Información de la revista
Vol. 12. Núm. 1.
Páginas 39-49 (enero - febrero 1998)
Respuestas rápidas
Compartir
Compartir
Descargar PDF
Más opciones de artículo
Vol. 12. Núm. 1.
Páginas 39-49 (enero - febrero 1998)
Open Access
La regulación de los medicamentos: teoría y práctica
Visitas
6495
C. Zara Yahni1,*, L. Segú Tolsa2, M. Font Pous3, J. Rovira4
1 Consorci Sanitari de Barcelona
2 Consorci Hospitalari de Catalunya
3 Settore farmaceutico ulss 20
4 Institut Universitari de Salut Pública de Catalunya
Este artículo ha recibido

Under a Creative Commons license
Información del artículo
Resumen

La regulación de los medicamentos por parte de las administraciones públicas es una actividad que se produce en los países de manera independiente del modelo sanitario que posean. En el ámbito de la financiación pública de los medicamentos se han experimentado diversas medidas para mejorar la eficiencia en su utilización. Sin embargo, el análisis del impacto de estas medidas es complejo y quizá ello justifique la escasez de resultados objetivables, especialmente a largo plazo.

El objetivo de este trabajo es realizar una revisión sistemática de dichas medidas dada la necesidad de disponer de información sobre las distintas alternativas previo a la toma de decisión.

El planteamiento de una medida aislada es en muchas ocasiones compensada por cambios en otros ámbitos reguladores o asistenciales lo que aconseja una estrategia integral afectando a distintos ámbitos (oferta/demanda de medicamentos y prescriptores).

Parece necesario proponer un debate social a partir de la información científica de que se dispone y promover la toma de decisiones que conduzca a la utilización racional de los recursos farmacológicos disponibles.

Palabras clave:
Prescripción de medicamentos
Eficiencia
Financiación de medicamentos
Medidas reguladoras
Summary

Regulation of drugs from the public administration is an activity which is produced in different countries independently from the sanitary model they own. In the field of public financing of drugs there have been several measures to improve the efficiency of their use.

However, the analysis of the impact of these measures is complex and this may justify the shortage of objectivable results, especially at long term.

The objective of this study is to perform a systematic review of such measures due to the need to have information about the different alternatives before making a decision.

The introduction of an isolated measure is in many cases compensated by other changes in other regulating or aiding fields wich suggests the creation of an integral strategy which affects different fields (supply/demand of drugs and prescribers).

It seems necessary to suggest a social debate taking as a basis the scientific information available at the moment and promote the taking of decisions which lead to a rational use of the available pharmacological resources.

