PHARMACOECONOMIC ANALISIS OF DRUG PROVISION OF PATIENTS WITH BRONCHIAL ASTHMA

The Tashkent pharmaceutical institute, The National university of Uzbekistan after Mirzo Ulugbek

Republic of Uzbekistan

N.D. Suyunov, Sh.F. Madrakhimov, G.M.Ikramova,

SUMMARY

Questioning was performed in the pharmaceutical market of Uzbekistan among 102 leading physicians of specialized institutions on 91 medications (indicating their form and dosage) used for the treatment of bronchial asthma. The aim of the study was to perform VEN analysis, that is, determination of vital – V, essential – E and non-essential – N preparations. Questioning data was treated by an intellectual method. After distribution of medications into VEN groups, preparations were revealed that should be more widely used in the treatment of bronchial asthma in future. Most important groups of medications were determined for the treatment of bronchial asthma in in-patient and out-patients conditions.

Keywords: bronchial asthma, medications, expert estimation, ABC and VEN-analysis, questioning, general estimation, intellectual data processing.

Bronchial asthma is one of the widespread diseases in the world. Epidemiological studies conducted during the past few years have revealed that 4% to 10% of the world population suffers from this disease. In Uzbekistan there has been a tendency toward the growth of bronchial asthma rate. In the last 5 years the number of patients with severe clinical forms of bronchial asthma increased from 0.7% to 17.5%, that is, almost in 20 times. At present, the number of asthmatic patients accounts for 42% to 65% of all the patients with allergic diseases applying to the Republican Specialized Allergy Research Center [5].

Economic analysis of pharmacotherapy (pharmacoeconomics) represents a possible variant to assess the efficacy of budget disbursement for the organization and implementation of treatment process Studies on minimization, efficacy, utility of expenses; comparison of expenses and results are the most used approaches to the assessment of the pharmacoeconomic cost in healthcare and allow study results to be directed at decision making in selection of drugs [6].

Pharmacoeconomic ABC-, VEN- and frequency analyses are auxiliary types of the clinical-economic analysis. Based on drug consumption parameters were divided into groups. ABC-analysis – distribution of drugs to 3 groups according to expenses for each of them in a total cost structure, from most to least. The groups A, B and C include drugs accounting for 80%, 15% and 5% of expenses, respectively. The group A usually accounts for 10-15%, group B for up to 50%, group C for up to 40% of all drugs under study. This method is used to determine priorities and utility of drug expenses based on the retrospective assessment of their real cost [3, 7].

To conduct the study, permission was given by the Research Coordination Department of the Ministry of Public Health of Uzbekistan. A questionnaire was worked out for VEN-analysis to determine priorities of selection and purchase of drugs according to their classification into vital and improving life quality (V), essential (E) and non-essential (N) [3, 8, 9].

There are 28008,8 population Among them According to medical and statistic review 54 771,0 people have bronchial asthma diseases according to medical and statistic review

A general estimator method was used in this study for the processing of questionnaire data to perform a complex and justified selection of modern, most effective and safe antiasthmatic drugs.

Material and methods

Questioning was carried out of the medical staff from the following institutions: the Ministry of health of Republic of Uzbekistan Republic scientific allergology centre, the Republican specialised scientifical and practical medical center of phthisiology and pulmonology named after Sh. Alimov, the The Republican specialized scientifical practical medical center of therapy and medical Rehabilitation, the First clinic of the Tashkent medical academy second clinic, Tashkent medical academy 1-st hospital, the Healthcare chief direction of Tashkent city, the Municipal hospital of Urgent medical aid, the Municipal hospital №1 after Ibn Sino.

Drugs were assigned to 3 classes according to recommendations of qualified physician-experts. Experts answered questions containing drug names (trade and international names, forms and doses). A three-score system was used for the assessment of drugs: 3 scores were given to vitally important and life quality improving drugs (drugs necessary for life saving and maintenance); 2 scores to essential preparations (effective for the treatment of less dangerous but serious diseases); 1 score to non-essential, secondary preparations (for mild disease, doubtful efficacy, expensive drugs with symptomatic indications).

