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August 23-27, 1993 World Congress, "Mental Health: Toward the 21st Century-Technology, Culture, and Quality of Life, " World Federation for Mental Health, Chiba, Japan. Contact: Secretariat for WFMH'93 JAPAN, Congr# sCorporation, Namiki Building 5-3, Kamiyama-cho Shibuya-ku, Tokyo 1S0, Japan; 81-3-34689330 tel ; , 81-3-34665246 fax ; . August 29-September matic Medicine, "How 2, 12th World Can We Help? Congress of PsychosoPsychosocial Interven. Significantly for any prescriber ordering menthol in aqueous cream, three strengths - 0.5%, 1% and 2% - have gone into Part VIII all at 15.30 for 500g based on the manufacturer Arjun. In alphabetical order: Amisulpride moves out of Category M to Category C based on Solian ; with a 30-40% price reduction. All strengths and forms of famciclovir and fluvastatin rise by 9% so e.g. 7x750mg famciclovir now 148.79 and 28x40mg fluvastatin capsules now 15.26 . A [very] slight reduction in the price of ondansetron [the start of many?]: 30x4mg tablets down 16p at 101.25 and 10x8mg down 11p at 67.48 . Finally, another price change for tamsulosin - 400mcg M R capsules now down 29p at 8.39 . Back in April unless there are significant changes next month. Andrew Martin Programme Director - Medicines Management Bury Primary Care Trust.

TO THE PHYSICIAN: The University of Waterloo Student Supplementary Health Plan drug formulary is designed to provide quality, therapeutic care for a reasonable cost. Generic plan based on modified ODB Formulary customized for the UW student population with the following notable exceptions: Deletions: sustained release formulations where an underlying generic is available except Tegretol CR, Ritalin SR, Biaxin XL ; over-the-counter drugs Diclectin Accutane, ciprofloxacin, cefadroxil, cefazolin, cefprozil, cefuroxime Axid, Losec, Pantoloc Additions: generic doxycycline 100 mg. famciclovir, valacyclovir, generic acyclovir, Avirax Epipen, Anakit, Glucagon Emergency kit Dalacin vaginal cream, Dalacin T solution Differin gel Flonase, Nasonex, Nasocort AQ, Symbicort Turbuhaler insulin, syringes, ultra fine needle pen preventive vaccines rosuvastatin Crestor ; , rabeprazole Pariet ; Restricted Use: requires approval of UW Medical Director; please see information booklet for more details ; Drug Maxima: Fertility drugs $2000 lifetime ; . Zyban smoking cessation drug ; limited to 90 day lifetime maximum upon approval by Health Services and flavoxate.
TABLE 1. Demographics and Clinical Data CNV QD 2 3 Vessel Activity No. Laser Steroid Pre-VA Post-VA Follow-Up Closure Q Q Q. Prescribed or recommended equally as the second most common antiviral 90 drug choice. Acyclovir therapy was 80 reported by patients in a small study 70 in the United Kingdom to be the most 60 Dentists 50 common treatment modality.17 In our Pharmacists 40 Physicians study, famciclovvir was the next most 30 common medication, and it was 20 chosen primarily by physicians who 10 were more than twice as likely to pre0 Cost Lack of Antiviral Side Other scribe this medication than were pharEffectiveness Drug Effects Resistance macists and seven times as likely than REASON were dentists. A similar pattern emerged for valacyclovir. Health care professionals' selecting penciclovir Figure 4. Health care professionals' reasons for not prescribing antiviral was almost nonexistent, as, despite a drugs. report of positive results in a recent penciclovir study, 19 it is not available and obtaining appropriate survey samples in Canada. through randomization. The response rate for The main OTC medication recommended 50 dentists was lower than that of the other two percent ; was Lipactin gel; it was recommended groups. Therefore, given that we sampled a primarily by pharmacists 87 percent ; . Zilactin smaller number of dentists to conform to the fact was the next choice, but it was chosen by 50 perthat their population was one-half the size of the cent less of the respondents. Fifty-four percent of other groups, the variability of their overall dentists and 69 percent of physicians did not recresponses would be greater. The response rate of ommend OTC treatment. The pattern for recomdentists to postal questionnaires can vary from 17 mending OTC treatment is understandable, given to 100 percent, depending on the questionnaire that pharmacists are more likely than dentists subject, incentives offered and the length of the and physicians to see customers when they have questionnaire.20 The lower response rate from cold sores. dentists may be because they are less likely to The primary reason pharmacists and physiencounter questions from patients about cold cians cited for not prescribing antiviral drugs was sores. cost. For dentists, the primary reason they cited In addition, the survey form was limited, owing for not prescribing antiviral drugs was lack of to space and timing considerations. We encoureffectiveness, with cost being a secondary issue. aged participants to be flexible, and this was This may be because dentists are less likely to be noticeable in the response patterns and from comprescribing the drugs than are physicians, and ments made by 13 percent of respondents. Participharmacists are more aware of prices because pants contributed valuable information and interthey receive payment at time of purchase. As esting anecdotal asides particularly those who drug coverage is optional on Alberta health care had had cold sores ; , which could provide assistinsurance plans, some patients are underinsured, ance for further surveys or focus groups. which means they have to pay more of drug costs Few similar surveys have been conducted to out of pocket. With cost being the major reason determine trends and patterns of treatment for not prescribing antiviral drugs, our findings among these three health professions. One study suggest that health care professionals are sensiused the same method of a mailed questionnaire tive toward financial concerns when providing to determine attitudes of general practitioners, treatment. pharmacists and consultant geriatricians on the Although the response rate to this survey was use of sugar-free and sugar-containing medicines for the elderly.21 very high compared with those of other surveys of health care professionals, the validity of the The development and marketing of new drugs results still can be an issue, despite the fact that or OTC products are dependent on surveys of consumers and health care professionals. Informawe followed appropriate methodologies such as tion from surveys can contribute to clinical guideobtaining accurate lists, conducting pilot projects.

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