Key words:
Prescription of drugs
Efficiency
Financing of drugs
Regulating measures
El Texto completo está disponible en PDF
Bibliografía
[1.]
G.M. Shenfield, A.N. Jones, J.W. Paterson.
Effect of restrictions on prescribing patterns for dextropropoxyphene.
Br Med J, 281 (1980), pp. 651-653
[2.]
G.M. Anderson, W.O. Spitzer, M.C. Weinstein, E. Wang, J.L. Blackburn, U. Bergman.
Benefits, risks, and costs of prescription drugs: a scientific basic for evaluating policy options.
Clin Pharmacol Ther, 48 (1990), pp. 111-119
[3.]
S.B. Soumerai, D. Ross-Degnan, E.E. Fortess, J. Abelson.
A critical analysis of studies of state drug reimbursement policies: research in need of discipline.
The Milbank Quarterly, 71 (1993), pp. 217-252
[4.]
Ministerio de Sanidad y Consumo Orden de 6 de abril de 1996 por el que se desarrolla el Real Decreto 83/1993, de 22 de enero, que regula la sección de los medicamentos a efectos de su financiación por el Sistema Nacional de Salut.
[5.]
A. Catalán, N. Parrellada.
Financiación selectiva: ¿reduce la factura farmacéutica?.
XIV Jornadas de economía de la salud. Santiago de Compostela. Junio, (1994),
[6.]
W.J. Moore, R.J. Newman.
US Medicaid Drug formularies. Do they work?.
Pharmaco Economics, 1 (1992), pp. 28-31
[7.]
T. Smith.
Limited lists of drugs: Iessons from abroad.
Br Med J, 290 (1985), pp. 532-534
[8.]
C. Ferrando, M.C. Henman, O.I. Corrigan.
Impact of a nationwide limited prescribing list: preliminary findings.
Drug Intell Clin Pharm, 21 (1987), pp. 653-657
[9.]
Zara C. Seguiment d'una mesura de finançament selectiu de medicaments. Tesina mestratge en Farmacoepidemiologia. UAB. Barcelona; 1994.
[10.]
M. Torralba, N. Casals, M. Calero, R. Morera, J.L. Segú, M. López.
La prescripción farmacéutica en Cataluña tras el Decreto de financiación selectiva de medicamentos.
Gac Sanit, 10 (1996), pp. 183-190
[11.]
A. Marino, J.M. Marqués, A. Velasco.
Impact of selective financing of drugs on pharmaceutical expenditure control in the province of Valladolid, Spain.
PharmacoEconomics, 10 (1996), pp. 269-280
[12.]
B. Van Hout, F. Rutten.
Economic appraisal of health technology in the European Community.
Proceedings of a Canadian Collaborative workshop on pharmacoeconomics. Princeton (NI), pp. 8-13
[13.]
R.I. Ferguson, C.E. Salmond, T.J. Maling.
The Nelson Prescribing Project.
PharmacoEconomics, 7 (1995), pp. 555-560
[14.]
C.M. Kozma, C.E. Reeder, E.W. Lingle.
Expanding Medicaid drug formulary coverage.
Med Care, 28 (1990), pp. 963-977
[15.]
A. Needham, M. Brown, S. Freeborn.
Introduction and audit of a general practice antibiotic formulary.
J Royal College Gen Practitioners, (1988), pp. 166-167
[16.]
M.J. Pearce, E.J. Begg.
A review of limited lists and formularies. Are they cost-effective?.
PharmacoEconomics, 1 (1992), pp. 191-202
[17.]
T. Wally.
A UK national prescribing list?.
PharmacoEconomics, 7 (1995), pp. 471-474
[18.]
J. Black, T. Griffin, N.W. Beisel, M.D. Bartels.
Implementation of an outpatient prescription drug formulaty in a managed-care system.
Am J Hosp Pham, 45 (1988), pp. 561-564
[19.]
M. Johannesson.
The Australian guidelines for subsidisation of pharmaceuticals.
PharmacoEconomics, 2 (1992), pp. 355-362
[20.]
G.B. Grant, D.a. Gregory, T.D. Van Zwanenberg.
A basic formulary for general practice 2nd ed.
[21.]
J. López, E. Mossialos.
Políticas de contención del gasto farmacéutico en los estados miembros de la UE.
Política y Gestión Sanitaria,
[22.]
G. Dukes.
Change on growth in generic markets in developed an developing countries. Ponencia presentada en el seminario de salud y medicamentos.
Universidad Carlos III, (1995),
[23.]
S. Stewart-Brown, R. Surender, J. Bradlow, A. Coulter, H. Doll.
The effects of fundholding in general practice on prescribing habits three years after introduction of the scheme.
BMJ, 311 (1995), pp. 1543-1547
[24.]
C.M. Kozma, R.M. Schulz, W.M. Dickson, J.T. Dye, E.R. Cox, D.A. Holdford, L. Michael, W.N. Yates, T.L. Young.
Economic impact of costcontainment strategies in third party programmes in the US.
Part II. PharmacoEconomics, 4 (1993), pp. 187-202
[25.]
OCDE Health Data 1995
[26.]
T. Cueni.
An industrial policy for the pharmaceutical industry in Europe. The way forward, in Health Care Reforms and the role of the pharmaceutical industry.
[27.]
G. Selke.
Reference price system in the European Community.
Cost containment, pricing and financing of pharmaceuticals in the European community: the policy markers view,
[28.]
R.A. Levy.
Prescription cost sharing. Economic and health impacts, and implications for health policy.
PharmacoEconomics, 2 (1992), pp. 219-237
[29.]
A.A. Nelson, C.E. Reeder, W.M. Dickson.
The effect of a Medicaid Drug Copayment Program on the utilisation and cost of prescription services.
Med Care, 22 (1984), pp. 724-735
[30.]
D.G. Smith, D.M. Kirking.
Impact of consumer fees on drug utilisation.
PharmacoEconomics, 2 (1992), pp. 335-342
[31.]
A. Leibowitz, W.G. Manning, J.P. Newhouse.
The demand for prescription drugs as a function of cost-sharing.
Soc Sci Med, 21 (1985), pp. 1063-1069
[32.]
C.E. Reeder, A.A. Nelson Jr.
The differential impact of copayment on drug use in a Medicaid population.
Inquiry, 22 (1985), pp. 396-403
[33.]
B.L. Harris, A. Stergachis, L.D. Ried.
The effect of drug co-payments on utilisation and cost of pharmaceuticals in a health maintenance organisation.
Med Care, 28 (1990), pp. 907-917
[34.]
C.E. Reeder, E.W. Lingle, R.M. Schulz, R.P. Mauch, B.S. Nigtengale, C.A. Pedersen, M.L. Watrous, S.E. Zetzl.
Economic impact of cost-containment strategies in third party programmes in the US (Part I).
PharmacoEconomics, 4 (1993), pp. 92-103
[35.]
S.B. Soumerai, J. Avorn, D. Ross-Degnan, S. Gortmaker.
Payment restrictions for prescription drugs under medicaid.
N Engl J Med, 317 (1987), pp. 550-556
[36.]
J. Bling, Walley.
The UK indicative prescribing scheme.
PharmacoEconomics, 2 (1992), pp. 137-152
[37.]
S. Stewart-Brown, R. Surender, J. Bradlow, A. Coulter, H. Doll.
THe effect of fundholding in general practice on prescribing habits three years after introduction of the scheme.
BMJ, 311 (1995), pp. 1543-1548
[38.]
C. Harris, G. Scrivener.
Fundholders' prescribing costs: the first five years.
BMJ, 313 (1996), pp. 1531-1534
[39.]
R. Wilson, I. Buchan, T. Walley.
Alterations in prescribing by general practitioner fundholders: an observational study.
BMJ, 311 (1995), pp. 1347-1350
[40.]
V.D. Shugldenberg, J.M. Graf, O. Schoffsky.
Implications of the structural reform of healthcare act on the referral and hospital admission practice of primary health care physicians. University of Hannover.
Discussion Paper N.° 34, (1993),
[41.]
J. Pomar.
Taula rodona: política d'incentius lligada a la prescripció farmacèutica. Insalud. Mallorca. VII Jornades sobre utilització de medicaments a l'atenció primària.
L'Hospitalet de Llobregat, (1996),
[42.]
H. Glennerster.
General practice fundholding in the United Kingdom. Is it working?.
PharmacoEconomics, 3 (1993), pp. 10-13
[43.]
S. Bogle, C. Harris.
Measuring prescribing: the shortcomings of the item.
BMJ, 308 (1994), pp. 637-640
Copyright © 1998. Sociedad Española de Salud Pública y Administración Sanitaria
Descargar PDF
Idiomas
Gaceta Sanitaria
Opciones de artículo
Herramientas
es en

¿Es usted profesional sanitario apto para prescribir o dispensar medicamentos?

Are you a health professional able to prescribe or dispense drugs?