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THE PRESCRIPTION TO OVER-THE-COUNTER SWITCHES AND DOUBLE REGISTRATION OF MEDICINES - THE PERSPECTIVE OF PHARMACISTS FROM THE GREATER POLAND.

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Zaprutko T., Kopciuch D., Ratajczak P., Paczkowska A., Adamczak O., Kus K., Nowakowska E.
Acta Poloniae Pharmaceutica - Drug Research
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2019
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vol. 76
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issue 5
907-912
EN
The prescription to over-the-counter switch is a global occurrence. However, the switch phenomenon might be considered controversial. Nevertheless, the further development of switches seems to be inevitable, thus we collected pharmacists’ opinions about Rx-to-OTC switches including double registration of medicines. The study was conducted in pharmacies from the Greater Poland, using an anonymous questionnaire, which was delivered by direct contact. Finally, answers from 232 pharmacies were included in the study. Moreover, we analyzed data from 5500 Polish pharmacies, concerning the turnover of selected and doubly registered medicines. Rx-to-OTC switches were negatively evaluated by the majority (81.5%) of respondents. “Furaginum” was the most frequently chosen (60.8%) substance, which according to obtained answers should be available only on prescription. Study participants claimed that the most important drawback (chosen by 44.4% participants) of the double registration of medicines is the development of uncontrolled self-medication. Data obtained from a market research company revealed that the Rx-to-OTC switch may lead to the market share growth of OTC class (e.g. “furaginum”), but it is not the rule (e.g. “omeprazole/pantoprazole”). Although Rx-to-OTC switches are considered somewhat controversial, the switch, as well as double registration phenomenon, seems to be a subject of further development. However, in pharmacists opinion substances like “furaginum” should be available as an Rx-only brand instead of double registered medicine. In the case of Rx-to-OTC switches, additional information about possible side effects and/or interactions should be provided to the patients who might inappropriately use medicines.
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ANALYSIS OF CHRONIC MYELOID LEUKEMIA PHARMACOTHERAPY COSTS IN POLAND

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Paczkowska A., Kus K., Nowicka M., Kopciuch D., Zaprutko T., Komarnicki M., Nowakowska E.
Acta Poloniae Pharmaceutica - Drug Research
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2019
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vol. 76
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issue 1
175-183
EN
The aim of this study was to analyze pharmacotherapy cost of chronic myeloid leukemia from the society’s, the payer’s (National Health Fund), and the patient’s perspective. The study included 55 patients with a diagnosed and treated chronic myeloid leukemia at the selected hematology clinic in the city of Poznan. Retrospective study involved time horizon of one calendar year – 2013. The data required for economic evaluation were obtained from the patients’ case histories and the Department of Organization and Accounting of the selected health care facilities. The total cost of chronic myeloid leukemia pharmacotherapy for 55 patients from the society’s perspective in 2013 amounted to 1,483,416.88 EUR. Average annual cost of medication per patient in 2013 amounted to 26,971.22 EUR (Median – 32,854.22 EUR). Average cost of chronic myeloid leukemia pharmacotherapy for a patient without transplantation was 32,167.34 EUR (Median – 30,623.00 EUR), and for a patient after transplantation amounted to 413.13 EUR (Median – 378.40 EUR). The cost from the payer’s perspective is 99.93% of total costs from the society’s perspective. The cost from the patient’s perspective represents 0.07% of the total cost of chronic myeloid leukemia pharmacotherapy from the society’s perspective. Costs of chronic myeloid leukemia pharmacotherapy are very high and represent a significant burden to society. The highest costs associated with treatment of chronic myeloid leukemia are incurred by the society, and, subsequently, the public payer (NHF), and the patient.
3
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The influence of olanzapine and aripiprazole on spatial memory of female rats exposed to stress in the perinatal period

