Nghien ciru anh htfong ciia hydroxypropyl-p-
r f r
cyclodextrin den do on dinh cua thuoc tiem dong kho pantoprazol
D a t v a n d e
Pantoprazol (PTZ) la mdt chit thude nhdm benzimidazol. Cung gidng nhu cae chit khac ciing nhdm, PTZ khdng bin, d i bi phan huy trong mdi trudng acid '^' ®' nen da cd nhiiu bien phap duge ap dung d i lam tang do dn dinh cua ehung nhu: sii' dung ta dugc kiim '^°' hoac hdn hgp ta duge kiim '"*', sir dung cac chit chdng oxy hda, bao c h i dang vien bao tan trong rudt '^®' hoac dang thude tiem ddng khd... Muc tieu eua nghien eiru nay la danh gia anh hudng cua hydroxypropyl-p-cyclodextrin d i n do dn dinh eua thude tiem ddng khd PTZ.
Nguyen lieu, thiet bj va phu'O'ng phap
Nguyen lieu
- Natri pantoprazol sesquihydrat x u i t xir:
. Tay Ban Nha, dat tieu ehuin Dugc dien Chau Au (EP6).
- Cac ta duge: natri hydroxyd, manitol, arginin, dinatri EDTA (Trung Qudc), hydroxypropyl-p-cyclodextrin (Trung Qudc) dat tieu ehuin nha san x u i t
- Cae hda chit tinh khiit phan tich: acetonltril, natri dihydrophosphat dinatri hydrophosphat dikali hydrophosphat va acid phosphoric (Merck), dat tieu chuan nha san x u i t
- Niit nhdm (Viet Nam), nut cao su f^isc), Ig thuy tinh trung tinh i^uic), dat tieu ehuin nha san xuit.
T h i i t bj
- May ddng khd LABCONCO.
- May Ige mang SATORIUS vdi mang Ige ed kich thude 0,2ijm.
- May do pH Inonab pH 370.
- May s i c ky Idng hieu nang cao hieu SHIMADZU 10AVP.
Pham Xuan Chung, Nguyen Van Long, Dao Minh Huy, Nguyen Minh Trang Truang dai hoc Dugc Ha Noi
- Tu s i y , tu vi khi hau CLIMACELL.
- May phan tieh nhiet vi sai SETARAM DSC131.
Phu'ang phap nghien eu'U
Phuang phap phan tich nhiet vi sai (DSC) Nghien ciru tinh c h i t nhiet hgc va tuang tac hda ly cua PTZ vdi ta duge, tir dd lya chgn duge cae ta duge lam tang tinh dn dinh cua hoat c h i t trong edng thu'C thude tiem ddng khd PTZ bing phuang phap phan tich nhiet vi sai (DSC). Vdi eae d i i u kien:
- T d e d g q u e t 10°C/phut -Khoang q u e t - 2 5 - 2 5 0 ° C . - M i u chuan: nhdm hydroxyd.
- Mdi trudng: khdng khi.
Phuang phap dong kho
Bao c h i thude tiem ddng khd PTZ 40 mg bing phuang phap ddng khd vdi cac thdng sd:
-Ddng lanh: -70°C, thdi gian: 6 gid.
- s i y sa c i p : -15°C, thdi gian: 20 gid, tdc do gia nhiet 0,5°C/1 phut.
- s i y thir c i p : +25°C, thdi gian: 20 gid, tde do gia nhiet: 0,25°C/1 phut
Phu'O'ng phap sac ky long hieu nang cao (HPLC)
Xae dinh ham lugng PTZ va ty le tap c h i t trong c h i p h i m thude tiem ddng khd b i n g phuang phap HPLC. Vdi cac d i i u kien:
- Pha ddng: Acetonltril va dem phosphat pH7.
- Cot HPLC: C I 8 (5 |j.m) 4,6 X 150mm.
- Detector tu" ngoai: bude sdng 290nm.
