Allocation of the resources in health care and finding a way how to prioritize spending within health care systems are hot issue, even in the developed countries. Introduction of new medical products and technologies is one important driver for increased health care costs. COPD is among top five causes of morbidity and mortality worldwide. The aim of this study is to evaluate cost effectiveness of antimicrobial regiments for treatment of acute exacerbation of COPD. Cost effectiveness analysis was performed based on data from two published observational, "real world" studies carried in Institute for occupational Health of Macedonia. Methodology is based on calculation of ICER in as many steps as needed until all exclusion criteria`s are met. All ICER`s are interpreted using cost effectiveness plane. Amoxicillin with clavulanic acid and cefuroxime dominated over other antibiotic regiments. Doxycycline, cefuroxime, cefpodoxime and moxifloxacin are cost-effective alternatives. When deciding, size of the available budget and patient's willingness to pay will be key factors. The results of this study provide data and useful information which antibiotic will give best expected outcomes, with least produced costs.

Supply Chain Management (SCM) in pharmaceutical industry is defined as a “responsible SCM” and its implementation is according to the principles of: business ethics, rights of labor and principles of healthy and safe working environment. Pharmaceutical companies with implemented “responsible SCM” have to use management systems to facilitate continuous improvement in accordance with their working principles. The main purpose of this management system is to ensure the consistency, reliability and continuous improvement of all workflows within an organization.The analyzed case describes the project of European generic pharmaceutical company, which intends to implement best practice SCM operations for five European manufacturing sites and European logistics organizations (active ingredients supply, distribution centers, affiliate customers and third party manufacturers). The main objectives of the project were the creation of the future improved To-Be situation through implementation of new SCM models to the existing To-Day situation.

The present study investigates the Health-related quality of life of teen/adults patients with cystic fibrosis in the Republic of N. Macedonia for the first time. The main objective was to describe the health-related quality of life status of these patients with cystic fibrosis and the second objective was to investigate the connection of the current medical treatment with the analysed parameters. The survey was conducted on 31 patients by using the Cystic Fibrosis Questionnaire Revised for Health-related quality of live measurement and questions for current medical treatment. All patients scored their digestive condition with the highest score, while the lower score was reported for social activity. The gender, the nationality and the educational level of the patients with Cystic Fibrosis had no significant impact on their perception of Health-Related Quality of Live. The highest score for digestive condition was in positive correlation with the fact that all patients continuously used enzyme therapy. Patients who practiced physical therapy and physical activities reported high scores for physical conditions and body images. This finding point out that patient with Cystic Fibrosis should be encouraged to practice physical activity more often. The lowest scores for life activities and treatment burden shows that this medical condition has a negative impact on the patients’ self-perception and in the execution of their daily activities. Keywords: cystic fibrosis, Health-Related Quality of Live, digest, daily activities

Pharmacoeconomics is new and modern health science, implemented in developed societies, to play core role in creating health policies. The main aim of pharmacoeconomic analysis is development of science methodology for evaluation of costs and outcomes of treatment, evaluation of economic parameters in the face of outcomes of clinical results, from different treatment options. Pharmaceutical companies implemented pharmacoeconomic principles for diversifying marketing approach and market access in pharmaceutical development. New healthcare systems demand increased costs for medical care, pharmaceutical products and medical devices. Process of medical costs for evaluation of costs evolved, indirect and hidden costs are part of sole process of evaluation. Health authorities from one side and pharmaceutical companies from other side developed unique methodologies for evaluation. With these implemented changes, traditional concept for evaluation of efficacy and safety of medical devices and pharmaceutical products was overbridged and pharmacoeconomics is base for research, development, registration, reimbursement, as well as dispensing and follow the life cycle of medicines. Results from antibiotic consumption analysis in Republic of Macedonia at 2016 showed that total antibiotic consumption and antibiotic consumption per DDD/1000 citizens is according to average EU trends, mostly similarly to the usage trends of low-income countries. But usage of new and innovative antibiotic is on very low level, which indicates the need of further implementing of pharmacoeconomic analysis and principles in decision making process, for improved health care for the patients. The ultimate goal of implementing the pharmacoeconomic system in each country is enhancing the benefit to the patient through improved resource allocation. Keywords: pharmacoeconomics, type of pharmacoeconomic analysis, antibiotic consumption, Republic of Macedonia