Optimizing Antimicrobial Use and Combating Bacterial Resistance: Benchmarking and Beyond
Robert C. Owens, Paul G. Ambrose, Charles H. Nightingale in Antibiotic Optimization, 2004
Drug utilization is a measure that can be easily collected and benchmarked, though there are a number of ways to represent antibiotic use. For analyses conducted in the community setting, the number of treatment courses or prescriptions is a common way to represent gross usage. For analyses in hospital settings, where the volume of antibiotic use is quite high, the defined daily dose (DDD) is a common measure, often advocated over other measures. This measure was developed more than two decades ago as a means to standardize drug utilization data (sales statistics or pharmacy inventory data) into medically meaningful units. As described by agencies such as the World Health Organization or the Centers for Disease Control and Prevention (CDC) (25), the DDD is derived by dividing the number of grams of a particular agent by the average daily dose. For example, the DDD for cefazolin, which is usually administered 1 g every 8 hours, is 3 g. However, because the DDD for a specific agent represents an average daily maintenance dose for a given indication (26,27) and there are discrepancies between definitions of DDD, one must be cognizant of such variances when comparing results from different studies or collecting data from different institutions. In the United States, definitions of DDD generally follow the recommendations of the CDC.
Health care and cost containment in Greece
Elias Mossialos, Julian Le Grand in Health Care and Cost Containment in the European Union, 2019
The only measure in this direction would be to expand the positive list that exists in IKA to all insurance funds, and to introduce a new system for the formulation of a positive list. Under the new system, drugs would be included in the list according to their average daily treatment cost. In July 1997, the government produced a first draft of the new positive list. All major active substances are included in the list. The government has calculated the average daily cost of treatment for each drug according to the defined daily dose scheme produced by the World Health Organization (WHO). Exactly how the list will work, which drugs will be included and what will happen to drugs currently on the list, but which exceed the average daily cost of their class or group, is not yet clear for two reasons. The first is that the list will have to be revised again according to more recent prices. The second is that the criteria for inclusion or exclusion from the list are still not clearly defined.
Potential savings from therapeutic substitution of 10 of Canada’s most dispensed prescription drugs
Norman J. Temple, Andrew Thompson in Excessive Medical Spending, 2018
From the BCE Emergis list we selected the top 10 brand-name drugs that were not available generically and for which independent reference sources identified a less costly alternative that was equally effective and safe in most instances. We used the IMS list to determine the number of prescriptions written annually in Canada for these products. To simplify calculations we assumed that all prescriptions were written for the defined daily dose (DDD). This is a concept developed by the Nordic Council on Medicines to study drug utilization. It is the assumed average maintenance dose per day for a drug used for its main indication in adults.6
Cancer risk and chemoprevention in Chinese inflammatory bowel disease patients: a population-based cohort study
Published in Scandinavian Journal of Gastroenterology, 2020
Joyce Wing Yan Mak, Jacqueline So, Whitney Tang, Terry Cheuk Fung Yip, Wai Keung Leung, Michael Li, Fu Hang Lo, Ka Man Ng, Shun Fung Sze, Chi Man Leung, Steven Woon Choy Tsang, Edwin Hok Shing Shan, Kam Hon Chan, Belsy C.Y. Lam, Aric J. Hui, Wai Hung Chow, Francis Ka Leung Chan, Siew Chien Ng
The primary endpoint was cancer development. Cancers were identified based on ICD-9-CM diagnosis codes retrieved from CDARS. Accuracy and validity of cancer coding was confirmed by investigators through reviewing the histological or radiological evidence of cancer. Defined daily dose (DDD) is the assumed average maintenance dose per day for a drug used for its main indication in adults, according to the World Health Organization (WHO) Collaborating Center for Drug Statistics Methodology and is a measure of drug utilization. A single DDD of 5-ASA would be equivalent to mesalazine 1.5 g and sulphasalazine 2 g, while a single DDD of statin would be equivalent to atorvastatin 20 mg, fluvastatin 60 mg, lovastatin 45 mg, pravastatin 30 mg, rosuvastatin 10 mg and simvastatin 30 mg, per the WHO Anatomical Therapeutic Chemical Index [21]. Immunosuppressant used was defined as ever use of azathioprine, 6-mercaptopurine or methotrexate.
Drug Utilization Evaluation of Medications Used by Hypertensive Patients in Hospitals in Nigeria
Published in Hospital Topics, 2022
Theophilus Ehidiamen Oamen, Kanayo Patrick Osemene
Data were collected retrospectively for drugs prescribed and dispensed to known registered hypertensive outpatients in the medical outpatients departments of State Hospital and Federal Medical Center, Abeokuta respectively, over a 1-year period (2017–2018). Data were retrieved by 2 (two) independent research assistants. Primary data extracted includes: bio-data (occupation and level of education), number of clinic visits, location of patient, blood pressure readings on each clinic visit, prescribed medications: dosages and duration of treatment and compute costs, compute cost (inclusive of other drugs apart from Primary Medication), changes to primary medication: classify medications along treatment plans and not along therapeutic groups (add-on medications) and compute the attendant costs, the prescriptions per clinic visit and cost per prescription. DEFINED DAILY DOSE (DDD) is the assumed average maintenance dose per day for a drug used for its main indication in adults was applied to compute antihypertensive drugs (Helena 2008).
Antipsychotic drug treatment of schizophrenia in later life: Results from the European cross-sectional AMSP study
Published in The World Journal of Biological Psychiatry, 2022
Oliver Zolk, Timo Greiner, Michael Schneider, Martin Heinze, Volker Dahling, Tabea Ramin, Renate Grohmann, Stefan Bleich, Tristan Zindler, Sermin Toto, Johanna Seifert
Dose equivalents were used to combine dose data from oral and LAI formulations of a drug or to estimate the patient’s total APD dose. Dose equivalents based on defined daily dose (DDD) published by the Collaborative Centre for Drug Statistics Methodology of the World Health Organisation were calculated because 1) unlike chlorpromazine equivalents, DDDs are available for most drugs, including all APDs, 2) DDDs are an internationally recognised measure, 3) with particular relevance to our project, DDDs of APDs are based on the treatment of psychosis rather than other indications for which lower doses are often used, and 4) DDDs are also reported for LAIs (Danivas and Venkatasubramanian 2013; Leucht et al. 2016). In patients treated with ≥1 APD, total APD dose exposure was calculated by adding the DDD of each APD.
Related Knowledge Centers
- Combination Therapy
- Drug Metabolism
- Simvastatin
- Hypertension
- Medication
- Anatomical Therapeutic Chemical Classification System
- Therapeutic Index
- Prescribed Daily Dose
- Maintenance Dose
- Gene Polymorphism