- T h i t i e h tiem: 20pl.
- Tdc do ddng: 1 ml/phut
Phu'O'ng phap lao hoa cap toe
Danh gia mgt sd chi tieu chit lugng eua thude tiem ddng khd nhu: hinh thu'C cua bgt ddng khd;
TAP CHI DUOC HOC - 12/2010 (SO 416 NAM 50) 19
Nghien CLFU - Ky thuat
mau sic, do trong eiia dung djch pha lai; ham lugng PTZ, ty le tap chit. Vdi cac diiu kien:
• - Cudng birc: trong tu 100°C.
- Trong tu vi khi hau: nhiet do 40°C ± 2, do i m 75 ± 5%.
- D i i u kien phdng thi nghiem: nhiet do 25 - 35°C, do i m 55% - 85%.
K § t q u a n g h i e n C I F U v a b a n l u a n Kit qua nghien CLPU anh hu'O'ng cua hydroxypropyl-p-cyclodextrin d i n do 6n djnh cua PTZ
Danh gia anh hudng cua hydroxypropyl-p- cyclodextrin (HP-p-Cyd) d i n do dn dinh cua PTZ trong cac hdn hgp vat ly M l , M2, M3 gdm:
PTZ, manitol va HP-p-Cyd b i n g phuang phap DSC vdi eae d i i u kien dugc ghi d phin Phu'O'ng phap phan tich nhiet vl sal. K i t qua dugc trinh bay trong bang 1 va hinh 1:
Bang 1: Thanh phin hdn hap vat ly
Thanh phan Ml M2 M3 Manitol (mg) 120 120 120
PTZ (mg) 50 50 50
HP-(3-Cyd (mg) 50 150
Ty le PTZ:HP-p-Cyd 1:0 1:1 1:3
Hinh 1: Dwang biiu diin phan tich nhiet vi sai (DSC) cua PTZ (1), manitol (2), HP-^-Cyd (3), hdn hap Ml (4), M2 (5) va M3 (6).
K i t qua hinh 1 eho thiy: Dudng nhiet cua eae hdn hgp vat ly M2, M3 gdm PTZ, manitol, HP-P- Cyd ed pic rdng trong khoang 50-100°C (tuang U'ng vdi sy m i t nude cua HP-p-Cyd), mdt pic thu
Bang 2: Anh hwang cua HP-^-Cyd din hinh thuc
nhiet manh khoang 160-170°C (tuang irng diem chay eua manitol), mdt pic tda nhiet khdng dac tarng khoang 190°C (tuang U'ng nhiet do phan huy eua PTZ) cd cudng do tuang irng (8mW va 21,4mW) thip han so vdi pic tda nhiet ciia PTZ trong hon hgp M l (53mW) va PTZ ty do (130mW). D i i u nay cd the dugc giai thieh nhu sau: HP-p-Cyd la ta dugc cd kha nang dn djnh cac hoat chit khdng b i n , do tao ra cae khung bao bgc xung quanh phan tu hoat c h i t cho nen han e h i sy tiip xue eua hoat chit vdi mdi trudng xung quanh, tuy nhien day ehi la hdn hgp vat ly nen vin edn cac phan tir PTZ ty do, trong qua trinh gia nhiet ehi nhO'ng phan tCr PTZ tiip xiic vdi HP-p- Cyd mdi tao phu'c hdn hgp PTZ - HP-p-Cyd, hdn hgp nay b i n vu'ng vdi nhiet han so vdi PTZ ty do trong khoang nhiet do da khao sat, do dd cudng do pic chi giam di nhieu chir khdng m i t (Jdng thdi cudng do eua pic cung phu thugc vao ty le HP-p- Cyd ed trong hdn hgp.
