An analysis on the drug list used in Hue Central Hospital in 2016

Journal of military pharmaco-medicine no5-2019

AN ANALYSIS ON THE DRUG LIST USED
IN HUE CENTRAL HOSPITAL IN 2016
Nguyen Ky Nhat1; Nguyen Thanh Binh1; Pham Tri Dung1
SUMMARY
Objectives: To verify the appropriateness of the list of drugs that have been selected and
used by the hospital in 2016. Method: Descriptive, retrospective study. Results: There were
27 drug classes with 1,295 drugs in the list, with about 530.78 billion in total cost. In terms of costs,
domestic medicine accounted for 15.84% among the drugs; imported drugs accounted for 84.16%;
single component drugs accounted for 92.14%; multi-component drugs were 7.86%; generic drugs
accounted for 76.32%; brand name drugs accounted for 23.68%; injections drugs accounted for
77.69%. The drugs were mainly used in the Ministry of Health (99.9%). Conclusion: The list of drugs
to be used at Hue Central Hospital in 2016 is suitable for treatment in hospitals.
* Keywords: Drug list; Hue Central Hospital; 2016.

INTRODUCTION
In developing countries, the management
of drug supply is not effective at all steps
in the supply chain and one of the
reasons for this is that managers and
policy makers do not have much analysis
and evaluation to find the shortcomings
and inadequateness in the system of drug
supply towards management interventions.
Drug selection is an important component
of hospital drug supply, affecting the
quality of medical care, which involves the
building and implementation of a drug list
[7]. The hospital drug list should include
safe, high-efficacy, cost-effective and

readily available medications that meet
local treatment needs.
Hue Central Hospital is a terminal
general hospital, a special class with a
very diverse disease pattern. Drug costs
account for a large portion of the total

treatment costs. In recent years, the
hospital has made a lot of efforts in
selecting drugs for safe, effective and
economical use to improve the quality of
medical examinations and treatments. For
the purpose of making recommendations
to improve the choice of drug use in the
hospital, we conducted the topic "Analyzing
the list of drugs used at Hue Central
Hospital in 2016" with the following
objectives: Verify the appropriateness of
the selected hospital drug list and used in
2016.
SUBJECTS AND METHODS
Conducted data collection related to
the drugs used in the hospital in 2016
based on the hospital drug use reports:
- Name of drug, content, dosage form.
- Pharmacological action group.
- Quantity and value of use.

1. Hue Central Hospital
Corresponding author: Nguyen Ky Nhat ()

Date received: 02/01/2019
Date accepted: 20/05/2019

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Journal of military pharmaco-medicine no5-2019
RESULTS
1. The proportion of single component drug and multi-component drug.
Table 1: The proportion of single component and multiple components.
Group

Number of types

Percentage (%)

Single component drug

1,191

91.97

489.06

92.14

104

8.03

41.72

7.86

1,295

100.00

530.78

100.00

Multi-component drug
Total

Costs (billion VND) Percentage (%)

Single component drugs accounted for a large proportion compared to multi-component
drugs in the hospital drug list in 2016, 91.97% in terms of the number of types, and 92.14%
in terms of costs.
2. The proportion of the drugs list by its origin and cost.
Table 2: The proportion of imported drug - domestic drug.
Origin

Number of types

Percentage (%)

Costs (billion VND)

Percentage (%)

Imported drug

1,036

80.06

446.70

84.16

Domestic drug

259

20.00

84.16

15.84

1,295

100.00

530.78

100.00

Total

Imported drugs accounted for 80.06% by number of types, and 84.16% by costs.
3. The proportion of generic drugs and brand name drugs.
Table 3: The proportion of generic drug and brand name drug analysis.
Number of types

Percentage (%)

Costs (billion VND)

Percentage (%)

1,021

78.9

405.09

76.32

Brand name drug

174

21.1

125.69

23.68

Toal

1,295

100.00

530.78

100.00

Generic drug

Generic drugs accounted for 76.32% in the total drug purchase cost and accounted
for 78.9% in total items. Drugs with the original brand name accounted for a small
percentage of items (21.1%) and value (23.68%), mainly for diagnosis, cancer,
cardiovascular and respiratory. Generic drugs are mainly antibiotics, domestic production
intravenous, cardiac.
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Journal of military pharmaco-medicine no5-2019
4. The proportion of drug forms.
Table 4: The proportion of drug forms.
Intravenous drug
Value of consumption
(billion)
412.36

Oral drug

Other drug

Percentage
(%)

Value of
consumption
(billion VND)

Percentage
(%)

Value of
consumption
(billion VND)

Percentage
(%)

77.69

105.20

19.82

13.21

2.49

Results of analysis of drug formulations showed that infusion drug ac counted for
the highest proportion of use in value (77.69%). Oral drugs accounted for 19.82% in
consumption value. Other types of drugs accounted for a small proportion (2.49%).
5. The appropriateness with the main drug list of the Ministry of Health.
Table 5: In main drug list of Ministry of Health.
Value of consumption

Number of types

Group

In main drug list
Out main drug list

Costs (billion VND)

Percentage (%)

Number of types

Percentage (%)

