Adopting drug codes to improve healthcare

ANYONE WHO has been sick and has had to take medicines for whatever reason knows that pharmaceuticals can be quite expensive.

The pharmaceutical industry worldwide is a US multibilliondollar one. Each year the Jamaican Government spends in excess of $8 billion to provide pharmaceuticals to public-sector patients through hospitals, health centres and the National Health Fund (NHF).

We also know that it takes immense care to ensure that when a drug is prescribed for someone, it is what they actually need and in the amount they need. Healthcare delivery requires that great care is taken to standardise and track drugs, and this can be done through coding.

Once this is achieved then the sector, through the electronic medical records, and specific electronic databases, can provide several valueadded services to patients that will improve healthcare delivery and enable effective drug administration, reducing drug costs all around.

These issues are why the Caribbean Drug Codes (CDC) is so important. Apart from being an essential part of the telemedicine and healthcare technology ecosystem, it can solve many problems associated with drug administration and use.

Jamaica is the only Caribbean island from which a comprehensive list of drugs – each with associated formularies – has been developed and is now used in other Caribbean territories.

This was done by Advanced Integrated Systems which has the copyright. Each drug has a unique code. There are now more than 9,000 over-thecounter and prescription items that previously were not coded. This meant that tracking and monitoring were difficult and approximately 20 new drugs are added to the database each week.

ACQUIRING ACCESS

The CDC database stores the formulary for every drug dispensed in the Caribbean. This provides a ready reference for doctors, or prescribers, and pharmacists. It also offers patient education information, written in layman’s terms, to ensure ease of understanding for patients.

Due to the foregoing, many countries have expressed an interest in acquiring access to this database. The CDC is used within the current provider access system used by health insurance companies and the NHF. It’s also integrated in the Health Information Management System at the University Hospital of the West Indies as well as the Medical Practice Management System and the Pharmacy Information Management System now being used by doctors and pharmacies.

What this has done is enable entities such as the NHF and the National Insurance Board in the Bahamas to be able to monitor drug dispensing based on formulary. For example, a person may be prescribed a brand and gets that prescription for a month but should not be able to get another such prescription until after that one has been completed.

But without a way to track the formulary, someone could get a different brand of the same drug. This would be an additional expense to the entity and could facilitate the hoarding of drugs and using excess gained in unauthorised ways.

ACTUAL NEED

Trinidad and Tobago has a similar programme to Jamaica’s NHF called the Chronic Disease Assistance Programme, and with half the population of Jamaica, the country spends about the same (TT$441 million) on pharmaceuticals each year, providing for just 36 per cent of actual need. (Pharmaceutical policy in countries with developing healthcare systems. ZaheerUd-Din Baba editor, 2017).

A major difference here is that Jamaica, like the Bahamas, uses technology along with the CDC to effectively and efficiently manage its pharmaceutical distribution, reducing the likelihood of leakage by any means.

The CDC, along with the other technology previously mentioned, also facilitates having an accurate database of drug use and not just of brand acquisition. Using the CDC, the healthcare technology can provide information on the use and distribution of drugs down to geographic location and other demographics.

This could be a very useful tool for pharmaceutical distributors to have real information on impact and use of their products, as well as for the Government and researchers to have an idea of when, where and what categories of persons are using which drugs.

It could also be useful to track outbreaks, disease prevalence and identify possible cause. Certainly, using a tool like the CDC with the technology we have can save resources we could use to improve healthcare.