Traceability of Pediatric Antibiotic Purchasing Pathways in Italy: A Nationwide Real-World Drug Utilization Analysis
PurposeThe aim of the present study was to describe the purchasing patterns of a set of antibiotics used exclusively in an out-patient pediatric setting in Italy using the Farma360 wholesale drug database (IQVIA Solutions Italy), identifying the proportion of medications which are not captured by It...
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| פורמט: | Article |
| שפה: | English |
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Frontiers Media S.A.
2020-08-01
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| סדרה: | Frontiers in Pharmacology |
| נושאים: | |
| גישה מקוונת: | https://www.frontiersin.org/article/10.3389/fphar.2020.01232/full |
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| author | Janet Sultana Gianluca Trifirò Valentina Ientile Andrea Fontana Francesco Rossi Francesco Rossi Annalisa Capuano Annalisa Capuano Carmen Ferrajolo Carmen Ferrajolo |
| author_facet | Janet Sultana Gianluca Trifirò Valentina Ientile Andrea Fontana Francesco Rossi Francesco Rossi Annalisa Capuano Annalisa Capuano Carmen Ferrajolo Carmen Ferrajolo |
| author_sort | Janet Sultana |
| collection | DOAJ |
| description | PurposeThe aim of the present study was to describe the purchasing patterns of a set of antibiotics used exclusively in an out-patient pediatric setting in Italy using the Farma360 wholesale drug database (IQVIA Solutions Italy), identifying the proportion of medications which are not captured by Italian National Health Service (NHS) pharmacy claims databases and examining the implications of such findings from a public health and pharmaceutical policy perspective.MethodsUsing a systematic approach, sixty-six antibiotic pediatric formulations were selected for the 5 most commonly used antibiotics in Italy in children and adolescents: amoxicillin in combination with clavulanic acid, amoxicillin, azithromycin, clarithromycin and cefixime. The Farma360 wholesale drug purchasing database was used to identify the yearly proportion of antibiotics not purchased based on NHS reimbursement in primary care from 2015–2017 at the national level. The relationship between product cost and purchase outside the NHS was assessed by a scatterplot. All analyses were stratified by geographic area: Northwest, Northeast, Central and Southern Italy.ResultsThe proportion of antibiotics not reimbursed by the NHS increased nationally from 24% in 2015 to 29% in 2017. The antibiotic with the highest proportion of purchases outside the NHS was amoxicillin, with almost two-thirds of all amoxicillin purchases in Southern Italy being made in this way in 2017. The relationship between antibiotic price and antibiotic purchase outside the NHS was almost linear for many geographic areas.ConclusionsThis study showed that a large proportion of antibiotics with a pediatric formulation is purchased outside the NHS drug purchasing pathway, especially in Southern Italy, indicating that it is not possible to fully monitor drug utilization, including appropriateness, for these antibiotics. A better strategy is needed to improve drug utilization monitoring, such as better data collection or data linkage. |
| first_indexed | 2024-04-13T23:10:42Z |
| format | Article |
| id | doaj.art-4c53b51a377f400f9d0113df13d6562b |
| institution | Directory Open Access Journal |
| issn | 1663-9812 |
| language | English |
| last_indexed | 2024-04-13T23:10:42Z |
| publishDate | 2020-08-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Pharmacology |
