The risks of the excess of medicines and the huge costs for their settlement by CNAS – Mures news, Targu mures news

April 24, 2024

During April 24-25, the Business Hotel Conference Center&Spa in the Municipality of Târgu Mureș hosts the “Pharma Forum” event, organized by Pharma Business, under the patronage of the College of Pharmacists from Romania, in which current topics from the world of pharmaceutical medicine, challenges and duties are addressed the pharmacist, the role of pharmacovigilance, the frequency of conditions that require drug treatment, the costs of these drugs and others.

On the first day of the conference, the presidium was made up of: Prof. Univ. Dr. Pharm. Dumitru Lupuleasa- the president of the College of Pharmacists from Romania and the moderator of the event, pharm. spec. Nicoleta Logigan- president of the Mureș College of Pharmacists, respectively Rodica Biro – general director of the Mureș County Insurance Company (CAS).

The risks of polymedication

In his presentation entitled ‘What happens when we take too much medicine? The pharmacist’s role in counseling the chronic patient”, pharm. spec. Nicoleta Logigan pointed out the risks generated by the simultaneous administration of several drugs by patients, a phenomenon known in pharmaceutical medical language under the term polypharmacy, and how effective pharmaceutical management can contribute to reducing these risks. Oftentimes, the administration of multiple medications is necessary because people may have multiple conditions that require treatment at the same time, and since most medications have singular therapeutic uses and treat only one condition, there is a need for a surplus of other supplements or pills to cure other conditions. “Thanks to the increase in the quality of life in the European Union and in Romania, life expectancy has increased and thus we have a fairly large population that from a certain age, I would say over 65, simultaneously has several diseases and must take more many treatments and here we are talking about polymedication and polypharmacy. In addition to the medicines that the doctor prescribes, the patient is used to, under the influence of TV commercials, under the influence of advice, to self-administer different supplements or medicines without a consultation”, explained the farm. spec. Nicoleta Logigan.

In 2021, a new service appeared in the Nomenclature of Pharmaceutical Services entitled “Polymedication Evaluation and Monitoring Service” which also provides an order stating that polypharmacy begins with the simultaneous administration of more than five drugs, although other specialists states that this term is suitable only for patients taking more than ten drugs simultaneously.

In mitigating the negative consequences of polymedication on the patient’s health, the pharmacist must identify the patient’s primary condition and focus on it. The pharmacist may also opt to replace those drugs known to cause serious side effects with drugs that have the same therapeutic effect, in consultation with the prescribing physician. At the same time, the pharmacist has the task of providing adequate advice to patients, in which to capture information such as: recommended dose, duration of treatment, correct administration, contraindications, adverse effects, interactions with other drugs, etc.

Adverse drug reactions

Another topic of the farm presentation. spec. Nicoleta Logigan has been linked to psychiatric side effects that can occur with certain medications. According to it, certain antibiotics, such as: macrolides, aminoglycosides, polymyxins, sulfonamides, can create states of psychological discomfort such as anxiety disorders, depression, delirium, confusion, or drowsiness, headaches and dizziness.

Likewise, the banal non-steroidal anti-inflammatory drugs that patients frequently take to combat common pain symptoms are also dangerous, because they can cause insomnia, mood disorders, psychosis, fatigue, delirium, lethargy, anxiety.

Huge expenses for medicine

“I am of the opinion that we need to think differently about everything that means financing in the system along the lines of medicine and pharmacy. I would like to emphasize once again that indeed the activity in the pharmacy must be financed by the Health Insurance House in a completely different way. We have a very important archive that we are trying to get rid of, an archive that still contains the prescriptions submitted by you, the pharmacies, to the CAS and which means 156 linear meters. It was a titanic job, we gained a lot in the system through the mechanism of the electronic prescription, but there would probably still be room for other improvements”, said ec. Rodica Biro.

During the conference, ec. Rodica Biro, the general director of CAS Mureș, provided a balance sheet of the expenses generated by settling the drug treatments of insured patients from Mureș county. According to the statistics provided by it, in the previous year no less than 1,632,571 medical prescriptions were registered that required settlement from CAS Mureș and which totaled over 100 million lei more than in 2021. All this highlighted the fact that most medical prescriptions fall within the horizon of chronic diseases.

Last but not least, eq. Rodica Biro showed that in the current year, the representatives of the Ministry of Finance issued an order regarding a new rule for the settlement of medical services by which a certain monthly limit amount, which cannot be changed, will be offered to the County Health Insurance Houses, which will not cover the real needs of financial resources, which will create new delays in the settlement by CAS of medical services to providers.

Mădălina ROHAN