KHAO SATTlNH HINH SUf DUNG THUOC BANG PHl/ONG PHAP ABC, VEN TAI BENH VIEN BENH NHIET Ddl TRUNG UONG
(10/2013-04/2014)
Nguyin Thi Dai Phong^ Nguyin Van Kinh^ va CS'.
Muc tieu: Phan tich tucmg quan giua luong thudc tieu thu hang nam va chi phi bing phuang phap ABC, VEN nham phan dinh nhiing thudc nao chidm ti le Idn trong ngan sach. Xac djnh uu tien va de xuat cac phuang an nang cao hieu qua hoat dpng mua sdm va tdn trir thudc trong benh vien.
Dot tu(mg: Danh muc thudc da su dung tai benh vien trong nam 2013. Phuomg phdp: Md ta hdi ciiu sd lieu vd su dung thudc tai benh vien giai doan 01/10/2013 - 30/04/2014. Ket qud vd Ket lu^n: Co 460 thudc dugc sii dung tai Benh vien Benh nhiet ddi Trung uong voi 303 hoat chSt gdc. Tdng chi phi thuoe 56.980.261.031 ddng. Trong dd 48 loai thudc (10,43%) dugc xdp nhdm A, chidm 79,77% chi phi su dung thudc; 78 loai thudc (16,96%) thuoe nhdm B chidm 15,15%.
Cdn lai 334 loai thudc (72,61%) thuoe nhdm C, chidm 5,08% chi phi sijf d^mg thudc trong benh vien. Phan tich VEN cho thdy, 39 loai thudc (chidm 8,48%) la thudc tdi cSn thiet (Nhdm V - Vita!
drugs), 414 loai thuoe (chidm 90,00%) la thudc cin thidt (Nhdm E - Essential drugs), cdn lai 7 loai thudc (1,52%) la thudc khdng thiet yeu (Nhdm N - Non essential drugs ). Trong phan tich ma tran ABC/VEN, thudc phan thanh Nhdm 1: Cac thudc quan trong nhdt (AV; AE;AN; BV;CV) cd 82 loai (chiem 17,83%), Nhdm II: Cac thudc quan trpng (BE; BN; CE) cd 371 loai (chiem 80,65%) va Nhdm III: Thudc it quan trpng (CN) cd 7 loai (chidm 1,52%). Khuyen nghi: Giam sat doTi dat hang va lucmg tdn kho cua nhdm V va E chat che han.
Tir khda: Su dung thudc, phuang phap ABC, VEN.
DAT VAN {) E
Cac nghien cuU da chi ra rang, van de cung litig thuoe bong benh vien ddng vai trd quan trgng, cd tae ddng tn/c tiep den hieu qua dieu ttj cua ngu'di benh. Mot trong nhiing yeu td ed anh hu'dng den hoat ddng cung uTig thudc trong benh vien la van de sir dung kinh phi. Theo cac bao cao, kinh phi mua thuoe tiiudng ehiem ty le rat Idn trong ^ n g ngan sach cua benh vien, cd the tdi 40 - 60% d cac nudc dang phat tiien; 15 - 20% d cae nu'dc phat ttien'^"^]. Tai
<"Khoa Dupc. Bfnh vifn Bfnh nhifl dm Trung uang <^>Benh vifn Bfnh nhift dai Trung uimg
Ngiy nhan bki: 08/04/2015 Ngiy pban bi^n xong: 14/4/2015.
Ngiy duyft flSng: 27/4/2015
NguM cbju tricb nhifm n^i dung khoa hQc: Nguyin Thj Dgi Phong, Khoa Dupc. Bfnh vifn Bfnh nhifl dai Thing vang.
Difn thogi 0I2S8889962: E-mail [email protected]
Viet nam nam 2010, ti le nay la 58,7%^.
