Perceptive to drug use

process:
Economic Factor
Sabin Thapa
Sanjita Shahi
 Economic burden due to Illness and
expensive treatments
• GDP of Nepal: around 34.47 billion U.S. dollars and a life expectancy
at birth of 71.07 years in 2020.
• Increased economic burden with increased illness.
• Limited progress in UHC.
• Increase in cost of newer and advanced treatment.
Pharmaceutical Industry Development and
Marketing
• Production/ import of newer and expensive molecules.
• Variation among cost for same medicines.
• Marketing strategies benefits manufacturer, prescriber and
pharmacies/ organization.
 Prescribing pattern

• Low compliance with WHO prescribing indicators with higher

prescription errors.
• Prescribing practices not confirmed to the standard recommended by
WHO.
• Prescribing from the Essential Drug List (EDL), low rates of generic
prescribing, high antibiotic prescribing and poly-pharmacy.
 Prescription and use of nutraceuticals

• Increased practice for prescription and OTC purchase of

nutraceuticals/supplements.
• Gap between the knowledge and practices among the patients for
nutraceuticals.
• More than 80% patients use nutraceutical on their own.
• On average, amount spent on prescription of the nutraceutical alone
contributed to NRs.575.78.
 How can it be minimized???
• Social health insurance, upgraded community-based health insurance
system, subsidy program expansion and third party liability motor
insurance.
• Policy to make the cost of treatment and drug therapy effective and
uniform.
• Amendment in price range of drugs by DDA.
• Balancing rational drug use and promotional activities of
pharmaceutical manufacturers, importers and distributors.
• Information to prescribers and patients regarding the use, monitoring
and cost effectiveness of drugs and drug therapy.
• Practices and policy formulation and implementation by DTC and
regulatory bodies to promote the rational use of medicine.
• Generic prescription and sticking to EDL/ hospital formulary as far as
practicable.
• Promoting rational use of nutraceuticals and other food supplements
and discouraging unnecessary use.
Reference:
• Swe, K. T., Rahman, M. M., Rahman, M. S., Saito, E., Abe, S. K., Gilmour, S., & Shibuya, K.
(n.d.). Cost and economic burden of illness over 15 years in Nepal: A comparative analysis.
PLOS ONE. https://journals.plos.org/plosone/article?id=10.1371%2Fjournal.pone.0194564

• Shrestha, R., & Prajapati, S. (2019, July 10). Assessment of prescription pattern and
PRESCRIPTION error in outpatient department at tertiary CARE District Hospital, CENTRAL
NEPAL. Journal of Pharmaceutical Policy and Practice.
https://joppp.biomedcentral.com/articles/10.1186/s40545-019-0177-y?
fbclid=IwAR1m0UxrL-1Re1jYlqS-AQtjb2F6VtaYf8QUzfILw6PJb6iEQfvIcEZyrbA.

• Shrestha R, Shrestha S, K. C. B, Shrestha S (2021) Evaluation of nutritional supplements

prescribed, its associated cost and patients knowledge, attitude and practice towards
nutraceuticals: A hospital based cross-sectional study in Kavrepalanchok, Nepal. PLoS ONE
16(6): e0252538. https://doi.org/10.1371/journal.pone.0252538