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16PHARMACEUTICS
ANALYSIS OF DRUGS FOR THE TREATMENT OF INFLAMMATORY DISEASES OF THE ORAL
CAVITY IN UKRAINE IN 2017-2019
Iakovlieva L.,
Doctor of Pharmacy, Professor of the Department of Pharmaceutical Management and Marketing, National University of Pharmacy of the Ministry of Health of Ukraine, Kharkiv, Ukraine
Stefaniv I.
Assistant of the Surgical Dentistry department, I. Horbachevsky Ternopil National Medical University of
the Ministry of Health of Ukraine, Ternopil, Ukraine
Abstract
This article is concerned with a comprehensive market study (structure, prices, origin) of drugs of A01A group Means for use in dentistry in Ukraine during 2017-2019. It has been established that the number of INNs during the study period were remained unchanged, and the total number of trade names were slightly changed. The majority of TNs are highly available to patients. Among them are drugs with an optimal variety of dosage forms.
Keywords: dental pharmaceutical products; range; prices; dosage forms; dynamics of indicators in 20172019.
Introduction. The scale and incremental increase in oral diseases (OD) incidence have not lost their relevance for many decades. According to the World Health Organization (WHO), today, periodontal disease is high on the list of the structure of OD. Inflammatory periodontal diseases are manifested in 60% of the population of Europe, and in some ecologically unfavourable regions, their number reaches 70-80% [1, 2, 3, 4].
The decrease of the dental health of a population is closely linked to adverse living conditions [5], uncontrolled use of drugs, the adverse environmental situation [6, 7, 8], social and family stress [9], poor nutrition [10], bad habits [ 11], intensive industrial development, insufficient hygiene of the OC as well as heredity [12, 13, 14].
According to E.E. Kerimov, a high incidence of gingivitis and periodontitis is observed in regions endemic for goiter, characterized by natural iodine deficiency [15].
According to the given epidemiological data, the most common periodontal diseases in young people are gingivitis and generalized periodontitis of initial degree. After 30 years, generalized forms of gingivitis and periodontitis of more severe severity [16, 17].
Inflammatory lesions, such as gingivitis and peri-odontitis, account for about 90% of all periodontal lesions [18, 19, 20]. Often they have an active course and severe consequences not only for the dental system but also for the patient's body as a whole [21].
There are many reasons for the development of gingivitis. They are divided into external and internal. External factors include effects of chemicals, mechanical damage to the gingival mucosa, burns, local infections. Infectious gingivitis, caused by non-observance of oral hygiene, most often occurs in adults [22, 23]. Internal factors are decreased immunity, diseases of the
digestive tract, beriberi, tooth growth in young children (in this case, a growing tooth damages the gums), caries [24].
Due to the relevance of this group of diseases, it was advisable to study the dynamics of drugs of A01A group (according to the ATC classification) - dental products in the pharmaceutical market of Ukraine during 2017, 2018, and 2019.
The main issues included in our review in this article are:
S range of drugs by international non-proprietary names (INN) and trade names (TN) in A01A group;
S origin of drugs on the Ukrainian pharmaceutical market: domestic or foreign;
S analysis of drug prices of this group;
S determining the presence of specific dosage forms among the drugs of this group.
Materials and methods. The analysis of the range of drugs of A01A group was performed on the basis of data from the analytical firm "Pharmstandard" of the program "Morion". Methods of data collection on the pharmaceutical market of Ukraine and analytical approaches to their consideration were used. The collection and analysis of literature data on the development and spread of the group of oral inflammatory diseases were performed. An analytical method was used to study the prices of these drugs and determine the presence of specific dosage forms.
Results and discussion. Studies have shown that in the pharmaceutical market of Ukraine during the study period (2017, 2018, and 2019) were identified eight subgroups of drugs of A01A group by ATC classification, and their number did not change during the study period (Table 1). The range of trade names by years, respectively, amounted to 101, 108, and 104 TN. That is, the number of drugs changed slightly.
