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KMID : 0869620070240030219
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Journal of Korean Society of Hospital Pharmacists
2007 Volume.24 No. 3 p.219 ~ p.225
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Drug use evaluation of 5-HT3 receptor antagonist in medical insurance
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Lee Yoon-Sun
Moon Jeong-Yon
Han Hyun-Joo
Son In-Ja
Oh Jung-Mi
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Abstract
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Antiemetics are used for the prevention and treatment of nausea and vomiting caused by chemotherapy and radiotherapy. Various antiemetics including 5-HT3 receptor antagonists, dopamine antagonists, and adrenal corticosteroids are used clinically. 5-HT3 receptor antagonists have shown more efficacies with fewer side effects and easy administration. Nevertheless their high efficacy as antiemetics, these kinds of antiemetics have a limitation for using by reason of their high price. Physicians abroad follow the ASCO (American Society of Clinical Oncology) guidelines to select the medication of antiemetics. But in Korea, the standard of National medical insurance has a great influence on the guide of using it. The objectives of this study were to evaluate the pattern of 5-HT3 receptor antagonists use and to suggest a better standard of national medical insurance standard out. The medical records of 3,059 patients over 19 years old, who were prescribed of ondansetron, ramosetron, dolasetron and granisetron in Seoul National University Hospital from January 1, 2005 to January 31, 2005, were reviewed. Analysis showed that 1,909 cases(62.4%) meet the criteria for the national medical insurance standards. But 1,150 (37.6%) couldn’t meet the criteria. 564 cases of ondansetron (36.7%), 360 cases of granisetron (54.3%), 187 cases of ramosetron (61.7%), 60 cases of dolasetron (10.8%) were inappropriate. 646 cases (56.2%) were prescribed for the prevention and treatment of postoperative nausea and vomiting(PONV), 371 cases(32.3%) were prescribed for the chemotherapy induced emesis(CIE) with excessive dosage, and 133 cases(11.5%) were prescribed for other things like the side effect of combining other medication, nausea and vomiting from itself and so on. There are diverse aspects of symptoms by individual, and their symptoms are based on subjective human feeling. Also the prevention and treatment of nausea and vomiting are closely related to the quality of patient’s life. As the result of this study, we have to focus on over 50% of patients who cannot meet the national medical insurance coverage are suffering from postoperative nausea and vomiting(PONV) and chemotherapy induced emesis with excessive dosage. That’s why we have to start to evaluate the clinical use of 5-HT3 receptor ntagonists. Also it is necessary to investigate the expansion of national medical insurance range to cover it.
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KEYWORD
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5-HT3 receptor antagonist, medical insurance, drug use evaluation
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