Tinh ttang sii* dung thudc bat hdp ly xay ra tai nhieu nddc tren the gidi. Lam dung khang sinh, lam dung thudc rat pho blenf^. Tai Viet Nam, vdi nhii^ig chinh sach md cu^
ttieo cd ehe thi trudng va da dang hoa cae loai hinh cung LJlig thudc, thi tru'dng thudc ngay cang phong phu ca ve sd lu'dng va chung loai. Theo sd lieu eua Cue quan ly Du'dc, hien cd 22.615 sd dang ky thudc lu\j hanh cdn hieu ldc, ttong dd ed 11.923 sd dang ky thudc nu'dc ngoai vdi khoang 1.000 hoat diat va 10.692 sd dang ky tiiuoc san xuat ttong nudc vdi khoang 500 hoat chatf*!. Oieu nay giup eho viee cung utig thudc de dang va thuan tien hdn, tuy nhien, cung gay ra nhieu kho khan, lung tijng trong viee ehpn lya, sir dung thudc. Viee xay dulig danh muc tiiudc da du'dc thdc hien d nhieu benh vien, nhuhg van cdn gan 10%
T R U Y t o N H i & f l V l t T N A M * s 6 2(10) - 2015 - 7 9
benh vien dnda xay duYig danh muc thudc. 36% (10/28) benh vien van Oiddng xuyen ke ddn ttiudc ngoai danh mud'i. NhiJtig van de bat cap neu tren ddi hdi cac nha quan ly ran phai cd cac giai phap can thiep de cai thien.
Viec \da chpn du'dc mdt danh muc ttiudc hdp ly la mgt trong eac yeu td mang tinh quyet djnh ddi vdi viee sir dung thudc hieu qua, hdp ly va an toan trong benh vien.
Cac nghien eiili tdng quat ve tinh hinh sir dung thuoe nhd phan tt'ch ABC, phan tich VEN se giup ich eho Hpi ddng thudc va dieu ttj ciJng nhu' cac nha quan ly xae djnh eae van de ve su" dung thudc, lam nen tang cho cae hoat ddng can thiep tiep theo nhu': lu^ dipn ttiudc, cung cap thudc, dd tnj thuoe va tdn kho. Nghien eu\j cung cap cho Hdi dong thudc va dieu ttj cac dH lieu quan ttpng de quyet djnh thudc nao nen loai khdi danh muc thudc, thudc nao can thiet va tiiudc nao it quan ttpng hdn, tten cd sd dd xay dulig mot danh muc thudc, quan ly sir dung thudc hdp ly, an toan, hieu qua, tiet kiem dam bao benh nhan khdi benh, benh vien cd du ngan sach de hoat ddng tdt.
Ml vay chung tdi thdc hien nghien CUXJ vdi 2 mue tieu:
(1) Phan tich tu'dng quan giiia lu'dng thudc tieu thu hang nam va ehi phi bang phu'dng phap ABC, VEN nham phan dinh nhiJtig thudc chiem ti le ldn trong ngan sach. (2) Xae djnh du tien va de xuat cac phu'dng an nang cao hieu qua hoat ddng mua sam va tdn trCi' thudc trong benh vien.
OOI TU'ONG VA PHl/ONG PHAP Doi tu'dng nghien cihi
Danh muc thudc da sir dung tai benh vien trong nam 2013:
Ten generic.
Sd lu'dng thudc; nong dp; ham lu'dng.
Ten biet dddc.
Gia thanh eiia cae thudc da sir dung.
Bao cao sir dung thudc tir 01/10/2013 - 30/04/2014.
Phu'dng phap nghien citu: Md ta hdi cuti sd lieu sir dung thudc tai benh vien giai doan 01/10/2013 - 30/04/2014.
Quy trinh phan tich ABC
BUdc 1; Liet ke cac san pham thudc trong danh muc thudc su'dung tai benh vien.
Bu'dc 2: Dien cac thdng dn sau moi san pham thudc: Odn gia cua san pham (sir dung gia cho cac thdi diem nhat djnh neu san pham cd gia thay doi Oieo thdi gian); Sd
Iddng tieu tiiu cua cac san pham thudc tai benh vien.