Nhu vay, trong hdn hgp vat ly vdi manitol va HP-p-Cyd, PTZ b i n vu'ng vdi nhiet han, ty le HP- p-Cyd ed trong hdn hgp cang Idn, PTZ cang bin virng. K i t qua nay cung phii hgp vdi nghien eiru eua M.EI-Badry va cdng sy v i anh hudng eua ty le HP-p-Cyd trong hdn hgp (omeprazol:HP-p-Cyd) d i n do dn dinh cua omeprazol (mdt chit trong nhdm benzimidazol)'^l
Kit qua danh gia anh hu'ong cua HP-P-Cyd din do 6n djnh ciia thude tiem dong kho PTZ
Tren ca sd k i t qua thu dugc tir phuang phap DSC vdi hdn hgp vat ly, t i i n hanh bao c h i thude tiem ddng khd PTZ vdi m i u CT233 ed HP-p-Cyd va m i u CT234 khdng cd HP-P-Cyd. Mdi me ddng khd 200 Ig theo ciing mdt quy trinh.
Danh gia bang cam quan va bang phuvng phap HPLC
San p h i m sau khi ddng khd duge theo ddi trong d i i u kien cudng birc, eu the: Cae m i u duge 6§ trong tu 100°C. Mdi 2 gid, kiem tra hinh thirc, mau s i c cua banh thude; mau s i c , do due eua dung dich pha lai vdi 2,5ml nude c i t pha tiem; ham lugng hoat c h i t va ty le tap chit dugc xac djnh b i n g phuang phap HPLC. K i t qua dugc trinh bay trong bang 2 va 3:
bdt va dung dich pha lai cua thude tiem ddng khd PTZ
Thai gian Bgt dong kho Dung dich pha lai
CT233 CT234 CT233 CT234
0 gid Hinh banh thuoc,trang, min Hinh banh thu6c,trang, min Trong, kh6ng mau Trong, kh6ng mau Sau 2 gid Hinh banh thuic, tring, min Hinh banh thuic, tring, min Trong, kh6ng mau Trong, khong mau Sau 4 gid Hinh banh thuic, tring, min Hinh banh thu6c,
vang, kh6ng min Trong, kh6ng mau Trong, mau vang nhat
Bang 3:
Thcyi gian
0 gid Sau 2 gid
So sanh Sau 4 gid
So sanh
Anh hwang cua HP-P-Cyd din do
Ham Iwg'ng (%) PTZ CT233
103,01 99,51 Giam 3,50%
97,96%
Giam 5,05%
CT234 104,92%
99,05%
Giam 5,87%
95,73%
Giam 8,19%
dn dinh cua thude tiem
CT233 0,06%
0,71%
Tang 10,8 l l n 1,56%
Tang 26 lan
ddng khd PTZ
Ty le (%) tap chat CT234 0,09%
1,32%
Tang 14,6 lan 4 , 5 1 % Tang 50,1 lan
K i t qua bang 3 cho thiy: sau 2 gid d i d d i i u kien cudng birc (nhiet do 100°C), ham lugng PTZ trong san p h i m pha c h i theo edng thire 233 giam it han so vdi san p h i m ddng khd theo cdng thu'C 234 (3,05% va 5,87%), trong khi ty le tap chit bj phan huy eung ft han (0,71% - tang 10,8 l i n va 1,32% - tang 14,6 lin). Sau 4 gid, tuang u-ng la (5,05% va 8,19%) va (1,56% - tang 26 l i n va 4,15% - tang 50,1 lin).