Drug consumption indices were studied in the Republican Specialized Allergy Research Center for 2005-2009 years. One hundred and two drugs for bronchial asthma were selected for the VEN-analysis. Ninety one physician-experts participated in the questioning.

One of the study aims was to determine a competency level of specialists giving expert assessment of drug use efficacy. Intellectual data analysis methods were used for general estimation of the competency level of specialists in distributing drugs to VEN groups.

A problem was stated of calculating aggregated, general estimation parameters without evident measure units, such as severity of the disease, competency level, etc. In calculation of general estimators by methods of intellectual data analysis based on the technology of neuron networks, information was used from “object-property” tables. In our case objects were drugs, signs (features) – their classification by experts in VEN-analysis [2, 4, 10].

Mathematic statement of the problem was formulated as following.

The fixed set of objects, contains representatives of two disjoint classes.The objects were described using nominal signs (features) (expert answers), each of those having 3 grades – 1, 2, 3 (according to VEN groups, respectively).

The necessity of two-class recognition task solution is related to the fact that any general assessment of parameters is relative. Objects of each class are opposed to objects from the opposite class (for example, class represented by expert assessment of drugs by allergologists and pulmonologists, to that by therapists);

For our case general estimator of object S was calculated by the formula:

.

Where – the number of j-th gradation of i-th sign (features) in the description of object S in classes K1 and K2, respectively;

– weight determined by interclass difference and innerclass similarity of i-th sign (features) values;

- the number of objects in class

The drugs were preliminary assigned to VEN groups taking into account graded assessment of experts (K₀ column, Table 2).

Three independent experiments were carried out to calculate general estimator of drug assignment to class as opposite to class, to assess the expert competence in classification. In the first experiment drugs from V group were classified into class with remaining ones into. General estimator of assigning drugs to class, presented in [0, 1] scale, is given in V column of Table 2, where 1 denotes absolute assignment of the drug to the class. In the second and third experiments drugs of E and N groups were classified to class (E and N columns, table 2).

Results and Discussion

Ninety one questionnaires were distributed to specialists (allergologist, pulmonologist, therapist) from the above institutions. Thirty six questionnaires were considered unsatisfactory and were resubmitted and reevaluated. Categories given in the questionnaire were fully assessed.

Displays information on 91 specialists, of them 23 allergologists, 44 pulmonologists, 24 therapists.

Characteristics of expert physicians and assessment of indices in scores

Characteristics of experts Index Number of experts and score

Specialty: allergologist 23; pulmonologist, 44; therapist 24.

Duration of work in healthcare (years) up: to 5, 6; from 5 to 10, 16; from 10 to 20 26; from 20 to 30, 28; above 30, 15.

Duration of work in specialty (years) up: to 5, 12; from 5 to 10, 21; from 10 to 20, 29; from 20 to 30, 22; above 30, 7.

Qualification category: highest 52; first, 18; second, 1; without category 20.

Academic degree: doctor of medical sciences, 4; candidate of medical sciences, 20; without degree, 67.

Academic rank: professor, 5; docent, 6; not ranked, 80.

Level of familiarity with bronchial asthma: practical experience 8; practical experience and theoretical knowledge of medications, 83.

Certification: certified 83; non-certified 8.

The majority of questioned participants were physicians of the highest category (57.1%). Service record in the healthcare system was 20-30 years in 24.2% and more than 30 years in 7.7% of the physicians.

