BARCELLONA 6 OTTOBRE

1
RATIONAL PHARMACOTHERAPY DIFFERENCES AMONG
EUROPEAN COUNTRIES
SILVIO GARATTINI Istituto di Ricerche
Farmacologiche Mario Negri - Milan Italy
COPENHAGEN 6 NOVEMBER 2002
2
Pharmaceutical products among the 50 most sold drugs in Italy, UK, Germany and France Pharmaceutical products among the 50 most sold drugs in Italy, UK, Germany and France Pharmaceutical products among the 50 most sold drugs in Italy, UK, Germany and France
1992 1996 2001
Omeprazole Omeprazole Omeprazole
Simvastatin Simvastatin Simvastatin
- - Atorvastatin
- Amlodipine Amlodipine
- - Cyclosporine
Ranitidine Ranitidine -
Nifedipine - -
Enalapril - -
Captopril Captopril -
Acyclovir - -
3
(No Transcript)
4
ITALY UK GERMANY
FRANCE
CEFTRIAZONE MORNIFLUMATE ESAMEPRAZOLE FENOFIBRATE
CLARITHROMYCIN GOSERELINE NADROPARINE PARACETAMOL
LORAZEPAM LAMOTRIGINE CERTOPARINE R
OXYTHROMYCIN ALPRAZOLAM GABAPENTINE ENOXAPARINE BU
PRENORPHINE TAMSULOSINE SUMATRIPTAN FILGASTRIM GLI
CAZIDE BICALUTAMIDE MIRTAZAPINE DONEXEPIL TICLOPI
DINE CERIVASTATIN NIMESULIDE
50 MOST SOLD DRUGS BY VALUE DRUGS PRESENT IN
ONLY ONE COUNTRY (2001)
5
BASIC (BActeraemia Study in Intensive Care)

• Surveying antibiotic policy for bacteraemia in
  different countries

6
Duration of antibiotic therapy in primary
bacteremia
PORTUGAL
SPAIN
BELGIUM
ITALY
GERMANY
NETHERLAND
UNITED KINGDOM
0
10
20
30
40
50
60
70
80
90
100
short (lt6 days)
medium (6-9 days)
long (gt9 days)
7
Duration of antibiotic therapy in peritonitis
related bacteremia
PORTUGAL
SPAIN
BELGIUM
ITALY
GERMANY
NETHERLAND
UNITED KINGDOM
0
10
20
30
40
50
60
70
80
90
100
short (lt6 days)
medium (6-9 days)
long (gt9 days)
8
Spectrum of antibiotic therapy in community
acquired Gram bacteremia
PORTUGAL
NETHERLAND
SPAIN
BELGIUM
ITALY
GERMANY
UNITED KINGDOM
0
10
20
30
40
50
60
70
80
90
100
restricted
broad
9
WHY IS SO DIFFICULT TO IMPLEMENT RATIONAL
PHARMACOTERAPY ?
10
WHY IS SO DIFFICULT TO IMPLEMENT RATIONAL
PHARMACOTERAPY ?
11
WHY IS SO DIFFICULT TO IMPLEMENT RATIONAL
PHARMACOTERAPY ?
12
WHY IS SO DIFFICULT TO IMPLEMENT RATIONAL
PHARMACOTERAPY ?
13
WHY IS SO DIFFICULT TO IMPLEMENT RATIONAL
PHARMACOTERAPY ?
14
WHY IS SO DIFFICULT TO IMPLEMENT RATIONAL
PHARMACOTERAPY ?