Bu'dc 3: Tinh sd tten eho moi san pham bang cadi nhan ddn gia vdi so lu'dng san pham. Tong sd tt^ se bang tong ciia lu'dng tien cho moi san pham thudc.
Bxidc 4: Tinh gia tti phan bam cua ma san pham bang each lay sd tien cua moi san pham thudc chia dio tong sd ben.
Bu'dc 5: Sap xep lai eac san pham theo thu'td phan ttam gia trj giam dan.
Bu'dc 6: Tinh gia trj phan tram tich luy eua tong gia tti cho moi san pham; Bat dau vcfi san pham sd 1, sau do cdng vdi san pham tiep theo trong danh sach.
Bu'dc 7: Phan hang san pham nhu'sau:
Hang A: Gdm nhung san pham chiem 75 - 80% tong gia trj tien.
Hang B: Gdm nhutig san pham chiem 15 - 20% tong gia tri tien.
Hang C; Gdm nhutig san pham chiem 5 - 1 0 % tong gia trj tien.
Bu'dc 8: Ket qua thu dddc cd the trinh bay dddi dang do thj bang each danh dau phan tram ciia td'ng gia trj tich luy vao cdt dpc hay tme tung ciia dd thj va sd san pham (tu'dng du'dng gia trj tich lijy nay) tren cdt ngang hay true hoanh ciia do tt\\j-^\
Quy trinh phan tich VEN
Bu'dc 1 : Khoa du'dc tdng hdp danh muc thudc sir dung tai benh vien va gui cac chuyen gia trong Hdi dong thuoe va dieu tri cho y kien danh gia.
BUdc 2: 17 thanh vien Hdi ddng thudc va dieu trj danh gia va sap xep cac nhdm thudc theo 3 loai V, E va N.
BUdc 3: Ket qua danh gia phan loai dLfOc tong hdp theo sd lu'dng phieu danh gia V, E, N cua timg loai tiiudc do dddc 17 chuyen gia binh chpn.
BUdc 4: Cac thudc dddc phan loai theo V, E, N theo hoat chat va theo biet du'dc, tiidng ke so lu'dng, gia tti eiia tirng loai.
BUdc 5: Phan tich ma tran ABC/VEN: Ket hdp cheo phan tieh ABC va phan tich VEN. Ket qua phan tich cheo xep thanh cae nhdm I, I I , I I I . Nhdm I bao gdm AV, AE, AN, BV va CV. Nhdm I I bao gdm BE, CE, BN. Nhdm 111 bao gom
XU ly so lieu: So lieu nghien cifU dddc xd ly theo tiiu'dng ttinh Excel 2003.
80 - TRUY^NHliMVl|TNAM*s62{10) - 2015
KET QUA
Trong giai doan tir 01/10/2013 - 30/04/2014, cd 460 thuoe dddc sir dung trong benh vien, bao gdm ca eac thudc ttong thau 2013 va cae thudc cdn tdn sau thau nam 2012; Tdng chi phi thuoe sir dung la 56.980.261.031 ddng.
Phan tich ABC
Ti le cac thudc nhdm A, B, C du'dc the hien theo chung loai va gia tri dddc the hien trong bang 1
Bang 1 : Ty le thuoe nhdm A, B, C theo chung loai va gia trj
TT 1 2 3
Nhom A B C Tong
Chung lo^i 48 78 334 460
Ty l# % 10,43 16,96 72,61 100%
Gia tri (dong) 45.454.124.152
8.628.792.194 2.897.344.685 56.980.261.031
T y l | % 79,77 15,15 5,08 100 Do thj phan tich ABC theo chung loai va gia tri dddc the hien trong Hinh 1.
H T B
- C C « 8 B 6 =
c
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Hinh 1 : Ket qua phan tich ABC
Bang 2: Phan tich nhom dieu trj cac thudc nhom A theo gia trj
Nhom tac dung I So san dieu t r i . pham 1 Khang smh I 2 ' Thuoe khang virut
3 thuoe dleti W va ho btJ ,
! d i l u tn benh gan 4 Thuoe khac (Dich tnjyen, I
' cac thuoe cap cu\j, chong.
