Department of Economics and Business, Area of Applied Economics, University of La Rioja , Logroño, Spain.
Expert Rev Pharmacoecon Outcomes Res. 2020 Aug;20(4):379-386. doi: 10.1080/14737167.2019.1647105. Epub 2019 Jul 31.
Inappropriate and indiscriminate use of antibiotics is one of the main factors contributing to the increasing bacterial resistance. Surveillance of antibiotic consumption is fundamental for assessing the effects of rational use-oriented measures introduced under economic or health policies. This study quantifies and assesses the introduction of a pharmaceutical co-payment and implementation of campaigns to increase awareness about and rational use in the consumption of antibiotics (volume and expenditure).
Monthly official dispensations recorded by a health authority (La Rioja, Spain) between January 2009 and December 2017 (108 observations). Total and disaggregated (by active principle and patient's income level) time series for a number of packages and expenditure were studied using intervention and counterfactual analyses (Box-Jenkins methodology).
Co-payment reduced the total antibiotic consumption (number of packages -8.52% and expenditure -8.61%) and the difference was greater for the highest-priced antibiotics. Only two of the four campaigns had a significant effect, which lasted 6 months. Counterfactual analysis estimated the savings.
Economic and health policies helped to reduce antibiotic consumption. Each policy has different effects, co-payment reduces overall drug consumption through a price effect (loss of purchasing power), awareness campaigns depend on other elements for their success (media, scope and patient income).
抗生素的不适当和无差别使用是导致细菌耐药性不断增加的主要因素之一。抗生素消费监测对于评估在经济或卫生政策下实施的合理使用导向措施的效果至关重要。本研究量化并评估了引入药品共付制度以及开展提高抗生素使用意识和合理性的宣传活动（数量和支出）的效果。
利用卫生当局（西班牙拉里奥哈）在 2009 年 1 月至 2017 年 12 月期间记录的每月官方处方（共 108 个观察值）。使用干预和反事实分析（Box-Jenkins 方法）研究了多种包装和支出的总时间序列和分类时间序列（按活性成分和患者收入水平）。
共付制度降低了抗生素总消费量（包装数量减少了 8.52%，支出减少了 8.61%），高价抗生素的降幅更大。四项宣传活动中只有两项有显著效果，持续了 6 个月。反事实分析估计了节省的费用。
经济和卫生政策有助于减少抗生素的消费。每种政策的效果不同，共付制度通过价格效应（购买力损失）降低整体药物消费，宣传活动的成功取决于其他因素（媒体、范围和患者收入）。