Table 1

Optimal assortment of drugs for bronchial asthma – VEN

№	International names	Trade names, dosage, packing	Drug forms	VEN-experiments, R(S)
	Name of drugs			K0	V-(E, N)		E-(V, N)	N-(V, E)		Kr
	Glucocorticoids
1	Dexamethasone	Dexamethasone 4 mg/ml 1 ml №25	sol. for inj.	V	1.00		0.00	0.00		V
2		Dexamethasone – GT 0.4 % 1 ml №5	sol. for inj.	V	0.63		0.43	0.28		V
3	Beclometasone	Beclazon ECO light breathing 250 мg/dose 200	aerosol	V	0.90		0.13	0.08		V
4		Beclazon ECO light breathing 100 мg/dose 200	aerosol	V	0.78		0.31	0.05		V
5		Beclazon ECO 250 мg/dose 200 doses	aerosol	V	0.74		0.35	0.13		V
6		Beclazon ECO 100 мg/dose 200 doses	aerosol	V	0.68		0.44	0.14		V
7	Prednisolone	Prednisolone 30 mg/ml, 1 ml №3	sol. for inj.	V	0.78		0.34	0.01		V
8		Prednisolone 0.005 g №100	tablet	V	0.61		0.45	0.24		V
9		Prednisolone Nycomed 25 mg/1 ml №50	sol. for inj.	V	0.61		0.40	0.35		V
10		Prednisolone 5 mg №100	tablet	V	0.58		0.47	0.27		V
11	Fluticasone	Flixotide evohaler 250 мg 60 doses	aerosol	V	0.64		0.42	0.27		V
12		Flixotide evohaler 125 мg 60 doses	aerosol	V	0.58		0.54	0.26		V
13	Dexamethasone	Dexamethasone 0.5 mg №10	tablet	E	0.24		0.96	0.34		E
14		Dexamethasone 0.4% 2 ml №10	sol. for inj.	V	0.43		0.79	0.18		E
15		Dexamethasone-Darnitsa 0.4% 1 ml № 5	sol. for inj.	V	0.55		0.64	0.13		E
16		Dexamethasone phosphate 0.4 % 1 ml №10	sol. for inj.	V	0.55		0.63	0.11		E
17		Dexamethasone 0.4 % 1 ml №5	sol. for inj.	V	0.57		0.61	0.13		E
18	Methylprednisolone	Solu-Medrol 125 mg / 1 ml	sol. for inj.	V	0.34		0.67	0.52		E
19		Solu-Medrol 500 mg, 7.8 ml	sol. for inj.	V	0.32		0.67	0.57		E
20		Methypred 4 mg №30	tablet	V	0.41		0.63	0.43		E
21	Triamcinolone	Polcortolone 4 mg №50	tablet	V	0.41		0.67	0.38		E
22	Budesonide	Budesonide forte 10 ml 200 doses	aerosol	V	0.44		0.65	0.40		E
		Budesonide Mite 10 ml	aerosol	V	0.41		0.63	0.50		E
24	Methylprednisolone	Solu-Medrol 40 mg / 1 ml	sol. for inj.	V	0.39		0.53	0.58		N
Antiallergic medications
25	Aminophylline	Euphyllinum 2.4% 10 ml №10	sol. for inj.	V	0.84		0.19	0.04		V
26	Salbutamol	Ventolin 100 мg/200 doses	aerosol	V	0.82		0.25	0.04		V
27		Salamol ECO 100 мg / dose 200 doses	aerosol	V	0.71		0.40	0.13		V
28		Salbutamol – GT 100 мg 200 doses 12 ml	aerosol	V	0.60		0.56	0.19		V
29	*Fluticasone propionate, Salmeterol xinafoate	Seretide 250, 120 doses	aerosol	V	0.66		0.43	0.19		V
