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[The use of antitubercular drugs in primary care]
A Blázquez Pérez1, R Mateos Campos
1Departamento de Medicina Preventiva y Salud Pública, Facultad de Medicina, Universidad de Salamanca.
Objectives:
To quantify the consumption of tuberculosis medication prescribed through the National Health Service in Spain during 1996. To calculate the prevalence of tuberculosis from this consumption. To analyse possible inequalities between autonomous communities. To analyse the cost of these drugs.
Design:
A crossover, retrospective and observational study.
Setting:
Primary care.
Measurements And Results:
5533233 DDDs were taken in 1996. 2215890 of these DDDs belonged to the rifinah association (rifampicin + isoniazid), followed by the active principle rifampicin with 973510 DDDs. Amikacin at 8,078 DDDs represented the lowest dose. DID (dose per inhabitant per day) in Spain was 0.37. Dosage was greater in Galicia (0.66) and Ceuta (0.52). The Canaries (0.19) and Balearics (0.27) were below the national average. Use was 40.05% for rifinah, followed by 17.59% for rifampicin. The least common active principles were amikacin (0.14%) and streptomycin (0.74%). The number of cases of tubercular disease in Spain calculated was 11,211; its prevalence was 27.7 cases per 100,000 inhabitants. Total medication cost was 863275147 pesetas (0.1% of total pharmaceutical expenditure). The attributable cost was rifinah, 40.26%, the rifater association, 21.68%, and rifampicin, 18.34%.
Conclusions:
The most often prescribed drug is the rifampicin + ilsoniazid association. Use varies between autonomous communities. We think that the prevalence calculated is high for a developed country.