One of our favorite blogs is called Psychopharmacology Institute. We find impressive outreach and scientific criticism that the authors carried out Pol Yanguas Emilio and Francisco Martinez Granados . The truth is that there are so many entries that we consider absolutely essential that we do not recommend any in particular. You have to read and frequent this blog, which gathers original research papers, articles and book chapters translated, all under the concern for the rational prescription of psychotropic drugs, from the point of view of the critical dose abuse and polimedicaciones without any empirical basis. I said: a blog essential.
Recently, one of the authors of this blog made an interesting comment on an entry ours, we gather here, "We usually all responsibility the industry of many evils, and we're right, but lately I prefer to think that "the greater evil is the weakness of health systems. If our health system had strength, had the elements you need to have to act with sensitivity analysis, we simply do not worry about the pharmaceutical industry, because it could not do many of the things that allow you to do. The focus of the debate must be to be moved to the weakness of our system. Drug consumption in an irrational and lacking in security can not depend on a clinician is more or less sensitive to sustainability the system can not depend on this . "We felt successful and relevant commentary (as we have ever said, not everything is going to be to rock the pharmaceutical industry ), and in that sense we answered. But we that the issue deserves a full entry to make clear our position.
So for that matter.
believe that the government in this country, starting with the Ministry of Health and following the most autonomous health service, with honorable exceptions, carry out an unfortunate neglect of duties in different areas:
The pharmacological research has been completely in the hands of private pharmaceutical companies, whose objectives are first and as is evident in a market capitalist logic of profit. This leads to no research on diseases of poor countries, that prevail over medication long-term maintenance and not curative, to persist in drug known lines too I dare not open new lines, more risky in terms of business, but potentially source de descubrimientos nuevos, etc.
La formación continuada del personal sanitario ha quedado también de forma casi absoluta en manos de las mismas empresas farmacéuticas, que deciden así cuáles son las líneas de investigación y avance teórico que florecen y cuáles quedan relegadas casi a la clandestinidad. Y no son inocentes en ello las asociaciones profesionales y otros colectivos con intereses formativos que establecen precios de inscripción para sus actividades absolutamente prohibitivos sino va uno pagado por las mismas empresas que comercializan los fármacos que se anuncian en tales eventos y que luego el médico prueba a ver how about , giving the impression that goes well (and passing at the same time backing any assessment of the placebo effect or observer bias, if one puts the edge, to see how you're going to Honolulu. ..).
The administration also systematically practiced an obvious hypocrisy approves public funding (which in the case of psychiatric drugs, most of the time is almost the full value of the product in question) for certain products with studies showing efficacy against placebo ... but not to existing drugs, cheaper and more popular (or, which is the same: more insurance). And I approve: more expensive, less safe because of ignorance, wildly sponsored guests, lectures, gifts, conferences ... And then, and here comes the hypocrisy, public administrations in documents that discuss various pharmaceutical products, we recommend that prescribers do not prescribe. Cojo. Well then, why do you fiancian (with our money, do not forget)?. Because we agree that the State, especially in these times, you can not pay for everything. In fact, our glasses and our fillings we pay to us. And, if we had no money to pay, we would be farsighted and caries, but the state would not comprárnoslos.
And in this vein, recently the Ministry of Health of the Galician regional government approved a list of available drugs to be prescribed in the Community. The list included all active, but left only prescribe cheaper presentations, we assume that essentially generic. And in an economy measure as sensible as that, the Health Ministry itself is up in arms, arguing that freedom is under attack limitation (will prescribe the coolest visitor mark, because active ingredients could prescribe all) and the fairness of the system (ie, that equity is that if you send the expensive brand in Asturias, Galicia can not save the generic cheap though, as we should already know , no differences in either efficacy or safety, equity must be squandering money equally in all communities).
We say in this connection that the Medical College (which is not very saint of our devotion to his usual corporatist policy and its not very striking concern by public health) has written an admirable document we can read the entire here. We quote a few paragraphs:
" Freedom of limitations is based on the physician's ability to prescribe a particular substance or its therapeutic equivalent, not whether to have a trade name or other. [.. .] Freedom of limitations also entails taking into account the economic aspects of medical decisions. The doctor can not forget that the resources are paid the requirements belong to the whole society. It is therefore particularly liable to prescribe with economic rationality and good sense. It is unacceptable deontologically prescription drugs higher price when their effectiveness is identical to that of other lower cost .
Clarito, clearly.
Well, now going our immediate environment, we say that we find it regrettable management Canary Islands Health Service on this issue. It is true that there is a service Control and Rational Drug Use , which provides freely accessible publications of interest. But the moment of truth, it downloads all the prescribers responsibility to control the excessive expenditure on health (and, obviously, as prescribers that's one of our responsibilities), but the Canary Islands Health Service itself do something about it. The last straw was the publication in the Official Journal of Canary a series of conservation measures, given the terrible situation of economic crisis and rampant unemployment that exists in the islands. The decree in question, apart from measures that we liked a little like going to charge less for our hours of duty, leaving to have free parking, lost days of the agreement, etc. (Not go into the relevance or justification of such measures or not, but obviously we did not like), including (by finally) clear measures of health cost containment:
" In order to rationalize public spending on the prescription and use of drugs in the area of \u200b\u200bthe Canary Islands, that the requirement is prioritized of drugs by doctors of the Canary Islands Health Service or centers with the Canary Islands Health Service, is carried out by identifying the active ingredient in the prescription official. "
" In order to rationalize the prescription and use of drugs, medical devices, effects and accessories and reducing expenditure on medicines, the doctors of the Canary Islands Health Service, as well as the centers with the Canary Islands Health Service, shall ensure that the requirement to carry out whatever it costs less to generate the Autonomous Community Canarias. To do this, those involving the treatment groups increased spending in the pharmaceutical bill is set by the body that determine the active ingredients, having the same or equally effective alternative therapy involving the most economical. If the patient's clinical circumstances is not possible the prescription of these active principles, will require that the physician prepare a supplementary medical report setting out the reasons justifying the prescription clinical .
this decree was supposed to came into force on January 1, 2011. We're running in March and we already have convention at days and we have no free parking, but no reports that have forced people to prescribe by substance (I do, but on a strictly voluntary basis and agree to be listed in that regard as the ultimate fan service ). We have no evidence that any competent body has made that list of active ingredients, but since then, competent body or not, nobody has sent doctors to the Canary Islands Health Service list of similar characteristics.
What we understood: we are totally in favor of forcing to prescribe by active. Only from interest away from the public for which (supposedly) work that can be understood as an attack on freedom of prescription (do not tell ourselves, says the Medical College). But not enough to make a good law. It is necessary to enforce compliance. And that, once again, our governments neglect to make functions. It's been three months and continue to squander the money of all.
Lords of the Canary Islands (including government), please make a damn time to apply the decree made yourself. You are responsible for managing it effectively and decent, but it is our money that is lost.
Lords of the Canary Islands (including government), please make a damn time to apply the decree made yourself. You are responsible for managing it effectively and decent, but it is our money that is lost.
0 comments:
Post a Comment