30		Seretide 125, 120 doses	aerosol	V	0.66		0.45	0.18		V
31		Seretide discus 50/250 мg 60 doses	Powder in caps.	V	0.65		0.45	0.19		V
32	Fenoterol	Berotec N 100 мg /10 ml 200 doses	aerosol	V	0.63		0.51	0.12		V
33	Aminophylline	Euphillin 2.4% 5 ml №10	sol. for inj.	V	0.58		0.51	0.24		V
34	Theophylline	Theophyl SR 300 mg №30	capsule	E	0.27		1.00	0.27		E
35		Theophyl SR 100 mg №30	capsule	E	0.29		0.88	0.35		E
36		Theopecum 0.3 g №50	tablet	E	0.31		0.83	0.37		E
37		Theotard 200 mg №40	capsule	E	0.36		0.75	0.36		E
38		Theophyl SR 200 mg №30	capsule	V	0.51		0.59	0.21		E
39	Aminophylline	Euphyllin – Н 200 5 ml №10	sol. for inj.	V	0.38		0.76	0.37		E
40		Euphyllin 0.15 g №30	tablet	V	0.38		0.67	0.46		E
41	Orciprenaline	Asthmopent 20 ml 400 doses	aerosol	V	0.33		0.73	0.50		E
42	Fenoterol, ipratropium bromide *	Berodual N 10 ml 200 doses	aerosol	V	0.47		0.71	0.23		E
43		Berodual 20 ml	for inhalation	V	0.47		0.68	0.24		E
44	Fenoterol	Berotec Н 100 мg/dose 10 ml 200 doses	aerosol	V	0.52		0.64	0.23		E
45	Salmeterol	Serevent 25 мg/60 doses	aerosol	V	0.52		0.63	0.26		E
46	Salbutamol	Salbutamol 12 ml, aerosol	aerosol	V	0.55		0.62	0.22		E
Antiallergic medications
47	Bacteria lyohpilizate	Cromoglin 20 mg/ml 15 ml	spray	E	0.18		0.94	0.58		E
48	Ketotifen	Ketotifen 1 mg №30	tablet	E	0.20		0.88	0.57		E
49		Ketotifen 0.001 №30	tablet	V	0.33		0.72	0.45		E
Immunomodulating medications
50	Bacteria lyohpilizate	Broncho-Munal P 3.5 mg, №10	capsule	E	0.16		0.87	0.54		E
51		Broncho-Munal P 7 mg, №10	capsule	E	0.23		0.82	0.45		E
	Expectorants
52	Butamirate cictrate	Sinecod 200 ml	syrup	N	0.01		0.99	0.82	E
53		Sinecod 200 ml	drops	N	0.00		0.98	0.88	E
54	Bromhexin	Bromhexin-REMEDY 0.008 g №10	tablet	E	0.12		0.99	0.61	E
55		Bromhexin – 4.4 mg/5 ml 60 ml	syrup	E	0.18		0.86	0.66	E
56		Bromhexin 0.008 g №50	tablet	E	0.19		0.86	0.59	E
57		Bromhexin 0.008 g №10	tablet	E	0.22		0.84	0.54	E
58		Bromhexin–8 Berlin Chemie 8 mg № 25	pill	E	0.24		0.83	0.52	E
59		Bromhexin 8 mg №20	tablets	E	0.22		0.83	0.54	E
60	Ambroxol	Pulmoxol 30 mg 5 ml, 150 ml	syrup	V	0.30		0.86	0.35	E
61		Ambroxol 0.03 №20	tablet	V	0.34		0.84	0.33	E
62		Ambroxol KMP 0.03 g №20	tablet	V	0.37		0.79	0.31	E
63		Ambrosan 30 mg №20	tablet	V	0.43		0.72	0.21	E
64		Lasolvan 15 mg/ 5 ml 100 ml	syrup	V	0.40		0.67	0.36	E
65		Аmbroxol 15 mg/5 ml, 100 ml	syrup	V	0.47		0.64	0.29	E