! KuSt huyft tieu hoa.
Globulin]
j i a t r i (dong) Ty le %
20 014,002 698 10 315,994 366
^ 1 2 18,10
11 ; 12.473 235 428 21,8?
9.133.938.910 16,03
Phan tich VEN
Danh mue 303 hoat chat (vdi 460 ten thddng mai tu'dng utig) da du'dc in girl 17 thanh vien eiia Hdi ddng thudc va dieu tri cho y kien bang van ban. Ket qua phan loai hoat chat theo Thudc V (Vital drugs), Thudc E (Es- sential drugs), Thudc N (Non - Essential drugs) duUe tdng hdp trong bang 3.
Bang 3: Ty le phan tich V, E, N theo hoat chat (theo ten thUcfng mai) va gia trj
TT Nhom 1 V 2 E 3 N Tong
Hoat chat (so SP theo Tyle%
tenTM) 27 (39) 272 (414)
4(7) 303 (460)
8,91 89,77 1,32 100
Gia tri (dong) Tvle%
4.001.334.323 7,02 52,902 933 980 92,85
75.992 728 56.980.261.031
0,13 100 Mdi tddng quan giiTa eac nhdm thudc: Nhdm I (AV, BV, CV, AE, AN); Nhdm I I (BE, BN, CE); Nhdm I I I (CN) theo chiing loai va gia trj dddc the hien trong bang 4.
Bang 4; Ty le thudc nhom I ; I I ; I I I theo chiing loai va theo gia tri
TT 1 2 3
Nhom 1 2 3 Tong
Chung loai 82 371 7 460
Ty le % 17,83 80,65 1,52 100
GiS trj (dong) 46.584.933.475 10.319.334.828 75.992.728 56.980.261.031
T y l f M ) 81,76 18,11 0,13 100
Bang 5: Cac thudc nhdm I I I (CN) theo ngan sach
TT 1 2 3 4 5 6 7
Nhom Phospholipid dau nanh Gingko biloba 40mg Lysozym 90mg Phospholipids dau nanh Gingko biloba 40{ng Arginine Tldiaciate 200mg Gingko biloba AQmg
Chung ioai Uvolin H 300mg Kolon Flavon 40mg Lozym 90mg Essencicaps Fori Takan 40mg Eganeen 200mg Gitoba Phytosome 40 mg Tong
Giatri (dong) 44,550.000 17081.894 6.193.250 3,920 384 2.993.700 942,000
3U,500 75.992.728
Tyle<W) 0,0782 0,0300 0,0109 0,0069 0,0053 0,0017
0,0005 0,1334
BAN LUAN Phan tich ABC
Qua phan tich ABC/VEN lu'dng thuoe su* dung trong 6 thang (tir 1/10/2013 - 30/04/2014), cho thay nhom thucic
THllYiNNHi&«Vl6TNANI*S0 2 ( 1 0 ) - 2 0 1 5 - 8 1
anh hddng nhieu nhat den ngan sach thuoe la nhdm A.
De eai thien van de ngan sach thudc, benh vien can quan tam cac thuoe frong nhdm nay ca 3 yeu td: si/ phii hdp vdi md hinh benh tat cua benh vien; gia ttiuoc va sd Iddng sir dung.
Nhdm thudc A: vdi it loai thuoe, cd 48 loai chiem Ichoang 10,43% ve chimg loai nhutig ehiem gia trj thanh toan rat Idn, den 79,77% l^ng tien thudc tieu thu.
Nhdm thudc B: chiem tl le khoang 16,96 % ve ehiing loai va chiem khoang 15,15% gia tri thanh toan.
Nhdm thudc C: Mae dii sd loai thudc nhieu 334 loai chiem 72,61% ve chiing loai nhutig ehi ehiem Idioang 5,08 % tong gia tn thanh toan.
Ket qua nghien cutj nay phii hdp vdi ti le quy djnh d-ong thdng tu" sd 21/2013/TT-BYT Quy dinh ve ^ chut va boat ddng eua Hpi dong thudc va dieu tri trong benh vien.
