, there was a significant difference between the pharmacy and the NHIF reimbursement prices, which may expose patients to fraudulent co-payments or hinder timely access to prescribed medicines. Therefore, effective price control policies and regulations for medicines are warranted in Tanzania.

Lipid-lowering therapy and patient adherence in the MULTI GAP 2013 trial

2014 ◽  
Vol 155 (17) ◽  
pp. 669-675
Author(s):  
Gábor Simonyi
Keyword(s):  
Health Insurance ◽  
National Health Insurance ◽  
National Health ◽  
Ldl Cholesterol ◽  
Patient Adherence ◽  
Lipid Lowering ◽  
Insurance Fund ◽  
Lipid Lowering Therapy ◽  
Health Insurance Fund ◽  
National Health Insurance Fund

Introduction: Dyslipidemia is a well-known cardiovascular risk factor. To achieve lipid targets patient adherence is a particularly important issue. Aim: To assess adherence and persistence to statin therapy in patients with atherosclerotic disease who participated in the MULTI Goal Attainment Problem 2013 (MULTI GAP 2013) study. Patient adherence was assessed using estimation by the physicians in charge and analysis of pick up rate of prescribed statins in 319 patients based on data of National Health Insurance Fund Administration of Hungary. Method: In the MULTI GAP 2013 study, data from standard and structured questionnaires of 1519 patients were processed. Serum lipid values of patients treated by different healthcare professionals (general practitioners, cardiologists, diabetologists, neurologists, and internists), treatment adherence of patients assessed by doctors and treatment adherence based on data of National Health Insurance Fund Administration of Hungary were analysed. Satisfaction of doctors with results of statin therapy and the relationship between the level of adherence and serum lipid values were also evaluated. Results: Considering the last seven years of survey data, the use of more effective statins became more prevalent with an about 70% increase of prescriptions of atorvastatin and rosuvastatin from 49% to 83%. Patients with LDL-cholesterol level below 2.5 mmol/l had 8 prescriptions per year. In contrast, patients who had LDL-cholesterol levels above 2.5 mmol/l had only 5.3–6.3 prescriptions per year. Patients who picked up their statins 10–12 or 7–9 times per year had significantly lower LDL-cholesterol level than those who had no or 1–3 pick up. The 100% persistence assessed by doctors was significantly lower (74%) based on data from the National Health Insurance Fund Administration of Hungary. About half of the patients were considered to display 100% adherence to lipid-lowering therapy by their doctors, while data from the National Health Insurance Fund Administration of Hungary showed only 36%. In patients with better adherence (90–100%) LDL-cholesterol levels below 2.5 mmol/l were more frequent (59.5%) compared to those with worse adherence. Satisfaction of doctors with lipid targets achieved was 69–80% in patients with total cholesterol between 4.5 and 6 mmol/l, and satisfaction with higher cholesterol values was also high (53–54%). Conclusions: The results show that doctors may overestimate patient adherence to lipid-lowering treatment. Based on data from the National Health Insurance Fund Administration of Hungary, satisfaction of doctors with high lipid level appears to be high. There is a need to optimize not only patient adherence, but adherence of doctors to lipid guidelines too.

scholarly journals Szociális ellátások a társadalombiztosítási családtámogatás rendszerében

2019 ◽  
Vol 160 (Supplement 1) ◽  
pp. 43-48
Author(s):  
Ivett Szombati
Keyword(s):  
Health Insurance ◽  
Child Care ◽  
Labour Market ◽  
National Health Insurance ◽  
National Health ◽  
Financial Support ◽  
Family Policy ◽  
Insurance Fund ◽  
Health Insurance Fund ◽  
The Social