Danh gia bang phwcrng phap DSC
Cae san phim ddng khd theo edng thu'C 233 va 234 dugc danh gia bing phuang phap DSC vdi cac diiu kien dugc ghi d phin Phu'ang phap phan tich nhiet vi sal. K i t qua duge trinh bay trong hinh 2:
Hinh 2: Dwang biiu diin phan tich nhiet vi sai (DSC) cua PTZ (1), manitol (2), HP-^-Cyd (3), bdt ddng khd cua cdng thirc 234 (4) va 233 (5)
K i t qua hinh 2 eho thiy: Dudng nhiet eua san pham ddng khd theo cac cdng thirc 233,
234 d i u eho pie thu nhiet tai khoang tir 160- 170°C tuang irng vdi nhiet do ndng chay manitol (cudng do tuang u'ng la-90mW va - 138mW) va ngay sau khi ndng ehay la mgt trang thai tda nhiet khdng dac trung (tuang quan vdi nhiet do phan huy cua PTZ - 190°C) vdi cudng do tuang irng 34mW va 80mW, chu'ng td sau khi ddng khd PTZ khdng edn d dang tinh t h i ma da chuyin sang dang vd djnh hinh. Tuy nhien, cudng do cua eae pie tren dudng nhiet eua san phim ddng khd theo edng thirc 233 d i u t h i p han cudng do cac pic tuang u'ng tren dudng nhiet cua san phim ddng khd theo cdng thire 234.
Nhu vay, k i t qua tu* phuang phap DSC phu hgp vdi k i t qua thu duge tu" phuang phap HPLC, ca hai phuang phap d i u eho thiy bdt ddng khd theo edng thire 233 b i n virng vdi nhiet han bdt ddng khd theo edng thu-c 234, diiu nay chu'ng td ring HP-P-Cyd da lam tang do dn djnh vdi nhiet ciia thude tiem ddng khd PTZ.
K i t qua nay eung phii hgp vdi nghien eu'U ciia mgt sd tac gia tren t h i gidi v i anh hudng cua HP-P-Cyd vdi mdt sd c h i t trong nhdm benzimidazol [^-^•^".
Tu' k i t qua thu dugc, cac me t i i p theo sir dung HP-p-Cyd lam ta dugc de dn djnh thude tiem ddng khd PTZ.
Kit qua nghien eu'U anh hu'O'ng eua ty le HP-P-Cyd d i n do 6n dinh eua thude tiem ddng kho PTZ
T i i n hanh ddng khd vdi eiing mgt quy trinh ky thuat cac edng thire ed eung ta dugc k i i m , ta dugc tao khung, ta dugc chdng oxy hda, nhung sir dung lugng HP-p-Cyd khac nhau:
Bang 4: Khdi Iwang HP-p-Cyd sw dung trong cac cdng thirc thude tiem ddng khd PTZ
Cong thii-c 306Y 3063 871 872 873 3182 2872 1971 7972 ^973 1974 1975 Kh6i lugng
HP-p-Cyd 50 100 150 200 300 350 400 450 600 750 900 1050 sir dung (mg)
TAP CHI DUOC HOC - 12/2010 (SO 416 NAM 50) 21
Nghien CLFU - Ky thuat
Danh gia bing cam quan va bing phipcmg phap HPLC
vi cam quan
- Cac m i u pha e h i Iheo cdng thire 1972; 1973;
1974; 1975 khdng ddng lanh, khdng thanh hinh banh thude hoac banh thude cd t>i mat khdng mjn, cd tach Idp. khdng xdp (cdng thire 1971). VI vay, eae san phim sau ddng khd theo cac cdng thirc
Bang 5: Ham Iwang (%) PTZ va tyle (%,) tap chit
nay khdng t i n hanh danh gia cae chT tieu khac.
- San phim sau khi ddng khd theo cae edng thu^ 3061; 3063; 871; 872; 873: 3182: 2872 cd hinh banh thude dep, mjn, cho nen tiip tuc danh gia cae chi fieu khae nhu ham lugng hoat c h i t ty le tap chat Tiin hanh lao hda cudng birc vdi cae diiu kien nhu d phin Phipong phap lao hoa cip tdc.
