CC BY
36
PROBLEMS OF HEALTH OF THE POPULATION
UDC 615.1+617.7
EYE DISEASES: INCIDENCE AND PHARMACEUTICAL MARKET OF OPHTHALMOLOGICAL DRUGS G.A.Antropova, T.I.Okonenko
Yaroslav-the-Wise Novgorod State University, [email protected]
Incidence evaluation of eye and its appendicular apparatus diseases (EAAD) among urban population of Novgorod region has been performed. The tendencies of high incidence of ocular organs particularly in children and teenagers have been investigated. Growth of incidence leads to an increase of ophthalmological medicines (OMs) use. The analysis of OMs sale at the pharmaceutical market retail segment of Novgorod region has been carried out.
Keywords: eye and its appendicular apparatus diseases, age, pharmaceutical market, ophthalmological medicines
Проведена оценка распространённости болезней глаза и его придаточного аппарата среди городского населения Новгородской области. Рассмотрены тенденции высокой заболеваемости органов зрения, особенно среди детей и подростков. Рост заболеваемости приводит к увеличению потребления офтальмологических лекарственных средств. Проведен анализ продаж офтальмологических препаратов в розничном сегменте фармацевтического рынка Новгородской области.
Ключевые слова: болезни глаза и его придаточного аппарата, возраст, фармацевтический рынок,
офтальмологические лекарственные средства
Introduction
One of the important medico-social tasks of the contemporary society is population eye protection and prevention of blindness. The functional status of ocular organs is one of the leading criteria in identifying the occupational fitness of the workers of various activities.
The total proportion of ocular invalids (taking into account the total population of the state) is rather high- 28 per 10.000 persons. From them 4-5 persons are at the age of 19; about 20 persons are capable of working age ones; and more than 105 persons (a rather high index) are persons over 65 years of age [1,2]. The main cause of invalidity is glaucoma; it comprises 20% of total number of causes of primary and common invalidity. The number of various eye traumas is increasing (19%); the prevalence of high complicated degenerative myopia (16%) is observed; retinal impairment comprises 16-17% (the diabetic retinal changes compose the main part); 18% of total cohort of ocular invalids are cataract sufferers [2].
At the same time, one of the contemporary medical problem, ophthalmology among them, is the patients’ unwillingness to follow the medical demands (the doctor’s prescriptions, pharmaceutical chemist’s recommendations who is performing pharmaceutical assistance) [3]. Often improper following the recommended therapy regimen is followed by clinical consequences: the course and prognosis of a disease worsens, a treatment protocol needs to be changed, financial expenses for additional examinations and prescriptions increase too [4]. Among the multiple factors influencing the patients’ compliance, the most essential ones are the causes connected with the drugs: amount of prescribed drugs, number of times of drug intake, sufficient assortment, package, convenience of use, the drug storage, therapy duration, treatment cost, side-
effects and so on. As the quality of vision is extremely important for a patient, the study of up-to-date state of the pharmaceutical market of eye drugs, assortment sufficiency and availability at the regional level is necessary.
The goal of the presented investigation is evaluation of incidence of EAAD as well as the study of the up-to-date OMs pharmaceutical market, investigation of the state and development tendencies of the pharmaceutical market at the regional level.
Materials and Methods
Ophthalmopathology has been studied basing the data of the annual accounts of Novgorod region outpatients (2006 — 2009). The ODs classification analysis has been based on the content-analysis of normative informational literature [5,6]. The analysis of OMs sale at the pharmaceutical market retail segment of Novgorod region has been carried out grounding on the large-scale regional retail network and some chemist’s shops of some other networks in Velikiy Novgorod as well. This analysis included two periods: I period — III and IV quarters of 2009, II period — I and II quarters of 2010. All data have been obtained from the working lists of the pharmaceutical institutions.
In the general incidence structure in Velikiy Novgorod in children aged 0-14 in 2009 the EAAD have been 5,77% (fig.1), which has remained at about the last year level (5,6%), and ranked the 3rd after respiratory and nervous diseases. In teenagers (aged 15-17) EAAD have been 7,52% (in 2008 — 7,7%) and ranked the 3rd in the general incidence structure after respiratory and endocrine diseases. In incidence structure in Borovichy-town in children aged 0-14, EAAD have been 4,76%, which was a little bit lower the last year level (5,6%) and ranked the 4th after respiratory and digestive diseases,
dermal and subcutaneous cellular tissue diseases. In Sta-raya Russa-town pediatric EAAD have been 4,6% (in 2008 — 5,7%); ranked the 3rd after respiratory, dermal and subcutaneous cellular tissue diseases. In teenagers aged 15-17 in Borovichy, EAAD has comprised 9,61%, which demonstrates growth vs the last year data (7,8%) and became the 2nd in the general incidence structure after respiratory disorders. In Staraya Russa EAAD at this age category have been the 3rd (8,7% vs 7,6% of the last year level) after respiratory diseases, traumas and poisonings.
