Polypharmacy may cause adverse health outcomes in the elderly. This study examined the prevalence of continuous polypharmacy and hyper‐polypharmacy, factors associated with polypharmacy, and the most frequently prescribed medications among older adults in South Korea. This was a retrospective observational study using National Health Insurance claims data. In total, 7,358,953 Korean elderly patients aged 65 years and older were included. Continuous polypharmacy and hyper‐polypharmacy were defined as the use of ≥5 and ≥10 medications, respectively, for both ≥90 days and ≥180 days within 1 year. A multivariate logistic regression analysis was conducted with adjustment for general characteristics (sex, age, insurance type), comorbidities (12 diseases, number of comorbidities, and Elixhauser Comorbidity Index [ECI] classification), and healthcare service utilization. Among 7.36 million elderly patients, 47.8% and 36.9% had polypharmacy for ≥90 and ≥180 days, and 11.9% and 7.1% of patients exhibited hyper‐polypharmacy for ≥90 and ≥180 days, respectively. Male sex, older age, insurance, comorbidities (cardio‐cerebrovascular disease, diabetes mellitus, depressive disorder, dementia, an ECI score of ≥3), and healthcare service utilization were associated with an increased probability of polypharmacy. The therapeutic class with the most prescriptions was drugs for acid‐related disorders (ATC A02). The number of outpatient visit days more strongly influenced polypharmacy than hospitalizations and ED visits. This study provides health policymakers with important evidence about the critical need to reduce polypharmacy among older adults.

Background: Polypharmacy has become a global health problem and is associated with adverse health outcomes in the elderly. This study evaluated the prevalence of polypharmacy and hyper-polypharmacy in elderly patients in South Korea during 2010–2019.Methods: We analyzed the outpatient care of persons aged ≥65 years covered by National Health Insurance (NHI) using NHI claims data from 2010 to 2019. Polypharmacy was defined as the use of ≥5 medications, and hyper-polypharmacy was defined as the use of ≥10 medications, and we examined them over periods of ≥90 days and ≥180 days. The average annual percent change (AAPC) was calculated using Joinpoint statistical software.Results: The prevalence of polypharmacy among ≥90 days of medication use elderly decreased from 42.5% in 2010 to 41.8% in 2019, and the prevalence of hyper-polypharmacy for ≥90 days increased from 10.4% to 14.4%. The prevalence of polypharmacy for ≥180 days increased from 37.8% in 2010 to 38.1% in 2019, and the prevalence of hyper-polypharmacy for ≥180 days increased from 6.4% to 9.4%. The prevalence of polypharmacy for ≥90 days and ≥180 days steadily increased among elderly patients, with AAPCs of 3.7 and 4.5, respectively.Conclusion: The prevalence of polypharmacy for ≥90 days and ≥180 days remained stably high, with rates of about 42 and 38%, respectively, and hyper-polypharmacy increased over the past 10 years in South Korea. Therefore, strategies to address polypharmacy need to be implemented. Further research is also required to identify the clinical outcomes (including mortality risks) associated with polypharmacy.

Objective: In order to identify the status and factors of polypharmacy of elderly of medical aid, this study compared them with national health insurance.Methods: We established a cohort for the elderly using the Health insurance claim data of 2018. Polypharmacy is defined as the use of at least five concurrent medications for over 90 days annually. We compared the risk of polypharmacy by medical aid with that of national health insurance. To analyze the status of polypharmacy of medical aid and associated factors, and compare them with those of national health insurance, we conducted Chi-square test, t-test, and multivaiate logistic regression.Result: 46.4% of national health insurance and 67.8% of medical aid showed polypharmacy. After adjusting gender, age, comorbidity, Elixhauser Comorbidity Index (ECI) scores, and the number of outpatient visits, the odds ratio (OR) of polypharmacy was 1.80 (95% Confidence interval (CI), 1.79-1.82) times higher among medical aid. The number of prescriptions, the number of total prescribed medications a year, the number of daily average prescribed medications, and the cost of annual total prescribed medications are higher among medical aid. Major factors associated with polypharmacy were diabetes, cardio-cerebrovascular diseases, ECI of 2 points or higher, and at least 16 outpatient visits a year. The OR of medical aid aged 70~74 to those aged 65~69 was 0.88 (95%CI 0.86-0.90).Conclusion: To reduce the incidence of polypharmacy among elderly, a focus needs to be placed on patients with diabetes, cardio-cerebrovascular diseases and patients who visited outpatient at least 16 times a year. The medical aid need to be manage polypharmacy, regardless of severity and age. Efforts at the national level are needed to reduce the polypharmacy of the elderly of medical aid.

originals (any pharmaceutical released before 01/08/1987, per 2007 decree). The product reference price was assumed to be 100 for all groups. The effect of amended regulations was estimated for all five product groups by applying the changed discount rates to the reference price throughout the years 2004 to 2011. RESULTS: The reference price in 2004 was considerably different than in 2012. The price of original products without generics decreased from 100 to 59. The price of generics, and original products with generics decreased to 47.5. The 20-year-old original and generic products were affected the least, as the price of the 20-year-old original products decreased to 69.1 and of generics to 71.3. The different effects of regulations on each product group indicate that companies are heterogeneously affected depending on inventory. CONCLUSIONS: Drug groups were not uniformly affected by the regulations. With less overhead and expenses (e.g., clinical trials, marketing, promotions), generic drug manufactures are more easily adaptable to new regulations and market conditions. This may cause a shift to extensive production of generic medications in the Turkish pharmaceutical industry and decrease research and development investments. OBJECTIVES:To evaluate Public Perception towards Medicine Quality and Prices in Afghanistan. METHODS: A cross-sectional descriptive survey involving 1282 population in six zones of Afghanistan was undertaken. RESULTS: The study findings revealed that a total of (50.2%) of respondents agreed that imported medicines and (41.4%) said that locally manufactured medicines have good quality. High proportions (61.4%) of Afghan doctors are prescribing quality medicines, and also medicines given by public hospitals in Afghanistan are of high quality (54.9%). (38.4%) agreed that the afghan drug regulatory authority controls quality of medicine. Interestingly, (96.3%) respondents were agreed, that Afghan government should adopt health policies to control the medicine prices and expenditure. (89.6%) respondents agree that higher medicine costs negatively impacts patient outcomes. Half of the respondents (44.5%) say that in Afghanistan doctors have poor understandings on medicine prices. (68.7%) of respondents agreed that the price regulation system should be implemented from manufacturer to patients. When respondents asked, (94%) agreed that all medicine need to be disclosed on the dispensed medicine label. A round, (19.9%) of respondents agreed that medicine prices in Afghanistan are affordable to everyone. (93.1%) of the respondents said, prescription drug prices need to be regulated by the government. When respondents asked (68.2%) agreed that medicine prices are high in private hospitals. CONCLUSIONS: The first national survey on medicine quality and pricing, suggests that, the government should take firm steps to control the quality and disparate medicine prices, to ensure accessibility, availability and affordability of medicine to all. The drug regulatory authority has less control to regula...