K i t qua dugc trinh bay trong bang 5 va hinh 3:
cua thude tiem ddng khd PTZ trong cac cdng thirc Thai gian CT3061 CT3063 CT871 CT872 CT873 CT3182 CT2872
Ham Iwang
(%)
pantoprazol
Ty le (/a) tap chat
0 gid Sau 2 gid So sanh (giam %)
Sau 4 gid So sanh (giam %)
O g i d Sau 2 gid So sanh (lln)
Sau 4 gid
100,01 95,51
4,50 93,96
6,05 0,12 1,21 10,08
2.51
99,89 96.38 3,51 94,33
5,56 0,13 1,13 8,69 2,00
106,70 103,49 3,21 102,20
4,50 0,12 1,01 8,42 1,71
102,30 99,28
3,02 98,30
4,00 0,12 0,99 8,25 1,53
106,70 104,14 2,56 103,19
3,51 0,09 0,59 6,56 1,01
100,08 97,95
2,13 97,06
3,02 0,08 0,43 5,38 0,89
107,6 105,55
2,15 104,48
3,12 0,09 0,51 5,67 0,91 So sanh (lln) 20.92 15.38 14.25 12,75 11.22 11.13 10,11
0 50 100 150 200 250 300 350 4O0 450 Ltpcmg h f - p - C y d SLP d u n g
Hinh 3: Dd thi bieu diin sw phu thude cua vao Iwgng HP-fi-Cyd trong thanh (a)- Bp giam ham lugng PTZ sau 2 va 4 gid; (b).' K i t qua tren eho t h i y vdi ciing thanh p h i n trong cdng thirc, do dn dinh eua thude tiem ddng khd PTZ 40mg phu thude vao lugng HP-p-Cyd su= dung. Lugng HP-P-Cyd sir dung cang nhiiu do dn dinh cua thude tiem ddng khd PTZ cang cao. Vdi lugng HP-p-Cyd sir dung la 50mg/lg, san p h i m ddng khd sau 2 gid de d nhiet do 100°C, ham lugng PTZ trong san p h i m pha e h i theo cdng thire 3061 giam (4,5%i), ty le tap c h i t (1,21% - tang 10,08 lin), sau 4 gid, tuang irng
)4S0
j
1
• " I
— • — Sau 2 gicT
— » — Sau4gicr
j
i
!
s
(%)
o Q.
P
3 - 2 , 5 -
? -
1.5 - 1 0 . 5 -
0 -
( ,
) 50
'"»
\ ^
•^. -^
~-*^ "~ —*-
*^^\ "^^^'^ *
100 150 200 250 300 350 4O0 450 LifOTig rP-p-Cyd si> d u n g
-Sau2opcr S a u 4 ^
(b)
ty le tap chat va do giam ham Iwang PTZ phin thude tiem ddng khd PTZ
Fy le tap chit trong bot dong kh5 sau 2 va 4 gid la (6,05%) va (2,51% - tang 20.92 lin). Trong khi dd n i u lugng HP-P-Cyd sir dung la 350mg/lg, san p h i m ddng khd sau 2 gid d i d nhiet do 100°C, ham iugng PTZ trong san p h i m pha e h i theo cdng thu'C 3182 chT giam (2,13%), ty le tap c h i t (0,43% - tang 5,38 lin), sau 4 gid, tuang irng la (3,02%) va (0,89% - tang 11,13 lin). Tuy nhien, n i u t i i p tuc tang lugng HP-P- Cyd SLf dung trong cdng thuc thi khdng nhung do dn ^ n h cua thude tiem ddng khd PTZ khdng
tang (nhu san p h i m bao e h i theo edng thirc 2872) ma cdn khdng ddng khd duge (nhu dung djch pha c h i theo cae cdng thuc 1972; 1973;
1974; 1975) hoic hinh thue x i u (khdng thanh hinh banh thude, khdng xdp) nhu san p h i m ddng khd theo cdng thire 1971.