Notes
1 D - TN of domestic production
2 I - TN of import production
Most drugs were represented by domestic manufacturers: in 2017 - 77.3% (78 TN), in 2018 - 79.6% (86 TN) and in 2019 - 82.7% (78 TN). Foreign drugs, which were represented by a small number, respectively amounted to 23 TN, 22 TN, and 18 TN. These drugs were supplied by nine countries: India, the United States, the United Kingdom, Germany, Canada, Switzerland, Israel, Bulgaria, and Poland. The number of foreign drugs in the pharmaceutical market was decreased by 5 TN.
The most number of TN was imported in 2019 by producers of India - 4 TN, the USA, and Great Britain - 3 TN each, Canada and Switzerland - 2 TN each, Israel, Bulgaria, Poland, and Germany - 1 TN each (Table 2).
Table 2
Table 1
The structure of the market of dental drugs of A01A group
№ ATC TN used in the market
2017 2018 2019
D I D I D I
1. A01A B03 Chlorhexidine 3 1 4 1 7 1
2. A01A B11 Various drugs 5 2 4 2 3 2
3. A01A B12 Hexetidine 2 3 2 3 2 2
4. A01A B18 Clotrimazole 0 1 0 1 0 1
5. A01A B53** Chlorhexidine, combinations 1 0 1 0 1 0
6. A01A B67** Metronidazole, combinations 4 4 4 4 4 2
7. A01A D02 Benzidamine 8 3 15 3 15 3
8. A01A D11 Others 55 9 56 8 54 7
Total 78 23 86 22 86 18
Total 101 108 104
Total, % 77,23 22,77 79,63 20,37 82,69 17,31
The structure of the market of dental drugs of A01A group by country of origin in 2019
ATC Ukraine Israel USA India United Kingdom Germany Canada Bulgaria Switzerland Poland Total
A01A B03 Chlorhexidine 7 1 0 0 0 0 0 0 0 0 8
A01A B11 Different drugs 3 0 0 2 0 0 0 0 0 0 5
A01A B12 Hexetidine 2 0 2 0 0 0 0 0 0 0 4
A01A B18 Clotrimazole 0 0 0 1 0 0 0 0 0 0 1
A01A B53** Chlorhexidine, combinations 1 0 0 0 0 0 0 0 0 0 1
A01A B67** Metronidazole, combinations 4 0 1 1 0 0 0 0 0 0 6
A01A D02 Benzidamine 15 0 0 0 3 0 0 0 0 0 18
A01A D11 Others 54 0 0 0 0 1 2 1 2 1 61
Total 86 1 3 4 3 1 2 1 2 1 104
Total, % 82,69 0,96 2,88 3,85 2,88 0,96 1,92 0,96 1,92 0,96 100
India represented 2 drugs from subgroup A01AB11 Different drugs and 1 TN from subgroups A01AB18 Clotrimazole and A01AB67 ** Metronidazole, combinations. The United States imported to Ukraine 2 TNs from subgroup A01A B12 Hexetidine and 1 TNs based on Metronidazole. 1 TN based on Chlorhexidine was supplied from Israel. The other five countries supplied 7 TN from subgroup A01A D11 others.
Thus, in 2019, Ukraine supplied to its pharmaceutical market 78 TNs, and foreign manufacturers supplied 18 TNs, which indicates Ukraine's ability to provide itself with drugs used in practical dentistry for the treatment of inflammatory and oral infectious diseases.
The analysis of prices for dental drugs of group A01A showed that only one drug on the pharmaceutical
market of Ukraine - PERIOCHIP, Dexel (Israel), dental tabs 2.5 mg blister, .№20 had a very high price (8 197.60 UAH - 8427.79 UAH) was characterized as inaccessible and consumed precious little. This is a preparation of the common antiseptic A01A B03 Chlorhexidine, which is also available on the market by cheaper TN in a simple, widely used dosage form - a solution for external use.
The other seven INNs are represented on the market only by highly available TN. Thus, the subgroup of drugs A01A D11 Other, which includes the largest number of TN in 2019, was characterized by prices ranging from 5.04 UAH to 182.80 UAH. In the other seven subgroups, the minimum prices were higher and the maximum lower, which indicates the high availability of these drugs for consumers (Table 3).