Introduction and aim: In my study, analysing the data available from the change of the regime to the present day, from among the social services, I examine the changes of the financial support relating to children and its parts which are currently financed from the budget of the National Health Insurance Fund of Hungary, with special emphasis on the Child Care Benefit and the Child Care Allowance and their modifications. Data and methods: Within the framework of our research, we analyze – through data from the National Health Insurance Fund of Hungary, the Hungarian Central Statistical Office, the Organisation for Economic Co-operation and Development (OECD) and the Hungarian State Treasury as well as on the basis of literature review – the social financial support and its changes, within the family policy system. Results: Hungarian family policy is still driven by the attitude of staying at home for three years with the child. The long period spent at home with the children fundamentally affects the adjustment of mothers to the labour market which has a direct effect on the economic productivity. Even though according to the current regulations, mothers are allowed to work full-time besides receiving child care allowance after their child fills 6 months, part-time employment and telework is still in its infancy compared to the Western-European countries. Based on our research, high percentage of families go for the child care benefit directly after the birth of the child thus not participating in the labour market processes. Besides if they do participate, the percentage of employment on minimal wage is still very high which means that in 2016–2017 36% of families with two breadwinners and two children were forced to survive on subsistence income. Conclusion: In the examined period, we found that social and family policy changes unfortunately were not able to react sufficiently to the demographic challenges despite Hungary spending significantly more on family policy than other European and OECD countries. Orv Hetil. 2019; 160(Suppl 1): 43–48.

scholarly journals A cukorbeteg-ellátás mutatóinak alakulása Magyarországon 2001–2014 között. Az Országos Egészségbiztosítási Pénztár adatbázis-elemzésének célja és módszertana

2016 ◽  
Vol 157 (32) ◽  
pp. 1259-1265 ◽  
Author(s):  
György Jermendy ◽  
Péter Kempler ◽  
Zsolt Abonyi-Tóth ◽  
György Rokszin ◽  
István Wittmann
Keyword(s):  
Health Insurance ◽  
National Health Insurance ◽  
National Health ◽  
Insurance Fund ◽  
Health Insurance Fund ◽  
Database Analysis ◽  
National Health Insurance Fund ◽  
Antidiabetic Treatment ◽  
Outpatient Departments ◽  
Central Database

In the last couple of years, database analyses have become increasingly popular among clinical-epidemiological investigations. In Hungary, the National Health Insurance Fund serves as central database of all medical attendances in state departments and purchases of drug prescriptions in pharmacies. Data from in- and outpatient departments as well as those from pharmacies are regularly collected in this database which is public and accessible on request. The aim of this retrospective study was to investigate the database of the National Health Insurance Fund in order to analyze the diabetes-associated morbidity and mortality in the period of years 2001–2014. Moreover, data of therapeutic costs, features of hospitalizations and practice of antidiabetic treatment were examined. The authors report now on the method of the database analysis. It is to be hoped that the upcoming results of this investigation will add some new data to recent knowledge about diabetes care in Hungary. Orv. Hetil., 2016, 157(32), 1259–1265.

scholarly journals Analysis of the Household and Health Care System Expenditures in Bulgaria

2021 ◽  
Vol 9 ◽  
Author(s):  
Zornitsa Mitkova ◽  
Guenka Petrova
Keyword(s):  
Health Care ◽  
Health Insurance ◽  
National Health Insurance ◽  
National Health ◽  
Medical Devices ◽  
Cost Containment ◽  
Insurance Fund ◽  
Budget Analysis ◽  
Containment Measures ◽  
Regulatory Analysis

Health care systems worldwide are experiencing tremendous financial pressure because of the introduction of new targeted health technologies and medicines. This study aims to analyze and compare public and household healthcare expenditures in Bulgaria during the period 2015–2019, as well as present the major cost-containment measures implied by the government and their probable influence on the overall health care cost. Regulatory analysis of the endorsed cost-containment measures, budget analysis of public and household health care expenditures, and their extrapolations were performed. The regulatory analysis reveals that a large number of measures are introduced and valid until January 2021, considering pharmaceuticals, medical devices, and negotiations between the National Health Insurance Fund (NHIF) and Marketing authorization holders (MAHs). NHIF costs due to pharmaceuticals, food supplements, and medical devices are rising from 2015 to 2019. The overall health expenditures average per household and the average per person also grow in this period. The cost extrapolation reveals that an increase in 3-year periods is expected. Despite the implementation of variety of cost-containment measures in Bulgaria, such as HTA, ERP, discounts, and annual negotiations, The National Health Insurance Fund's (NHIF) spending on pharmaceuticals continues to rise in recent years, and further increases are expected in the next 3 years. The average expenditure per household and per person also increased, which confirms the global trend of rising medicine and outpatient services value.

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