The World Health Organization (WHO) estimates that over 50% of medicines are not taken correctly – they may be prescribed or dispensed inappropriately and patients may take them incorrectly. This is in addition to those patients who do not receive the right medicine, or any medicine in a timely manner. These circumstances exemplify the fact that medicines are not always optimally used, resulting in a significant loss of health and increase in healthcare expenditures, contributing to high growth of healthcare spending. With more responsible medicines use, research from the IMS Institute shows that $500 billion US in global healthcare spending could be avoided annually.
On the occasion of the Centennial Congress held by the International Pharmaceutical Federation (FIP), the Dutch Ministry of Health, Welfare and Sport is convening an international summit for Ministers of Health on the theme ‘The responsible use of medicines. Setting policies for better and cost-effective healthcare’. To inform and support the discussion, the Dutch Ministry invited two technical partners, the World Health Organization (WHO) and the IMS Institute for Healthcare Informatics, to identify priority areas for improvement.
Recommendations for healthcare system leaders
The WHO and the IMS Institute recommendations focus on areas where Ministers of Health can have the greatest influence. The IMS Institute identified over fifty recommendations for health ministers and public and private healthcare stakeholders to implement pragmatic changes, based on learnings from countries with existing evidence. Prioritised recommendations include strengthening the role of the pharmacist in medicines management, using medical audits to focus on elderly patients, implementing mandatory reporting of antibiotic use and encouraging a ‘no blame’ culture towards error reporting.
The WHO identified seven strategic recommendations underpinned by eighteen tactical recommendations. The recommendations are particularly relevant for middle and low-income countries where limited healthcare coverage and weak health systems are barriers to responsible medicine use. Strategic recommendations include mandating a list of essential medicines, investing in efficient national medicines procurement and supply systems, supporting early screening and diagnosis, implementing evidence-based treatment guidelines and promoting the patient at the centre of treatment to maximise adherence.
The WHO and IMS Institute reports offer case studies and examples from multiple countries, including the United Kingdom, United States, Denmark, Brazil, China, India and Ethiopia, to support the conclusions.
FIP and its 127 Member Organisations lead improvement efforts
As the representative of three million pharmacists and pharmaceutical scientists worldwide, FIP is advocating action at all levels to improve the way medicines are used in the immediate and long term. Michel Buchmann, President of FIP: “FIP is actively partnering with legislators and governments to develop policies that support a greater role for pharmacists. In addition, we are mobilising pharmacists at all levels to increase their roles as medicines experts in the healthcare team to ensure optimal patient outcomes. We believe that all members of the healthcare team have the same objective, one that can be achieved more effectively if we all work together. As the representative of Dutch pharmacists, KNMP is fostering similar efforts at a national level.”
The Dutch Ministry of Health, Welfare and Sport will also take action in the Netherlands. Edith Schippers, Dutch Minister of Health, Welfare and Sport: “Medicines have played a substantial role in many areas of healthcare. However, medicines are not always optimally used. That is a missed potential, both in terms of gains in health and in containing health expenditures. Ministers of Health attending the Summit, including myself, could possibly learn from each-others examples and hopefully apply some of these in our own countries.”
How to take action is something the report by the IMS Institute for Healthcare Informatics demonstrates. Murray Aitken, Executive Director of the IMS Institute: “The actions that are outlined in our global report are pragmatic, measurable, and have been demonstrated to bring positive impact. Harnessing available information to set priorities, monitor progress and support behaviour change among healthcare stakeholders including patients is a vital first step. This week’s events will trigger further activity to advance the understanding and implementation of new approaches to improve medicine use.”
The WHO report emphasises that all nations can benefit from the outcomes from the reports; it supports developments that provide ethical, cost-effective solutions to global health challenges. ‘Responsible use of medicines’ flows from this core function and is applicable to all nations, benefitting patients and resulting in major savings. This WHO report provides case-based data and insights on responsible use of medicines to promote evidence-based policies to achieve better health at lower cost worldwide.
All parties want the momentum from the Summit and FIP events to continue beyond October and trigger activity and events that will stimulate and advance the understanding of responsible medicines use, including monitoring and tracking how this is best done worldwide.