In adult population of Velikiy Novgorod EAAD occupy the 5th place in the incidence structure after circulatory disorders, respiratory impairments, skeletal and muscular pathologies, digestive diseases; this level is equal to the last year one. As for adults in Borovichy, EAAD occupy the 7th place, only circulatory, respiratory, urogenital, skeletal and muscular, and digestive diseases, and oncology rank higher. For adult population in Staraya Russa, EAAD occupy the 4th place after circulatory diseases, skeletal and muscular pathologies, and respiratory disorders.
Fig.1. Eye and its appendicular apparatus diseases, the age aspect (Novgorod region, 2009)
The proportion of commonly occurring ocular diseases of a whole ophthalmopathology in adult population of Novgorod region is shown in Fig.2. In 2009 cataract (0,23%) was revealed in other age categories (children, teenagers), the data are confirmed by published reports about early appearance of such pathologies as cataract, glaucoma, allergic diseases.
Study of ocular incidence structure during the investigating period has shown the leading position of eye myopathy, accommodation and refraction impairments, and impairment of concomitant eye motion or strabismus: these comprise 50% — 89% from total number of EAAD in different age cohorts. Of the above-mentioned diseases myopia, hypermetropia and astigmatism are the commonest. The prevalence of blindness in urban population of Novgorod region has been 0,02%-1,0% (data obtained from the medical cases of the patients who had sought for ophthalmologic help, 2009).
Dynamics of EAAD prevalence in urban population during the investigating period is shown in Fig.3. High incidence in teenagers’ group (aged 15-17) is supposed to have been declined but, nevertheless, it remains higher than the level of incidence in people over 18 years of age according to prognosis.
Fig.2. Proportion of some eye diseases among identified ophthal-mopathologies in urban population of Novgorod region, 2009
Fig.3. Dynamics and prognosis of prevalence of EAAD in Velikiy Novgorod population up to 2011
Taking into consideration the identified significant level of ophthalmopathology as well as the high prevalence of eye diseases it is essentially necessary to carry out the more active identification and registration of the mentioned diseases at various stages of ophthalmologic examinations, before eye surgery, before contact lenses selection. Also, treatment of identified pathology demands timely pharmaceutical aid, available and qualitative supply with the required ocular drugs.
Drugs using for eye diseases treatment may be divided onto several groups [6,7].
While performing the content-analysis of ophthalmologic medicines, an International Nonproprietary Names (INN), a country-manufacturer, a company-manufacturer and medicinal form have been taken into account.
OMs can be in the forms of drops, ointments, gels, suspensions, emulsions, ocular plates, and tabs.
According to Anatomical Therapeutic Chemical Classification (ATCC), OMs are referred to following groups: group S — drugs effecting the sense organs (the main anatomic group); group S01 — drugs for eye diseases treatment (the main therapeutic group). The OMs at the retail market are divided onto 8 groups according to their direct effect and according to ATCC. On the territory of the Novgorod region the increase of OMs sale has been either positive or remained at the same level with regard to investigating periods. Almost half of the market retail
segment is occupied by the group of medicines ranking 1st at the OMs sale rating by the amount of sold units.
The first place belongs to group S01A (Antimicrobial drugs). Into TOP5 of trade marks of this group Sulfacilum-natrium, antibiotics Tetracyclinum, Laevo-mycetinum are included as well as antibacterial drugs of fluorochynolon line - Cipromed and Ciprolet.
The second place at the sale rating belongs to group S01X (Other OMs); the leaders of sale are Tau-fonum, Taurin, Quinax, Oftan Catachrom, and Visine. The third place belongs to group S01E (Anti-glaucoma and myotic drugs). Into TOP5 of the trade marks of this group Timolol, Pilocarpinum, Betoptic, Fotil and Xalatan are included.
The performed study evidences that the low-cost antimicrobial OMs are the most in demand. Some groups of medicines possess obvious seasonal demand (e.g., antiallergic drugs), and the sale size of one and the same medicine is changing during a year. The sale share of OMs at the drugstores total commodity circulation is influenced by near-by location of the Eye Protection Centers, optic salons. It is also expedient for the apothecary institutions to take into account the peculiarities of consumers’ demand.
Conclusion
The level of ophthalmopathology in Novgorod region population, in children and teenagers in particular, is rather high, therefore the study of prevalence causes of EAAD and development of preventive and sanitary meas-
ures for their reducing is one of the prominent current tasks of the regional medical science and public health services.
Nowadays, the sale size is permanently increasing alongside with the extension of medicinal assortment as more and more new drugs appear at the pharmaceutical market. Thus, timely information about the introduced new medicines at the pharmaceutical market is absolutely needed for the apothecary institutions, which will allow realize complete and qualified pharmaceutical aid for population.
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