Danh gia bang phuveng phap DSC
Cae san pham ddng khd duge danh gia bing phuang phap HPLC ddng thdi eung duge danh gia bing phuang phap DSC vdi eae d i i u kien dugc ghi d phin Phu'ang phap phan tich nhiet vl sai. K i t qua duge trinh bay trong hinh 4:
Hinh 4: Dwang biiu diin phan tich nhiet vi sai (DSC) cua PTZ (1), manitol (2), HP-p-Cyd (3), bot dong khd theo cdng thirc 3061 (4), 871 (5), 873(6) va 3182 (7). :
K i t qua hinh 4 eho thiy: Dudng nhiet ciia san phim ddng khd theo cae edng thire 3061;
871; 873; 3182 d i u khdng ed pie phan hiiy cua PTZ, tuy nhien cudng do eiia eae pic thu nhiet khae nhau phu thugc vao lugng HP-p-Cyd cd trong edng thire, trong dd bdt ddng khd theo edng thuc 3182 (su- dung HP-p-Cyd 350mg/lg) ed cudng do pic t h i p n h i t
Nhu vay, k i t qua tu' phuang phap DSC eung phii hgp vdi k i t qua thu dugc tu' phuang phap HPLC, ea hai phuang phap d i u cho t h i y bdt ddng khd theo cdng thu'C 3182 su' dung HP-p- Cyd 350mg/lg b i n vu'ng vdi nhiet han ca, d i i u nay eung phii hgp vdi k i t qua nghien ciru anh hudng eua ty le HP-p-Cyd d i n do dn djnh cua PTZ trong hdn hgp vat ly.
K i t l,uan
Tu' nhirng k i t qua nghien ciru, thye nghiem thu duge, riit ra mdt sd k i t luan:
- HP-p-Cyd lam tang do dn djnh PTZ. Tuy nhien, mu'C do dn djnh phu thude vao lugng HP-
P-Cyd ed trong cdng thire. Trong nghien ciru nay, thude tiem ddng khd PTZ 40mg dn djnh han ea khi su" dung 350mg/lg HP-p-Cyd.
- K i t qua danh gia do dn djnh cua thude tiem ddng PTZ bing phuang phap HPLC phu hgp vdi k i t qua tu- phuang phap DSC.
Summary
Hydroxypropyl-p-cyclodextrin increase the stability of pantoprazole in lyophilized injectable powder. However, the stability depends on the proportion of hydroxypropyl-P-cydodextrin in the formulation. The research indicates that, pantoprazole lyophilized injectable powder is the most stability with hydroxypropyl-p-cyclodextrin 350mg/vial. The pantoprazole stability were evaluated by method DSC and HPLC.
A formulation consists of pantoprazole sodium sesquihydrate, sodium hydroxide, mannitol, disodium EDTA, hydroxypropyl-p-cyclodextrin with reasonable proportion and water for injection were improved. Pantoprazole lyophilized injectable powder was prepared in laboratory scale, each batch comprised 200 vials.
Tai lieu tham khao
1. A.KristI, Acido-basic properties of proton pump inhibitors in aqueus solutions, Drug Dev. Ind. Pharm., (2009), 35, p. 114-117.
2. Ana Figueiras et al. Solid-state characterization and dissolution profiles of the inclusion complexes of omeprazole with native and chemically modified beta- cyclodextrin, Eur J. Pharm. Biopharm., (2007), 67, p.531-539.
3. Ana Figueiras et al, In vitro evaluation of natural and methylated cyclodextrins as buccal permeation enhancing system for omeprazole delivery, Eur. J.
Phanv. Biophanv., (2009), 71, p. 339-^45, .
4. Ana Figueiras et al, The role of 1-arginine in inclusion complexes of omeprazole with cyclodextrins, AAPS PhamiSciTech., (2010), 11,1, p. 233-240.
5. Chantal Holvoet et al. Development of an omeprazole parenteral formulation with hydroxypropyl-beta-cyclodextrin, Pharm. Dev.
Teehnol., 12, p.327-336, (2007).
6. M.EI-Badry et al. Effects of Kollicoat IR and hydroxypropyl-beta-cyclodextrin on the dissolution rate of omeprazole from its microparticles and enteric- coated capsules, Phanv. Dev. Teehnol., (2010), 15, 5, p.500-510.
