■注射抗生素的消费没有得到广泛的研究,尽管注射剂占抗生素费用的主要份额。这项研究旨在了解印度国家一级口服和注射抗生素消费的份额和成本。以及喀拉拉邦公共和私营部门在注射剂的供应和成本中所占的份额。
■我们使用了PharmaTrac私营部门销售数据集和喀拉拉邦医疗服务公司公共部门采购数据集。利用世卫组织的准入,观看,储备(AWARE)和解剖治疗化学(ATC)分类,我们估计了每年的总消费量和人均消费量,和年度总数,每个定义的每日剂量(DDD),和人均注射支出。
■尽管在国家一级消耗的抗生素总量中,有94.9%是口服制剂,总支出的35.8%用于注射。在喀拉拉邦,私营部门抗生素总支出中约有33%用于注射剂,相比之下,公共部门的这一比例约为25%。与私营部门(n=69)相比,公共部门使用更少的可注射抗生素制剂(n=21)。与公共部门相比,私营部门的每个DDD成本要高得多。尽管仅占成本份额的6.3%,公共部门提供了31.4%的注射剂,表明非常高的效率。在这两个部门,观察组抗生素的消耗量明显高于访问组抗生素的成本,例如,私营部门的数量几乎是每个DDD的两倍,价格是每个DDD的1.75倍。储备群体抗生素的消费份额最低(私营部门为0.61%),但每个DDD的成本最高(超过Access的16倍)。
■与私营部门相比,公共部门在抗生素供应方面显示出更高的成本效率。适当的抗生素使用不能仅通过药品价格控制来实现,而是需要通过结构化的管理计划与私人提供者广泛接触。
这项研究试图了解公共和私营部门在印度抗生素注射量和费用中所占的份额。特别是在喀拉拉邦。我们使用药品销售数据(PharmaTrac)和喀拉拉邦政府采购数据进行分析。这项研究是由波士顿大学(美国)的研究人员进行的,印度公共卫生基金会(印度),全球发展中心(英国和美国),INSEAD(法国)并得到了惠康基金的资助.我们使用世界卫生组织将抗生素分类为Access,观看,储备(Aware),这是基于抵抗出现的风险。我们估计了年度总消费量和人均消费量,和年度总数,每剂量,和人均注射支出。我们发现,尽管抗生素注射不到全国抗生素消费总量的6%,占总支出的35%以上。喀拉拉邦的数据显示,公共部门通过使用更少的配方提供三分之一的抗生素注射剂量,显示出更高的效率,只有6%的成本分摊。储备组抗生素,构成最低的消费份额,每个剂量的成本最高(超过Access抗生素的16倍)。总之,与私营部门相比,公共部门在可注射抗生素供应方面显示出更高的成本效益。适当的抗生素使用需要通过结构化的管理计划与私人提供者广泛接触。
UNASSIGNED: Consumption of injectable antibiotics is not widely studied, despite injectables constitute a major share of antibiotic cost. This study aimed to understand the share of oral and injectable antibiotic consumption and cost at the national level in India, and the public and private sector shares in the provision and cost of injectables in Kerala state.
UNASSIGNED: We used the PharmaTrac private sector sales dataset and the Kerala Medical Services Corporation public sector procurement dataset. Using WHO Access, Watch, Reserve (AWaRe) and Anatomical Therapeutic Chemical (ATC) Classifications, we estimated the annual total and per-capita consumption, and the annual total, per defined daily dose (DDD), and per-capita spending on injectables.
UNASSIGNED: Although 94.9% of total antibiotics consumed at the national level were oral preparations, 35.8% of total spending were on injectables. In Kerala , around 33% of total antibiotic spending in the private sector were for injectables, compared to around 25% in the public sector. The public sector used fewer injectable antibiotic formulations (n=21) compared the private sector (n=69). The cost per DDD was significantly higher in the private sector as compared to the public sector. Despite only accounting for 6.3% of the cost share, the public sector provided 31.4% of injectables, indicating very high efficiency. Across both sectors, Watch group antibiotics were significantly more consumed and at a significantly higher cost than Access group antibiotics, for example in nearly double the quantity and at 1.75 times the price per DDD in the private sector. Reserve group antibiotics made up the lowest consumption share (0.61% in the private sector), but at the highest cost per DDD (over 16 times that of Access).
UNASSIGNED: Public sector showed higher cost efficiency in antibiotic provisioning compared to private sector. Appropriate antibiotic use cannot be achieved through drug price control alone but requires extensive engagement with private providers through structured stewardship programs.
This study tried to understand the share of public and private sectors in the volume and cost of antibiotic injections in India, particularly in the state of Kerala. We used drug sales data (PharmaTrac) and Kerala government procurement data for the analysis. The study was conducted by researchers at Boston University (USA), Public Health Foundation of India (India), Center for Global Development (UK and USA), and INSEAD (France), and was supported by a Wellcome grant. We analysed data using the World Health Organization classification of antibiotics into Access, Watch, Reserve (AWaRe), which is based on the risk of emergence of resistance. We estimated the annual total and per-capita consumption, and the annual total, per-dose, and per-capita spending on injectables. We found that although antibiotic injections were less than six percent of total antibiotics consumed nationally, they accounted for more than 35% of total spending. Kerala data showed that the public sector showed higher efficiency by providing one-third of antibiotic injection doses using fewer formulations, with only six percent of the cost share. Reserve group antibiotics, which made up the lowest consumption share, had the highest cost per dose (over 16 times that of Access antibiotics). In conclusion, public sector showed higher cost efficiency in injectable antibiotic provisioning compared with private sector. Appropriate antibiotic use requires extensive engagement with private providers through structured stewardship programs.