66	Bromhexin, levomenthol	Bronchosan 25 ml	drops	E	0.27		0.73	0.52	E
67	Aminophyllin, ammonia chloride, diphenhydramine menthol *	Hydrilline 120 ml	syrup	N	0.23		0.72	0.64	E
68	Salbutamol, bromhexin, guaifenesin, menthol *	Lorkof 100 ml	syrup	V	0,35		0,68	0.43	E
69	Dextromethorphan, diphenhydramine	Hydrilline DM 120 ml	syrup	V	0.27		0.67	0.62	E
70	Glaucin, ephedrine*	Broncholytin 125 g	syrup	V	0.28		0.65	0.58	E
Antibiotics
71	Midecamycin	Macropen 400 mg № 16	tablet	E	0.09		0.97	0.68			E
72		Macropen 175 mg/5 ml 115 ml	granule	E	0.10		0.96	0.70			E
73	Ceftazidime	Ceftazidime 1 g	pulv. for inj.	E	0.09		0.97	0.68			E
74	Cefazolin	Cefazolin sodium salt 1 g № 5	pulv. for inj.	E	0.15		0.87	0.67			E
75	Ceftriaxone	Loraxone 1000 mg	pulv. for inj.	V	0.28		0.81	0.49			E
76	Cefotaxime	Cefotac 1 g	pulv. for inj.	N	0.09		0.79	0.82			N
77		Cefotaxime 1 g	pulv. for inj.	N	0.19		0.67	0.81			N
78		Claforan 1,0	pulv. for inj.	N	0.25		0.60	0.68			N
79	Cefoperazone	Cefobid 1 g	pulv. for inj.	N	0.25		0.59	0.80			N
80	Cefazolin	Cefasolin – AKOS 1 g	pulv. for inj.	N	0.18		0.73	0.79			N
81		Cefamezin 1000 mg №1	pulv. for inj.	N	0.20		0.67	0.77			N
82		Cefazolin – GT 1 g	pulv. for inj.	N	0.18		0.74	0.77			N
83		Cefazolin KMP 1 g	pulv. for inj.	N	0.22		0.68	0.75			N
84		Cefazolin 1 g	pulv. for inj.	N	0.20		0.69	0.74			N
85		Cefazolin Teva 1 g	pulv. for inj.	E	0.20		0.77	0.70			N
86	Ceftriaxone	Ceftriaxone 1 g №1	pulv. for inj.	N	0.23		0.65	0.79			N
87		Ceftriaxone 1 g	pulv. for inj.	V	0.30		0.53	0.75			N
88		Ceftriaxone – KMP 1 g	pulv. for inj.	V	0.29		0.56	0.67			N
89	Azithromycin	Azithromycin 0.25 №6	capsule	V	0.26		0.58	0.70			N
Synthetic antibiotics
90	Ciprofloxacin	Ciprofloxacin 250 mg, №10	tablet	N	0.11	0.83		0.79		E
91		Cipro –500 mg №10	tablet	N	0.13	0.82		0.80		E
92		Sispres 250 mg № 14	tablet	N	0.16	0.75		0.73		E
93	Ofloxacin	Tarivid 200 mg №10	tablet	N	0.09	0.67		1.00		N
94		Ofloxacin 200 mg №10	tablet	N	0.18	0.66		0.82		N
95	Ciprofloxacin	Ciprox 100 ml	sol. for inj.	N	0.14	0.77		0.81		N
96		Ciproflaxacin 0.2 % 100 ml	sol. for inj.	N	0.14	0.76		0.81		N
97		Ciprinol 250 mg № 10	tablet	N	0.13	0.79		0.81		N
98		Ciprolox 500 mg № 10	tablet	N	0.11	0.82		0.80		N
99		Ciflox 500 mg №10	tablet	N	0.14	0.76		0.79		N
100		Cipro –250 mg №10	tablet	N	0.16	0.78		0.79		N
101		Ciprox 250 mg №10	tablet	N	0.19	0.71		0.77		N
102		Ciflox 250 mg № 10	tablet	N	0.17	0.73		0.77		N

