Pharmaceutical Drugs not Available in Argentina. A Perception Perspective

D. FONTANA; DIAZ, P; TOGNONI, G; MAZZIERI, MR

Congreso; XVII IEA World Congress of Epidemiology; 2008

Introduction: Orphan drug (OD) was one of the major non-availability problems faced officially in industrialized countries, being USA the pioneer. OD definition refers almost exclusively to drugs used for rare diseases. The restrictive scope leave out of consideration neglected diseases, orphan dosage form, ?off label? use of drugs, among others situations. We tried to find out the scope of the problem in Argentina considering every possible causes that lead to drug unavailability and also the partners involved: health professionals, sanitary authority and pharmaceutical industry. Pharmacoepidemiological approach were selected for conducting the research. Objective: To describe the perception of health professionals about situations related to medicine unavailability (MU). Methods: A cross-sectional descriptive study was carried out between March and November 2007. A semi-structured interviewer-administered questionnaire based on previous experience was designed. Stratified random sample used (n=1202). Physicians (P), nurses (N) and pharmacists (F) of public (PU) and private (PR) hospitals at Cordoba city (Argentina) were interviewed. Sociodemographic data and situations related with MU were requested. Descriptive statistical techniques and logistic regression analysis were performed to estimate odds ratios (OR) and 95% confidence intervals (CI) for covariates (STATA IX). Significantly association p<0.05 Results: From the 1202 interviews, 640 were from PU setting (P=299, N=307, F=34) and 562 from PR (P=308, N=245, F=9). Percentage of professionals that identified MU situations and the association were: a) Need for drugs that are not marketed in Argentina: PU%: P 40; N 14; F 50; PR%: P 39; N 10; F 33. Association: position (OR=0.40 BOSS baseline; CI=0.26-0.63); profession N (OR=0.23 F baseline; CI=0.11-0.46) b) Need to use orphan dosage forms: PU%: P 28; N 35; F 65; PR%: P 23; N 17; F 67. Association: hospital (OR=0.61 P baseline; CI=0.46-0.81); profession N (OR=0.27 F baseline; CI=0.14-0.54) and P (OR=0.33 F baseline; CI=0.16-0.65) c) Need to use off label drugs: PU%: P 24; N 6; F 32; PR%: P 19; N 2; F 22. Association: position (OR=0.38 BOSS baseline; CI=0.23-0.62); profession N (OR=0.13 F baseline; CI=0.06-0.30) Conclusion: Health professionals identified several situations related with MU and the designed questionnaire were useful to know the factors involved.