The study of the state of pharmaceutical provision for patients with cardiovascular diseases using ABC-and VEN-analyses

Aim. To assess the state of pharmaceutical provision for patients with cardiovascular diseases (CVD) using ABC, VEN and complex ABC/VEN analyses. Materials and methods. The study was performed according to the data of the medical records of outpatients who were registered in the Public Health Institution (PSI) “Kharkiv City Clinical Hospital No. 27”. The methods of ABC, VEN and complex ABC/VEN analysis were used. Results and discussion. The results of the study using the ABC-analysis method allowed us to determine that the largest number of drugs was in the group C, which included 25 drugs, or 51.02 % of the total number of prescriptions. During the VEN analysis it was found that the vast majority of drugs (41 drugs) belong to the group V – vital essential medicines. The complex ABC/VEN analysis showed that drugs with the A/V status (the most costly and vital essential medicines) had the highest percentage (32.20 %) of the total consumption. It should be separately noted that the A/N group (the most costly and nonessential medicines) took the second position by percentage after the A/V group. A high percentage (31.05 %) in the A/N group is explained by the fact that the group includes the drug Magnikor, which has the highest frequency of prescription although this drug is not included in the National List of Essential Medicines (NLEM) and in the “Available medicines” program. Conclusions. The results of the studies of the state of pharmaceutical care for patients with CVD make it possible to draw attention to the urgency of the problems of drug availability to the population, namely expanding the list of medicines that are reimbursed in the framework of the government programs, in particular by including the drug Magnikor in the “Available medicines” program.

Ключевые слова: комплексный АВС/VEN-анализ; лекарственные средства; сердечно-сосудистые заболевания; Правительственная программа; фармакоэкономика Cardiovascular diseases (CVD) are one of the most common diseases of our time. Thus, according to the data of the European Cardiovascular Statistics over the past ten years, the prevalence of CVD in the world and in Ukraine has increased almost twice, and this situation leads to a number of socio-demographic and medical problems [1]. Because of the economic crisis, high inflation and instability of foreign exchange rates, high pharmacotherapy of CVD and low solvency of patients the rational and effective use of drugs in the healthcare system and pharmacy in the conditions of implementation of the government programs concerning the availability of drugs becomes relevant.
The aim of the work was to study the state of pharmaceutical provision for patients with CVD using ABC, VEN and complex ABC/VEN analyses.

Materials and methods
The study was performed according to the data of the medical records of outpatients who were registered in the Public Health Institution (PSI) "Kharkiv City Clinical Hospital No. 27"; the drug prescribing was within the framework of the "Available medicines" government program; the National List of Essential Medicines (NLEM), the Registry of wholesale prices for drugs [2, 3,4]. The following methods were chosen. The ABC-analysis method providing the ranking of drugs into three groups depending on size of expenditures by their cost price: А -(spent approximately 80 % of the total costs for pharmacotherapy), В -(spent approximately 15 % of the costs) and C -(spent approximately 5 % of the costs). The VEN analysis is based on distribution of drugs depending on their degree of importance into V -vital essential, E-essential and N -nonessential medicines. The ABC/VEN analysis provides sufficient objectivity of distribution of costs for pharmaceutical support of patients and helps to optimize the costs of public procurement of drugs [5].

Results and discussion
At the initial stage of the study the analysis of 1190 medical records of outpatients with CVD who were registered in the PSI "Kharkiv City Clinical Hospital No. 27" was performed. In total, 43 drugs were prescribed by the international nonproprietary name (INN) used in the "Available medicines" program taking into account the product forms and dosage and 6 drugs by the trade name (TN) that were not included in this program.
The next stage of the study was ABC analysis of three groups. Thus, the group A included 10 drugs (20.41% of the total number of drug prescriptions), there were 14 drugs (28.57 %) in the group B and 25 drugs (51.02 %) in the group C. The results are presented in Tab. 1.
At the third stage the VEN analysis by a formal sign was performed, i. e. distribution of drugs into groups based on the following normative legal documents: the resolution of the Cabinet of Ministers of Ukraine dated 25.03.2009 No. 333 "Some issues of state regulation of prices for medicines and medical products" and the resolution of the Cabinet of Ministers of Ukraine dated 09.11.2016 No. 863 "On introduction of reimbursement of the cost of drugs". Therefore, drugs included in NLEM and in the "Available medicines" program were referred to the group V -vital essential medicines, drugs included only in NLEM comprised the group E -essential, while drugs that were not included in all of the abovementioned regulatory documents were referred to the group N -nonessential medicines.
At the final stage the complex ABC / VEN analysis of drug prescriptions was performed. The results are presented in Tab. 2 [5,6]. Table 1 The results of ABC-and VEN-analyses of drug consumption in patients with CVD (by the experimental sample)  Table 2 The results of complex ABC/VEN-analyses of drug prescribing