530.24

99.9

1286

99.31

0.54

0.1

9

0.69

Drugs in main drug list accounted for 99.9% of total drug costs, and accounted for
99.31% of total drug items. The results showed that the list of drugs used in the hospital
was based on main drug list used in medical facilities issued by the Ministry of Health.
Drugs not on the primary drug list were mainly cancer medicines, anti-rejection
drugs in kidney transplant and anti-thrombotic drugs.
DISCUSSION
In order to meet the demand for medical
examination and treatment and at the
same time to well implement the regulations
of the Ministry of Health, the Hue Central
Hospital annually organizes the bidding
for the purchase of medicines and building
the list of drugs to be used at hospitals.
The 2016 list of drugs ensures that the full
group of drugs used in the Ministry of
Health's medical facilities are on the list.
One of the criteria recommended by the
World Health Organization when choosing

a drug is to select one that is prepared in
a mono-form [5]. The drugs used in the
hospital in 2016 were mostly single

component drugs, accounting for 91.97%
by type and 92.14% by cost. When
selecting drugs, the DTC considered the
choice of proven drugs for therapeutic
efficacy and safety. Hospitals that prefer
to use single component drugs will be
more favorable in controlling drug interactions.
This result is similar to the study done at
the Central Endocrinology Hospital, which
accounted for 88.7% by type.
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Journal of military pharmaco-medicine no5-2019
Domestic medicine will reduce the
costs for patients and also promote
domestic production. With the hospital
domestic drugs using rate in 2016
accountting for 15.84%, it proved that the
hospital was interested in using quality
domestic medicine. This result was also
consistent with Vu Thi Thu Huong’s study,
the value of domestic drug use in central
hospital ranged from 12.1% to 27.9% [4].
The hospital uses a lot of imported
medicines, partly because the patient is
treated at the end-line, and many patients
in serious conditions need specialized
imported drugs. However, the hospital
should be more concerned about imported

drugs that are mainly used in India and
Korea for the origin of these drugs.
Generic drug - brand name drug analysis
results showed that generic drugs
accounted for 78.9% in items and 76.32%
in value. Generic drugs, with the advantage
of cheaper costs than the patented drug
and still the necessary active ingredients,
have been used widely in many countries
around the world, such as in the United
States (50%), Germany (60%), Malaysia
(40%), and their use are on the rise in
developing countries. Therefore, the use
of generic drugs brings great benefits to
both business and patients. Using generic
drugs is a way to reduce the cost of
treatment.
Many imported drugs and expensive
brand - name drugs are used at central
hospitals. This is unavoidable when patients
are in severe conditions. However, the
hospital also needs to increase the use of
domestic drugs and generic drugs because
there are many domestically produced
154

drugs that are of good quality and cheap
but as effective as brand - name drugs.
The proportion of injectable drugs in
the hospital was higher than that of oral

drugs. The use of injectable drugs was
more effective for treatment of more
severe patients. Worldwide, there were
4.7 million cases of hepatitis B/C and
160,000 people infected with HIV each
year. Therefore, the hospital should
reduce some injectable drugs in hospital
drug list if other drugs can meet the needs
of patients.
The results of the analysis also show
that 99.31% of the drugs used were within
the primarily drug list of the Ministry of
Health. This showed that DTC has
selected drugs based on primary drug list
from the Ministry of Health and primary
drug list have met the requirements of
hospital treatment and guarantee health
insurance benefits for participants.
CONCLUSION
The 2016 hospital drug list included
27 drug classes with 1,295 drug categories.
Total cost of use was 530.78 billion VND.
Single component drugs, multi-component
drugs accounted for 92.14% and 7.86% of
funding. The proportion of domestic medicine
accounted for 15.84%. Generic drugs
accounted for 76.32% of funding. Drugs
are mainly used in main drug list of the
Ministry of Health (99.31%).
The hospital has selected reasonable

use drugs, the drug structure is compatiple
with disease patterns and characteristics
of the hospital. The drugs used are mainly
imported drugs, in the form of single
component, trade name, most of which


Journal of military pharmaco-medicine no5-2019
have active ingredients in primary drug list
covered by health insurance. The hospital
was interested in the use of domestically
produced medicines and generic drugs.
REFERENCES
1. Hue Central Hospital. Hospital drug list.
2016.
2. Ministry of Health. Circular 23/2011/TTBYT: Guiding the use of medicines in medical
establishments with beds. 2011.
3. Vu Thi Thu Huong. Evaluate the
functioning of the drug board and treatment in
the development and implementation of the
drug list at a number of general hospitals.
Doctorate Ph.D. in Pharmacy. Hanoi University
of Pharmacy. 2012.

4. World Health Organization (WHO). Drug
and Therapy Committee. Practical Handbook.
2004.
5. Huynh Hien Trung. Research on some
solutions to improve the quality of drug supply
in People's Hospitals 115. PhD Thesis in

Pharmacy. Hanoi Pharmacy University. 2012.
6. Anthony Savelli Harald Schwarz, Andrei
Zagoski, Alerxander Bykov. Manual for the
development and maintenance of hospital
drug formularies. Management Sciences for
Health. 1996, April.
7. WHO. Drug and Therapeutics Committee
Practical. World Health Organization. 2004.
7. World Health Organization. Management
Sciences for Health, Drug and Therapeutics
Committee Training Course. 2007.

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