*Note: combined medications: solution for inhalation; powder in capsules for inhalation; solution for injection; lyophilisat for solution of injections (bottles); in set with water dilution for injections 7,8 ml, 15,6 ml (bottles); powder for solution of injections per 1 g (bottles); solution for injection 0,2 % per 100 ml (plastic bottles); solution for injection per 100 ml.

After treating questionnaire data taking into account scores of competency level 102 preparations were assigned to groups V - 55 (53.92%), E – 21 (20.59%) and N – 26 (25.49%) (K₀ column, Table 1).

Drug redistribution was performed using a maximum principle by general estimators in VEN groups. It was found that of 102 preparations used in bronchial asthma 21 (20.59%) were assigned to group V, 56 (54.90%) to group E, 25 (24.51%) to group N (column k, Table 1).

Based on the findings “Beclazon ECO light breathing 250 мg/dose 200 dose aerosol” was distributed to groups V, E, N with coefficients 0.90, 0.13 and 0.08, respectively.

Table 1 listed 21 preparations assigned to group V with their proportion close to 1, that is, insignificant. “Dexamethasone 4 mg/ml 1 ml №25 ampoule” had the greatest share in group V followed by “Prednisolon 30 mg/ml, 1 ml №3”, “Prednisolon Nycomed 25 mg/ml №50, “Dexamethasone – GT 0.4% 1 ml №5”. Glucorticoid preparations used in the treatment of bronchial asthma such as “Beclazon ECO light breathing 250 мg/dose 200 dose aerosol”, “Beclazon ECO light breathing 100 мg/dose 200 dose aerosol”, “Beclazon ECO 250 мg/dose 200 dose aerosol”, “Beclazon ECO 100 мg/dose 200 dose aerosol”, “Flixotide evohaler 250 мg 60 dose aerosol had higher indices and were recommended to group V. Preparations used only for a relief of bronchial asthma attacks such as “Ventolin 100 мg / 200 dose aerosol”, “Salamol ECO 100 мg/dose 200 dose aerosol”, “Salbutamol-GT 100 мg 200 dose 12 ml aerosol”, Euphyllin 2.4% 10 ml №10” ampoule” had also high indices and were assigned to group V. Combined broncholytic preparations such as “Seretide 250, 120 doses”, “Seretide 125, 120 doses”, “Seretide discus 50 / 250 мg 60 doses” had lower indices and were assigned to group V.

Drug form and tablets’ dose under the international name Prednisolon, dealing with glucocorticoids enter group V. Differences between two producers are 0,61 and 0,58, and, ampules are 0,78 and 0,61 accordingly.

Due to drug form under international name dexametason is differed between four producers, dealing with group E, and, they are from 0,79 to 0,61; and, differences between three trade names of salbutamol, dealing with group E, are determined in terms from 0,82 to 0,60. Differences by ketotifen,having the same international and trade name, and dealing with group E, are determined from 0,88 to 0,72.

By the study results at process of treatment bronchial asthma the importance of aerosol drugs’ use, dealing with groups of glucocorticoids and broncholiths, were determined. Aerosol form of drugs have necessary for life significance at treatment bronchia asthma. And at treatment severe form of this disease in hospital conditions the high efficacy has the solution for injection dexematason 4 mgr /1ml. Use antibacterial synthetic substances showed their non-effecacy.

Allergologists were more competent in prescribing preparations for the treatment of bronchial asthma.

In 2005–2009 the amount of using drugs at treatment bronchial asthma are determined in us dollars.

Fig. 1 shows the number of preparations used in 2005-2009 years with their distribution to ABC groups. It was found that the number of preparations in groups A and B was decreased. In 2009 preparations of group C accounted for 65.6%. Preparations used in the treatment of allergic rhinitis, medical items for the treatment of concurrent diseases, preparations purchased in the Republican Specialized Allergologic Research Center were excluded from ABC-analysis. At the first stage of our pharmacoeconomic study of drug consumption, ABC-analysis was carried out of preparations for bronchial asthma used in the Republican Specialized Allergologic Research Center for 2005-2009 years. In Table 2 drug consumption parameters were given in dollars and percents. As it is seen usage of preparations (in sums) decreased in 2009 compared to 2005. In market economy conditions means allocated by the government should be maximally used.

Table 4

Results of ABC and VEN analyses (expenses for treatment of bronchial asthma,%)

Years	АВС	Groups
		V		E		N		Total
2005		dollars	%	dollars	%	dollars	%	dollars	%
	А	11708,93	68,71	818,82	4,80	944,15	5,54	13471,90	79,04
	В	225,01	1,32	1141,71	6,70	1201,78	7,05	2568,50	15,07
	С	237,86	1,40	560,84	3,29	201,99	1,19	1000,70	5,88
		12171,80	71,43	2521,37	14,89	2347,92	13,78	16464,82	100
2006	А	8621,71	72,08	310,16	2,60	390,23	3,26	9322,10	77,94
	В	476,82	3,99	709,88	5,93	507,16	4,24	1693,86	14,16
	С	210,40	1,76	462,56	3,87	271,46	2,27	944,42	7,90
		9308,93	77,83	1482,61	12,40	1168,85	9,77	11960,39	100
2007	А	7167,66	74,86	342,26	3,58	–	–	7509,92	78,44
	В	256,20	2,67	522,59	5,46	746,68	7,80	1525,48	15,93
	С	124,13	0,86	302,71	3,16	154,16	1,61	581,00	5,63
		7547,99	78,39	1167,56	12,20	900,84	9,41	9616,39	100
2008	А	7643,18	76,91	–	–	–	–	7643,18	76,91
	В	923,71	9,30	432,21	4,35	306,24	3,08	1662,16	16,73
	С	284,22	2,86	188,57	1,19	159,12	1,60	631,92	5,65
		8851,11	89,07	620,78	5,54	465,36	4,68	9937,27	100
2009	А	8683,44	78,28	–	–	–	–	8683,44	78,28
	В	564,69	5,09	1018,04	9,17	316,91	2,85	1899,64	17,11
	С	92,22	0,83	312,47	2,82	105,14	0,95	509,83	4,61
		9340,35	84,20	1330,51	11,99	422,05	3,80	11092,91	100

