1. T.C. SOCIAL SECURITY INSTITUTION DIRECTORATE GENERAL of UNIVERSAL HEALTH INSURANCE DEPARTMENT of PHARMACY and PHARMACEUTICALS RATIONAL DRUG USE - SOCIAL SECURITY PERSPECTIVE Hüseyin KILIÇASLAN, MD Department of Pharmacy and Pharmaceutıcals Head of the Department

2. SSI DG of UHI Department of Pharmacy and Pharmaceutıcals WHO DEFINED RATIONAL DRUG USE AS ; In simplest words rational use means “prescribing right drug, in adequate dose for the sufficient duration & appropriate to the clinical needs of the patient at lowest cost. Nairobi,1985 2

3. lowest cost ??? The cost is not only the price written on the box of the medicine Advers reactions – contrindications Protecting from complications Duration of use Budget impact - the incidence / prevalence ……… 3 SSI DG of UHI Department of Pharmacy and Pharmaceutıcals

4. Antibiotic resistance Adverse drug effects Wrong habits of drug use Direct costs / indirect costs IRRATIONAL DRUG USE 4 SSI DG of UHI Department of Pharmacy and Pharmaceutıcals

5. Covering nearly the whole of the population Accessible health service delivery The scope of the social security package Access to ‘only with prescription’ medicines Participation fees and exemptions ACCESS to MEDICINE in TURKEY 5 SSI DG of UHI Department of Pharmacy and Pharmaceutıcals

6. While the most prescribed drugs all over the world are medicines for cardiovascular disease, The antimicrobial drugs are most common in Turkey And the drugs for cardiovascular diseases are sixth (2004/2006 data) One example… 6 SSI DG of UHI Department of Pharmacy and Pharmaceutıcals

7. Education Guides and clinical guidelines Assessment and evaluation Rewards and Sanctions HOW TO DEVELOP RATIONAL DRUG USE ? 7 SSI DG of UHI Department of Pharmacy and Pharmaceutıcals

8. Rational drug use… Is good for the physician: the most accurate way to treat patients. Is good for the patient: they get the most appropriate treatment, for the most appropriate time and by the most appropriate way Is good for the health authority: the community will be presented in the correct drug treatment options Is good for the Social Security Institution : the best treatment would be financed with the least possible cost …is good for everybody. 8 SSI DG of UHI Department of Pharmacy and Pharmaceutıcals

9. Hüseyin KILIÇASLAN, MD Department of Pharmacy and Pharmaceutıcals Head of the Department 9