> • ; • (Xem tiep trang 13)
TAP CHi DUOC HOC - 12/2010 (SO 416 NAM 50) 23
Nghien
CLFU- Ky thuat
Ket luan
v i mang lu'ai phan phdi TTB y t§
He thdng phan phdi TTB y t i dugc hinh thanh tir TW d i n dja phuang va dugc m d rdng vdi sy tham gia cua nhiiu thanh phin kinh t i nhu: Doanh nghiep nha nude, cdng ty TNHH, cac cdng ty lien doanh... trong dd eae cdng ty TNHH ludn ehiim ty le cao nhit. Nam 2008 ed 751 cdng ty TNHH tham gia kinh doanh TTB y t i . Pham vi hoat ddng cua eae DN nay r i t rdng, duge quyin kinh doanh cac mat hang do Bd Y t i quy djnh.
sd lugng cac ca sd san x u i t TTB y t i tang nhanh qua cac nam g i n day, nam 2008 ed 56 ea sd, tang 16,7 % so vdi nam 2007
Nam 2008 ca nude cd 13.433 ea sd y t i sir dung TTB y t i , trong dd cac benh vien ehiim 6,73% tren tdng sd nhung gia trj d i u t u TTB y t i lai r i t Idn.
v i c l u ngudn nhan lye trong nganh TTB y t§
Nhin Chung cdn thiiu can bd du nang lye quan ly chuyen mdn ky thuat va nghiep vu thuang mai. Sy phan bd ngudn nhan lye khdng d i u , ehu y i u tap trung d cae thanh phd Idn.
V§ cc c l u va s y phan bd TTB y t i tren thj tru'd'ng
Trang thiit bj y t i nude ta da p h i n la duge cac cdng ty nhap khiu tir nhiiu nude tren t h i gidi. Nam 2007 cd 70 thj trudng eung c i p TTB y t i cho Viet Nam, tdng gia trj nhap khau dat - 191,7 trieu USD. Nam 2008, ed 53 qudc gia x u i t
khiu TTB y t i vao Viet Nam, tdng gia trj nhap khiu dat 209,5 trieu USD, tang 5,6%o so vdi nam 2007. Nhat Ban v i n d i n d i u v i kim ngaeh x u i t khiu TTB y t i vao Viet Nam, ehiim tren 16%> thj phin. Trong dd san x u i t trong nude mdi dap irng dugc khoang 40% nhu c i u sir dung va mdi
san x u i t dugc 5% thiit bj y t i hien dai.
Phin ldn TTB y t i tap trung d cae benh vien Idn d thanh phd Idn nhu Ha Ngi, TP Hd Chi Minh, Da Ning... la nhO'ng nai cd he thdng y t i phat triin, dan sd ddng va giao thdng thuan Igi.
Summary
To complete our medical facilities supply system which Is aimed to improve the quality of heathycare service and disease prevention for our people, by retrospective method, we have done a survey on the whole system and come to the findings as follow: the medical facilities supply system is widespread and has a pool of
1.157 teachnical staff (in2007). In 2008, there were 751 companies, most of which are liability limited ones, involving in this system. In 2008, the number of medical facilities importing companies was 650 in group 4,2%, and 10,85%
up as compared with 2007 and 2006 respestively. The import value of medical facilities was 202,5 milion USD, in 2008 increased by 5,6% against 2007, etc.
The Ministry of health and Department of Medical facilities and Works continue to provide instructions on the implementation of the National medical facilities policy and the Project on the reseach and manufacturing of medical facilities with a focus on strengthening State management over medical facilities and human development for medical facilities.
Tai lieu tham khao
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3. Bd Y te, Ky yeu hdi nghj trien khai chinh sach qudc gia ve TTB y t i giai doan 2004-2008, Ha Ndi, (2008).
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