Note. Sum to USA dollar exchange rate was taken from data of the Central Bank of Uzbekistan for 2005-2009 years [1].

In 2005, according to ABC-analysis, consumption of “Cephamezin 1000 mg №1” and “Serevent 25 мkg/60 doses” came to 5.54% and 4.80%, respectively. Both the preparations belonged to group A.

But these preparations, by importance, fall into groups E and N. According to the findings, preparations of group V should be purchased first.

Consumption was determined of drugs rated in group V according to ABC-VEN analysis used only for the therapy of bronchial asthma for years 2005 – 68.71%, 2006 – 72.08%, 2007 – 74.86%, 2008 – 76.91% and 2009 – 78.28%.

These are vital medications for bronchial asthma that should be purchased by population and medical institutions in future. A list was compiled of necessary secondary medications used for the treatment of the disease. In future medical institutions should properly distribute their funds in purchasing medications.

Conclusions

Based on methods of intellectual data processing, general estimators were obtained for assignment of drugs to VEN groups with determination of specialist competence level in their classifying.

Scores in questionnaires for distribution of medications to VEN groups were treated by a modern intellectual technique to assign preparations with highest indices into group V. A list was also given of medications of groups E and N.

In future medial-preventive institutions specialized in treating bronchial asthma should really estimate their potentialities in obtaining vitally necessary medications.

Main medications used in treatment of bronchial asthma belong to groups E and N.

A list was compiled of medications effective for recovery of life quality and physical condition of asthmatic patients.

Based on study results, population and medical-preventive institutions will be given an opportunity for rational use of their resources.

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Authors’ data

Suyunov Nizom Davurovich, Doctor of philosophy (Ph. D) pharmaceutical sciences, professor-assistant of the Department of Pharmacy Organization of the Tashkent Pharmaceutical Institute. Home address: 13/37, Cherdantseva street 1, Mirzo-Ulugbek district, Tashkent. Post-code 100170.

Madrakhimov Shavkat Fayzullaev, candidate of physico-mathematical sciences, docent of the Department of Programmed and Network technologies of the Uzbekistan National University after Mirzo Ulugbek.

Ikramova Guzal Makhamadzhanovna, professor-assistant, Doctor of philosophy (Ph. D) pharmaceutical sciences, docent of the of the Department of Pharmacy Organization of the Tashkent Pharmaceutical Institute.

Address: 40, Aybek street, Mirabad district, Tashkent.

1. Suyunov Nizom Davurovich, the 3-d-year-doctorant of the Chair of Organization of the Pharmaceuticsm.

Suyunov Nizom Davurovuch Tashkent Pharmaceutical Institute

With great gratitude, Doctorant of the Chair of Organization of the Pharmaceutics. Tashkent. Pharmaceutical Institute.

Oybek Street, 40. Mirabad District,Tashkent. Uzbekistan.

1. Суюнов Низом Давурович, докторант III курса кафедры «Организация фармацевтического дела» Ташкентского фармацевтического института. Домашний адрес: город Ташкент, Мирзо-Улугбекский район, ул. Черданцева 1, дом 13, квартира 37. Индекс 100 170.

2. Икрамова Гузал Махамаджановна, ассистент, соискатель кафедры «Организация фармацевтического дела» Ташкентского фармацевтического института.

3. Мадрахимов Шавкат Файзуллаевич, кандидат физико-математических наук, доцент кафедры «Программные и сетевые технологии» Национального университета Узбекистана имени Мирзо Улугбека.

Республика Узбекистан, г.Ташкент, Ташкентский фармацевтический институт, г.Ташкент, Мирабадский район, ул. Ойбека, 40.