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Kus K., Ratajczak P., Zaprutko T., Kopciuch D., Paczkowska A., Nowakowska E.
Acta Poloniae Pharmaceutica - Drug Research
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2019
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vol. 76
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issue 5
885-893
EN
Cognitive functions, such as learning and memory, are instrumental in improving the patient’s quality of life. Commonly used antipsychotic drugs are also useful in depression treatment, and have a positive effect on spatial memory dysfunction caused by schizophrenia. Olanzapine (OLA) and aripiprazole (ARI) are known to have substantially different pharmacokinetics depending on sex, thus their therapeutic efficacy and dose of treatment may be different for males and females. The aim of the study was to assess whether dysfunction of spatial memory (Morris Water Maze - MWM) and locomotor activity (LA) improve in prenatally stressed rats (animal model of schizophrenia (AMS)) by OLA and ARI. OLA (0.5 mg/kg ip) and ARI (1.5 mg/kg ip) were administered to female Wistar rats (non-stressed control group (NSCG) and PSG). Single administration of ARI and OLA in the NSCG yielded no differences in spatial memory compared to the control group (C-NSCG), while OLA improved memory after 7 days of treatment compared to the C-NSCG. In the prenatally stressed group (PSG), an impairment of spatial memory by the drug was observed (vs. C-NSCG) after long-term treatment. Only chronic administration of ARI and OLA (PSG) improved spatial memory in female rats. Conclusion: Stress causes memory dysfunction in female rats. Chronic administration of ARI and OLA reverses this effect which can probably be associated with the mechanism of action of the drugs used (ARI/OLA). ARI acts as an agonist or antagonist mainly on D2 and 5-HT2A receptors, while OLA induces antagonist effects for these receptors.
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Access to vaccination in the Greater Poland (Poland)

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Zaprutko T., Kopciuch D., Paczkowska A., Sawicka D., Stachowiak Z., Bogdaniec P., Kus K., Nowakowska E.
Acta Poloniae Pharmaceutica - Drug Research
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2019
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vol. 76
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issue 1
195-201
EN
Immunization is a very effective health intervention. Moreover, the global vaccines market has been growing rapidly and costs of full children immunization are dramatically higher nowadays than 30 years ago. High vaccine prices may limit affordability of vaccination which is why we attempted an evaluation of availability and affordability of 7 and non-reimbursed vaccines mostly used in children in Poland. The study was conducted between October 2016 and October 2017 using a specially designed anonymous questionnaire comprising three closed-ended questions. The study tool was distributed by direct contact or via the Internet. Eventually, answers from 505 pharmacies from the Greater Poland region and 10 primary care clinics were included. 5 out of 7 vaccines were available in all types of facilities. There were some issues, however, with availability of Bexsero® and Nimenrix®. Considering prices, the highest difference (of more than 100%) was found for Infanrix hexa® and the lowest (38.5%), for Infanrix IPV+HIB®. In 88.17% of pharmacies included, patients were informed about a thermo-insulating package. 48.39% of respondents indicated that such package is free of charge, while in other pharmacies an average price for the package was EUR 0.48. Although availability and affordability of medicines are crucial objectives of the public health policy, it seems that access to vaccines in Poland might be an area for improvement. Thus, prices of non-reimbursed vaccines could be regulated in Poland nationwide. Moreover, to provide trustworthy information concerning vaccination, healthcare decision makers should consider social education about immunization as an important issue.
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Employment in schizophrenia –students’ point of view

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Zaprutko T., Kopciuch D., Sawicka D., Majchrzycka B., Nowak M., Michalak M., Kus K., Nowakowska E.
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EN
Schizophrenia is a serious mental disorder and has a huge economic burden related to direct and indirect costs. Direct costs include such expenditure as hospitalization. Indirect costs, however, result mostly from the loss of productivity. Although patients are frequently interested in job opportunities, unemployment is widespread among them. Thus, we evaluated opinions of medical universities students’ concerning situation on the labor market among those in the remission stage of schizophrenia. The study was carried out between October 2015 and October 2016 in Poland and other European Union countries using a self designed questionnaire. The study tool consisting of five questions was distributed to students by direct contact and via the Internet. Of a 5200 distributed sheets, we received 1036 questionnaires and 942 were finally analyzed. In the students’ opinion, patients are generally interested in finding a job but they are afraid coming back to work. Although unemployment is common among patients with schizophrenia, the number of patients capable of working is significantly higher than the number of those actually employed. According to results of the study, getting a job might be effectively supported by non-pharmacological interventions. Considering the noticeably higher number of patients capable of working compared to those employed, development of employment possibilities should be a priority for mental health care decision makers. It should lead to reduction of the patients’ concerns related to looking for a job. Moreover, comprehensive treatment could reduce the economic burden of schizophrenia.
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