E-drug: Correct use of antiretrovirals (cont'd)
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Hi all,
Hilbrand raised a concern about access to appropriate guidelines on
ART for developing country settings - while the following does not
completely address his very good question about "What will we do
to control poor sales practices from ARV manufacturers", it is
perhaps worth bringing to readers' attention.
The South African private sector has been faced with a similar
challenge, with the third party payers (medical aid schemes in local
terminology; analagous perhaps to health insurers or sick funds in
other settings) being faced with claims for inappropriate single or
double-drug therapies. The medical aid administrators
(intermediaries between the providers and the schemes) have
responded with disease management programmes to assist
clinicians in making appropriate therapy and management choices.
One of these is the Aid for AIDS programme operated by
Medscheme. They have produced a concise set of guidelines, which
are also available on the web at
http://www.aidforaids.co.za/ClinicalGuidelines/introduction.html
(this page will then show links to the various parts of the
document, for both adult and paediatric cases)
A PDF version can be downloaded at
http://www.aidforaids.co.za/PublicationsStore/Clinical_Guidelines_2
002-A5.PDF (repair URL if necessary)
To return to Hilbrand's question - while a measure such as a
disease management programme can be used to guide practice for
those patients whose care is covered by insurance, something else
is needed to control selling practices to cash patients - who are
particularly vulnerable. Education is certainly part of the answer
(and is being used in this country by the medical association and
partners), but is probably not sufficient.
regards
Andy
Andy Gray MSc(Pharm) FPS
Senior Lecturer
Dept of Experimental and Clinical Pharmacology
Nelson R Mandela School of Medicine
University of Natal
PBag 7 Congella 4013
South Africa
Tel: +27-31-2604334/4298 Fax: +27-31-2604338
email: graya1@nu.ac.za or andy@gray.za.net
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