E-drug: Drug Expenditure Breakdown - Palau
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Dear E-Druggers,
As a start in the formulation of a National Drug Policy for the Republic
of Palau (Micronesia, population 17,000) I have analysed the expenditure
by the Ministry of Health on Pharmaceuticals for the last twelve months
to see where our resources are being spent. I have grouped these along
the headings used by the BNF and the breakdown of expenditure is as
follows:
Antiinfectives 36.47%
Cardiovascular 12.78%
Respiratory 11.44%
Nutrition 7.08%
Behavioral Health 6.93%
Analgesics/CNS 5.97%
Endocrine 5.13%
Skin 4.31%
Blood Modifiers 3.56%
Gastrointestinal 1.25%
Anaesthesia 1.20%
Disinfectants 1.10%
Ob/Gyn UT 0.84%
Eye 0.80%
ENT 0.78%
Radiopaque 0.23%
Antidotes 0.14%
As can be seen we spend a significant proportion of our drug budget on
Antiinfectives. This figure is closer to 40% if topical antiinfectives
were included here and even higher if TB drugs were included also
(presently obtained through WHO). In fact two drugs Ceftriaxone and
Ciprofloxacin consume 8.35% and 6% of the total budget respectively.
For cardiovascular drugs, the majority of this (80%) is spent on a long
acting ACE inhibitor (Fosinopril) and the calcium channel blocker
Diltiazem (in a twice a day formulation).
The top 20 drugs (by expenditure) of a total of 380 items stocked by the
Pharmacy consume 49% of the drug budget.
For comparison purposes I would be grateful if I could be provided with
figures for other countries (both developing and developed) to help
identify area that we may overspend and under spend in. Any comments or
observations are more than welcome and more detailed figures by
individual drugs can be provided on request.
With thanks
Richard Duncan (Australian Volunteer Abroad)
Chief Pharmacist
Ministry of Health
P.O.Box 6027
Koror PW 96940
Republic of Palau
phone/fax (680) 488 2552/1211
email: pharmacy@palaunet.com
[dear Richard, quite a challange to procure drugs on a small island!
To judge your ABC analysis, we need to know a bit more on the health/
disease pattern on Palau. And: what kind of Treatment Guidelines or
Formulary are the prescribers on Palau using? WB]
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