Thdng thddng, san pham hang A chiem 10 - 20% tong sd san pham, hang B ehiem 10 - 20% va cdn lai la hang C ehiem 60 - 80%.
Tien hanh phan tieh cae thuoe nhdm A eho thay, cac thudc ehiem ti le cao la thudc khang sinh (35,12% ngan saeh); thudc khang Virus (18,10% ngan sach). Ket qua nay la hdp ly so vdi mo hinh benh tat tai Benh vien Benh nhiet ddi Trung ddng, benh nhiem khuan va nhiem vi rut ehiem tl le cao. Theo bao cao sd ket hoat ddng cua benh vien trong 6 thang dau nam 2014, ti le benh nhan viem gan nhap vien dieu tri npi tru tren ^ n g so benh nhan nhap vien la 11,2% (795/7.109).
Ngoai ra vdi Iddng benh nhan viem gan vl rut B, C ldn, benh vien da sir dung mdt iddng dang ke eac diuoc dieu tri va ho trd dieu tri gan (10,51% ngan sach). Trong cac thudc nhdm A, cd 2 thudc Cycloferon 0,15g; Ur- sodeoxycholic Acid 200mg cung dddc sir dung vdi sd Iddng nhieu, qua xem xet thi thay rang day la hai thudc dddc bac sy ke eho nhieu benh nhan viem gan ngoai tru.
Xem xet ky nhdm A, ket qua eho diay phan ldn ngan sach tap trung vao eac biet dddc, dac biet la nhdm khang sinh. Vi du: Tienam 500mg; meronem I g ; invanz I g ; eol- istin l.OOO.OOOUI; roeephin I g ; tazoein 4,5g; sulperazon I g ; avelox 400/250ml; ciprobay IV Inj 200mg; fdrtum I g ; tavanic SOOmg/lOOmI; unasyn Inj l,5g; zitromax tab 500mg; dalaeln C inj 600mg... Oa vdi mdt benh vien trong
nganh tmyen nhiem, cae thudc khang sinh thut sd quan trpng va ehiem ty trong Idn la phii hdp vdi md hinh benh tat. De giam chi phi, can chuyen sang diing thudc generic.
Tuy nhien, dieu nay cung can phai can nhac vi Benh vien Benh nhiet ddi Trung ddng la benh vien chuyen khoa truyen nhiem tuyen cudi, nhieu benh nhan bi nhiem friing benh vien, vl khuan da khang vdi cac khang sinh tir tuyen dddi chuyen len.
Vdi nhdm thudc khang vi rut, benh vien cijng da luli y diing nhieu thudc generic, dac biet uti den diing hang Viet Nam chat Iddng cao. Nhdm thuoe khac chii yeu la cac thudc an than, cap ciTu cung ehiem ti le 16,3% trong nhdm A. Dieu nay cung hdp ly trong dieu kien Benh vien Benh nhiet ddi Trung ddng cd sd glddng cap cutj va dieu trj tich cdc chiem tl le cao so vdi cac benh vien khac (17%).
Can can nhac vdi eac loai thudc nhdm A, tiiy theo tinh hinh cd the de xuat \da ehpn thay the cac loai thudc sd dyng nhieu nhutig chi phi thap hdn. Cung can xem xet vdi nhdm C vi qua nhieu loai thuoe nhutig ty trpng kinh phi lai rat thap gay phi^e tap cho quan ly thudc. Ket qua nay cung phii hdp vdi ket qua nghien culi eiia tae gia Huynh Hien Trung nam 2011 tai Benh vien Nhan dan 115 (thanh phd Hd Chi Minh)™, Tran Quang Hien, nam 2013 tai Benh vien da khoa Trung tam An Giangt^"'.
Trong sd eac thudc nhdm C cd the can nhac bd bdt cac thuoe nhdglypressin Inj Img, carexime I g (cefotaxim Ig), neurolaxan 100 mg (magnesi oxyd lOOmg + pyri- doxin hydroclorid lOmg), digoxin 0,25mg, glueosamin SOOmg, paralys 2,5mg (galatamine 2,5mg) vi sd Iddng sijr dung it va khdng thudc eae nhdm thudc V hoac E.