This is a very positive factor for the prevention and treatment of widespread oral diseases.
Table 3
Dynamics of prices for dental drugs of group A01A in 2017-2019_
ATC Average retail prices for TN used in the market (UAH)
2017 2018 2019
min max min max min max
A01A B03 Chlorhexidine 5,69 8197,6 4,79 7706,43 6,03 8427,79
A01A B11 Various drugs 22,80 44,19 26,78 51,78 31,88 52,53
A01A B12 Hexetidine 12,38 86,17 18,68 100,82 46,86 132,15
A01A B18 Clotrimazole 139,72 149,67 152,33
A01A B53** Chlorhexidine, combinations 22,04 25,24 35,68
A01A B67** Metronidazole, combinations 12,13 51,10 12,01 59,03 24,10 67,15
A01A D02 Benzidamine 32,00 154,06 34,91 155,90 32,33 159,81
A01A D11 Others 3,89 477,09 4,36 242,98 5,04 182,80
it is very important to have appropriate dosage forms for topical
- 13,9%;
- 6,9%;
- 15,8%;
- 30,7%;
Notes
1 min - minimum prices
2 max - maximum prices
For the studied group of dental drugs A01A administration in OC. There are seven types: S sprays S lozenges S gels for OC S liquids:
liquid extracts drops
restorative drinks solutions S herbal raw materials S dental tabs S oral paste
The largest number of dental drugs is presented in the form of liquid dosage forms (30.7%), which are prepared mainly on the basis of medicinal herbal raw materials. The herbal raw material itself, in dry form dosed in filter bags or in bulk in boxes, as well as liquid drugs is a third of all drugs. The third place among the dosage forms presented on the pharmaceutical market is occupied by gels for gums, dental and for OC - 15.8%. The fourth place is occupied by sprays - 13.9%. There are few solid dosage forms in the form of lozenges on the Ukrainian pharmaceutical market - 6.9% and dental tabs and oral paste are presented in one TN.
The analysis showed the presence in Ukraine of specific dosage forms for the group of drugs A01A, intended for the treatment of dental diseases.
Conclusion. In such a way, studies have shown that drugs of group A01A are presented in the pharmaceutical market of Ukraine in eight subgroups, which can be characterized as a moderate range: 101TN, 108 TN, and 104 TN, respectively, by years - 2017, 2018 and 2019. The vast majority of drugs are represented by domestic manufacturers: 78 TN (77.3%) in 2017, 86 TN (79.6%) in 2018, and 86 TN (82.7%) in 2019. The number of foreign-made drugs was low: 23 TN in 2017 and 18 TN in 2019. Imported TN is supplied from nine countries. The share of domestically produced drugs
30,7%
1,0%;
1,0%.
has been increasing every year, which ensures the pharmaceutical independence of Ukraine in this medical field. Only one drug on the market during the study period had a high price (8 197.60 UAH, 7 706.43 UAH, 8
427.79 UAH) and was inaccessible (PERIOCHIP, Dexel (Israel), dental tabs 2.5 mg blister No. 20). Prices for other drugs presented on the pharmaceutical market of Ukraine ranged from 5.04 UAH to 182.80 UAH in 2019, which compared to prices in previous years is characterized by a slight increase in minimum prices and a significant decrease in maximum prices and subgroup A01A D11 Other (477.09 UAH, 242.98 UAH,
182.80 UAH). In other subgroups, there was a slight increase in both minimum and maximum prices, but all drugs, except for the above, remained highly available to consumers.
It was established that A01A group Means for use in dentistry in the pharmaceutical market of Ukraine is represented by seven types of dosage forms. Most commonly, the drugs are presented in the form of oral liquids and dry herbal raw materials by 30.7% of the total amount of TN. Among the other dosage forms, there are oral gels - 15.8%, sprays - 13.9%, lozenges - 6.9%, and one drug in the form of dental inserts an oral paste. Pharmaceutical products are presented in the form of specific dosage forms intended for the treatment of inflammatory diseases of the oral cavity
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