Purchase and use of antimicrobials in the hospital sector of Vietnam, a lower middle-income country with an emerging pharmaceuticals market
<p><strong>Introduction</strong></p> Antimicrobial use is associated with emergence of antimicrobial resistance. We report hospital antimicrobial procurement, as a surrogate for consumption in humans, expenditure and prices in public hospitals in Vietnam, a lower middle-incom...
| প্রধান লেখক: | , , , , |
|---|---|
| বিন্যাস: | Journal article |
| ভাষা: | English |
| প্রকাশিত: |
Public Library of Science
2020
|
| _version_ | 1826269718932094976 |
|---|---|
| author | Dat, VQ Toan, PK van Doorn, HR Thwaites, CL Nadjm, B |
| author_facet | Dat, VQ Toan, PK van Doorn, HR Thwaites, CL Nadjm, B |
| author_sort | Dat, VQ |
| collection | OXFORD |
| description | <p><strong>Introduction</strong></p>
Antimicrobial use is associated with emergence of antimicrobial resistance. We report hospital antimicrobial procurement, as a surrogate for consumption in humans, expenditure and prices in public hospitals in Vietnam, a lower middle-income country with a high burden of drug resistant infections.
<p><strong>Method</strong></p>
Data on antimicrobial procurement were obtained from tender-winning bids from provincial health authorities and public hospitals with detailed bids representing 28.7% (1.68 / 5.85 billion US $) of total hospital medication spend in Vietnam. Antimicrobials were classified using the Anatomical Therapeutic Chemical (ATC) Index and the 2019 WHO Access, Watch, Reserve (AWaRe) groups. Volume was measured in number of Defined Daily Doses (DDD). Antimicrobial prices were presented per DDD.
<p><strong>Results</strong></p>
Expenditure on systemic antibacterials and antifungals accounted for 28.6% (US $482.6 million/US $1.68 billion) of the total drug bids. 83% of antibacterials (572,698,014 DDDs) by volume (accounting for 45.5% of the antibacterials spend) were domestically supplied. Overall, the most procured antibacterials by DDD were second generation cephalosporins, combinations of penicillins and beta-lactamase inhibitors, and penicillins with extended spectrum. For parenteral antibacterials this was third generation cephalosporins. The average price for antibacterials was US $15.6, US $0.86, US $0.4 and US $11.7 per DDD for Reserve, Watch, Access and non-recommended/unclassified group antibacterials, respectively.
<p><strong>Conclusions</strong></p>
Antimicrobials accounted for a substantial proportion of the funds spent for medication in public hospitals in Vietnam. The pattern of antibacterial consumption was similar to other countries. The high prices of Reserve group and non-recommended/unclassified antibacterials suggests a need for a combination of national pricing and antimicrobial stewardship policies to ensure appropriate accessibility. |
| first_indexed | 2024-03-06T21:29:30Z |
| format | Journal article |
| id | oxford-uuid:4430a671-b325-4f4c-9db9-4ff92d552461 |
| institution | University of Oxford |
| language | English |
| last_indexed | 2024-03-06T21:29:30Z |
| publishDate | 2020 |
| publisher | Public Library of Science |
| record_format | dspace |
| spelling | oxford-uuid:4430a671-b325-4f4c-9db9-4ff92d5524612022-03-26T15:00:09ZPurchase and use of antimicrobials in the hospital sector of Vietnam, a lower middle-income country with an emerging pharmaceuticals marketJournal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:4430a671-b325-4f4c-9db9-4ff92d552461EnglishSymplectic ElementsPublic Library of Science2020Dat, VQToan, PKvan Doorn, HRThwaites, CLNadjm, B<p><strong>Introduction</strong></p> Antimicrobial use is associated with emergence of antimicrobial resistance. We report hospital antimicrobial procurement, as a surrogate for consumption in humans, expenditure and prices in public hospitals in Vietnam, a lower middle-income country with a high burden of drug resistant infections. <p><strong>Method</strong></p> Data on antimicrobial procurement were obtained from tender-winning bids from provincial health authorities and public hospitals with detailed bids representing 28.7% (1.68 / 5.85 billion US $) of total hospital medication spend in Vietnam. Antimicrobials were classified using the Anatomical Therapeutic Chemical (ATC) Index and the 2019 WHO Access, Watch, Reserve (AWaRe) groups. Volume was measured in number of Defined Daily Doses (DDD). Antimicrobial prices were presented per DDD. <p><strong>Results</strong></p> Expenditure on systemic antibacterials and antifungals accounted for 28.6% (US $482.6 million/US $1.68 billion) of the total drug bids. 83% of antibacterials (572,698,014 DDDs) by volume (accounting for 45.5% of the antibacterials spend) were domestically supplied. Overall, the most procured antibacterials by DDD were second generation cephalosporins, combinations of penicillins and beta-lactamase inhibitors, and penicillins with extended spectrum. For parenteral antibacterials this was third generation cephalosporins. The average price for antibacterials was US $15.6, US $0.86, US $0.4 and US $11.7 per DDD for Reserve, Watch, Access and non-recommended/unclassified group antibacterials, respectively. <p><strong>Conclusions</strong></p> Antimicrobials accounted for a substantial proportion of the funds spent for medication in public hospitals in Vietnam. The pattern of antibacterial consumption was similar to other countries. The high prices of Reserve group and non-recommended/unclassified antibacterials suggests a need for a combination of national pricing and antimicrobial stewardship policies to ensure appropriate accessibility. |
| spellingShingle | Dat, VQ Toan, PK van Doorn, HR Thwaites, CL Nadjm, B Purchase and use of antimicrobials in the hospital sector of Vietnam, a lower middle-income country with an emerging pharmaceuticals market |
| title | Purchase and use of antimicrobials in the hospital sector of Vietnam, a lower middle-income country with an emerging pharmaceuticals market |
| title_full | Purchase and use of antimicrobials in the hospital sector of Vietnam, a lower middle-income country with an emerging pharmaceuticals market |
| title_fullStr | Purchase and use of antimicrobials in the hospital sector of Vietnam, a lower middle-income country with an emerging pharmaceuticals market |
| title_full_unstemmed | Purchase and use of antimicrobials in the hospital sector of Vietnam, a lower middle-income country with an emerging pharmaceuticals market |
| title_short | Purchase and use of antimicrobials in the hospital sector of Vietnam, a lower middle-income country with an emerging pharmaceuticals market |
| title_sort | purchase and use of antimicrobials in the hospital sector of vietnam a lower middle income country with an emerging pharmaceuticals market |
| work_keys_str_mv | AT datvq purchaseanduseofantimicrobialsinthehospitalsectorofvietnamalowermiddleincomecountrywithanemergingpharmaceuticalsmarket AT toanpk purchaseanduseofantimicrobialsinthehospitalsectorofvietnamalowermiddleincomecountrywithanemergingpharmaceuticalsmarket AT vandoornhr purchaseanduseofantimicrobialsinthehospitalsectorofvietnamalowermiddleincomecountrywithanemergingpharmaceuticalsmarket AT thwaitescl purchaseanduseofantimicrobialsinthehospitalsectorofvietnamalowermiddleincomecountrywithanemergingpharmaceuticalsmarket AT nadjmb purchaseanduseofantimicrobialsinthehospitalsectorofvietnamalowermiddleincomecountrywithanemergingpharmaceuticalsmarket |