| spelling | doaj.art-4c53b51a377f400f9d0113df13d6562b2022-12-22T02:25:35ZengFrontiers Media S.A.Frontiers in Pharmacology1663-98122020-08-011110.3389/fphar.2020.01232551846Traceability of Pediatric Antibiotic Purchasing Pathways in Italy: A Nationwide Real-World Drug Utilization AnalysisJanet Sultana0Gianluca Trifirò1Valentina Ientile2Andrea Fontana3Francesco Rossi4Francesco Rossi5Annalisa Capuano6Annalisa Capuano7Carmen Ferrajolo8Carmen Ferrajolo9Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Messina, ItalyDepartment of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Messina, ItalyDepartment of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Messina, ItalyIstituti di Ricovero e Cura a Carattere Scientifico Casa Sollievo della Sofferenza, San Giovanni Rotondo, ItalyDepartment of Clinical and Experimental Medicine, University of Campania “L. Vanvitelli”, Naples, ItalyCampania Regional Centre for Pharmacovigilance, Naples, ItalyDepartment of Clinical and Experimental Medicine, University of Campania “L. Vanvitelli”, Naples, ItalyCampania Regional Centre for Pharmacovigilance, Naples, ItalyDepartment of Clinical and Experimental Medicine, University of Campania “L. Vanvitelli”, Naples, ItalyCampania Regional Centre for Pharmacovigilance, Naples, ItalyPurposeThe aim of the present study was to describe the purchasing patterns of a set of antibiotics used exclusively in an out-patient pediatric setting in Italy using the Farma360 wholesale drug database (IQVIA Solutions Italy), identifying the proportion of medications which are not captured by Italian National Health Service (NHS) pharmacy claims databases and examining the implications of such findings from a public health and pharmaceutical policy perspective.MethodsUsing a systematic approach, sixty-six antibiotic pediatric formulations were selected for the 5 most commonly used antibiotics in Italy in children and adolescents: amoxicillin in combination with clavulanic acid, amoxicillin, azithromycin, clarithromycin and cefixime. The Farma360 wholesale drug purchasing database was used to identify the yearly proportion of antibiotics not purchased based on NHS reimbursement in primary care from 2015–2017 at the national level. The relationship between product cost and purchase outside the NHS was assessed by a scatterplot. All analyses were stratified by geographic area: Northwest, Northeast, Central and Southern Italy.ResultsThe proportion of antibiotics not reimbursed by the NHS increased nationally from 24% in 2015 to 29% in 2017. The antibiotic with the highest proportion of purchases outside the NHS was amoxicillin, with almost two-thirds of all amoxicillin purchases in Southern Italy being made in this way in 2017. The relationship between antibiotic price and antibiotic purchase outside the NHS was almost linear for many geographic areas.ConclusionsThis study showed that a large proportion of antibiotics with a pediatric formulation is purchased outside the NHS drug purchasing pathway, especially in Southern Italy, indicating that it is not possible to fully monitor drug utilization, including appropriateness, for these antibiotics. A better strategy is needed to improve drug utilization monitoring, such as better data collection or data linkage.https://www.frontiersin.org/article/10.3389/fphar.2020.01232/fullantibioticspediatricself-medicationobservational studyItaly |
| spellingShingle | Janet Sultana Gianluca Trifirò Valentina Ientile Andrea Fontana Francesco Rossi Francesco Rossi Annalisa Capuano Annalisa Capuano Carmen Ferrajolo Carmen Ferrajolo Traceability of Pediatric Antibiotic Purchasing Pathways in Italy: A Nationwide Real-World Drug Utilization Analysis Frontiers in Pharmacology antibiotics pediatric self-medication observational study Italy |
| title | Traceability of Pediatric Antibiotic Purchasing Pathways in Italy: A Nationwide Real-World Drug Utilization Analysis |
| title_full | Traceability of Pediatric Antibiotic Purchasing Pathways in Italy: A Nationwide Real-World Drug Utilization Analysis |
| title_fullStr | Traceability of Pediatric Antibiotic Purchasing Pathways in Italy: A Nationwide Real-World Drug Utilization Analysis |
| title_full_unstemmed | Traceability of Pediatric Antibiotic Purchasing Pathways in Italy: A Nationwide Real-World Drug Utilization Analysis |
| title_short | Traceability of Pediatric Antibiotic Purchasing Pathways in Italy: A Nationwide Real-World Drug Utilization Analysis |
| title_sort | traceability of pediatric antibiotic purchasing pathways in italy a nationwide real world drug utilization analysis |
| topic | antibiotics pediatric self-medication observational study Italy |
| url | https://www.frontiersin.org/article/10.3389/fphar.2020.01232/full |
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