Towards the rational use of medicines

Rational use of medicines is 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 medicine procurement in order to manage budget expenditures on medicines in a multidisciplinary health facility for the period of 2011-2014.

ABC/VEN analysis is a simple and effective method of analyzing 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 an expert method," says 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 in a multidisciplinary health facility with over 1000 beds (an average number of beds over three years), which is responsible for provision of care to a population of about 1.4 million people.

Educational intervention included detailed discussion of the results of the ABC/VEN analysis for the years 2011-2012 from the standpoint of evidence-based pharmacology, recommendations for medicine procurement and training workshops for the heads of clinical departments on evidence-based principles in clinical pharmacology, and rational use of medicines; the results were significant. Medicine expenditures for the year 2014 were less than for the year 2013, reversing the previous trend of increasing medicines expenditures over the preceding three years. However, Prof. Ziganshina adds, "Regular educational interventions for practicing physicians and heads of clinical departments of health facilities that promote rational prescribing are needed."