Viec loai bd thudc nhdm C can phai ket hdp vdi phan ti'ch VEN vi cd the cac thudc trong nhdm nay la thudc de dd phdng djch cd the xay ra hoac la thuoe de dieu bi nhiitig benh dae thu cua bvyen nhiem. Vi du: refortan 6%
- 500ml, artesunat 60mg, pnmaquin 13,2mg, praziquan- tel SOOmg, triclabendazole 250mg. Day la mdt dac diem phai lu\j y ciia Benh vien Benh nhiet ddi Trung ddng khi xay dutig DMT
Phan tich VEN
Nhdm thudc V: diiem sd iddng 8,48 % va ty trpng kinh phi 7,02%; Nhdm thudc E: chiem so Iddng den 90,00% va ehi phi sir dung thudc tai benh vien 92,85%.
Ket qua nay cho Utay, ti trpng thudc nhdm V va E
8 2 - T R U Y ^ N H l i M V i e T N A M * s 6 2 ( 1 0 ) - 2 0 1 5
chiem 98,48% ve chung loai va 99,87% kinh phi su" dung thudc ciia benh vien. Ket qua nay cung tddng t d v * ket qua nghien culi eua Tran Quang Hien nam 2013 tai Benh vien da khoa Trung tam An Giang, nhdm thudc V va E chiem 94,10% ngan sachPJ.
Nhdm ttiuoe N la thudc khdng can Oiiet ehi ehiem sd Iddng 1,52 % ve sd Iddng va chi phi la 0,13 %. Benh vien dang han che tdt cac thudc nhdm N.
Them vao dd, can nghien cifU xem xet lai nhdm thudc E de giam so ludng thudc d nhdm nay neu thay chung khdng cdn la thuoe thiet yeu ddi vdi benh vien. Oe lam dude dieu nay, chung ta can du^ vao ma tran phan b'ch ABC/VEN. Ket qua nghien euli eho thay nhdm I (Nhdm thudc quan bong nhSt) la 82 san pham, chiem ti" le 17,83
%; Nhdm n = BE + CE 4- BN = 371 san pham, ehiem ty le 80,65 %; Nhdm I I I : CN = 7 san pham, ehiem ty le 1,52 %.
Nhdm thudc CN mac dii khdng ehiem nhieu ve sd Iddng nhutig cung la nhdm thudc khdng thiet yeu can dutfc xem xet loai bd bdt trong danh muc thudc dieu b-|.
Phan b'ch ma tran ABC/VEN vdi eac ti le tren cho thay, viec sir dung thudc d Benh vien Benh nhiet ddi Trung udng giai doan nghien eutJ la phu hdp vdi Hu'dng dan cua Bd Y te, ngan sach dddc sir dung hdp ly va giam thieu dddc eac thudc khdng thiet yeu (nhdm CN).
KET LUAN
Trong giai doan nghien cutJ cd 460 thudc dddc su"
dung trong benh vien vd^ 303 boat chat gdc. Tong chi phi thudc sd dung la 56.980.261.031 ddng.
48 loai tiiudc (10,43%) dddc xep nhdm A (chiem 79,77% chi phi sd dung thudc). 78 loai thuoe (16,96%) thupe nhdm B (chiem 15,15% chi phi sd dung thudc); 334 loai thudc (chiem 72,61%) tfiudc nhdm C (chiem 5.08% chi phi sd dung Oiudc tfong benh vien).
Phan tieh VEN cho tfiay, 39 loai tfiuoc (ehiem 8,48%) la thuoe toi can thiel (Nhdm V), 414 loai Uiude (chiem 90,00%) la thudc can tiiiet (Nhdm E), cdn lai 7 loai tiiude (1,52%) la thudc khdng thiet yeu (Nhdm N).
Trong phan tieh ma ti-an ABC/VEN, thudc Nhdm I cd 82 loai (chiem 17,83%), Nhdm I I cd 371 loai (chiem 80,65%) va Nhdm I I I (CN) ed 7 loai (chiem 1,52%).
KHUYEN NGHI
Giam sat ddn dat hang va lu'dng tdn kho eiia nhdm V va E chat ehe hdn nhdm N. Quan ly, theo doi chat che thudc nhdm I de kiem soat sir dung thudc hang nam dddc tdt hdn, dong thdi kiem soat thuoe nhdm I I d mu'c trung binh va ha mii'c thap hdn vdi thudc nhdm I I I .
TAI LIEU THAM KHAO
1. Bd Y te (2009). Hdi thao chuyen de "Danh gia vai tid Hdi dong thuoe va dieu tri".
2. Doloresco, F. and LC. Vermeulen (2009). Global survey of hospital pharmacy practice. Am J Health Syst Pharm; 66(5 Suppi 3): p. S13 - 9.
3. Huynh Hien Trung (2012). Nghien cuU mdt sd giai phap nang eao chat Iddng cung utig thudc tai Benh vien Nhan dan. Luan an Tien sy Dddc hpc.
4. Huynh Hien Trung, Nguyen Ngpc Phddng Trang, Nguyen Thj Thuy Ha, Nguyen Thanh Binh, Td Mmh Kodng (2011). Ap dung ke ddn dien td, Mdt giai phap nang cao chat luwng ke ddn tfiudc tai Benh vien Nhan dan 115. Tap chi duWc hpc sd 427 (11/2011), tr. 14 - 18.
5. Jonatiian et al (1997). Managing Drug Supply, Man- agement Sciences for Health., pp.
6. Milovanovic, D.R., et al. (2004). Public drug pro- curement: the lessons from a drug tender in a teaching hospital of a transition country. Eur J. Clin Pharmacol;
60(3): p. 149 - 53.
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8. Trddng Qudc Cddng (2010). Tong quan ve eung utig thudc thiet yeu eiia Viet Nam. Hdi nghj tang cddng kha nang tiep can thudc thiet yeu tai Viet Nam. Bp y te.
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TRUY^IVM^\fltTIUAM*s62(10) - 2015 - 83
SURVEY ON THE USE OF MEDICINES BY ABC, VEN METHODS AT NATIONAL HOSPITAL FOR TROPICAL DISEASES ( 1 0 / 2 0 1 3 - 4 / 2 0 1 4 )
Summary
The aim: 1- Analyse the correlation betiween the amount of medicine consumption and annual costs by ABC, VEN methods in order to define tiie drug accounted for a large proportion of the budget. 2- Dertermine prior- ities and proposed solution to improve the efficiency of procurement and storage of medicines in Hospital. Object:
The list of medicines used in Hospital in 2013. Methods:
DesCTipbve retrospective data on medicine use in tfie hos- pital during period from 10/2013 to 4/2014. Results and conclusions: Study of 460 medicines have been used in hospital with 303 original substances. The total cost of medicine use was 56,980,261,031 Vietnames dong, in which 48 kind of medicines (10.43%) as category A ac- counted for 79.77% of the using medicine costs. 78 kind
Key words: Medicine use, ABC, VEN methods.
of medicines in group B accounted for 15.15% of using medicine costs, the remaining 334 kind of medicine of group C accounted for only 5.08% of medicine using costs in the hospital. The analysis of VEN method showed that 35 kinds of medicines (8.48%) was hight essential medi- cines (group V). 414 kinds of medicines (90%) was es- sential (gnjup E). The remaining 7 medicines was not essential drugs (gnjup N). In tiie analysis matrix MBC/MQi, medicines were classified into groups. Group I had 82 eategries (17.83%), group I I had 371 (80.65%) and group I I I (CN) 7 categories (1.52%). Recommendadon; Closely monitoring of medicine orders and inventory level of V and E groups than group N Is important.
8 4 -TRUYfeyNHl6MVieTNAM*s62(10)-2015