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ANALYSIS OF DRUG LIST USED
IN MILITARY HOSPITAL 354 IN 2019
BY ABC/VEN ANALYSIS METHOD
Do The Khanh1, Trinh Anh Duc2, Nguyen Minh Tuan1, Nguyen Tuan Quang1
Nguyen Cam Van1, Hoang Xuan Cuong1, Nguyen Trung Ha3
1Vietnam Military Medical University
2General Department of Logistics, Military Hospital 354
3Military Central Hospital 108
ABSTRACT
Objective: To analyze the drug list (DL) structure used at Military Hospital (MH) 354 according to general
criteria and the ABC/VEN classification method. Subjects and methods: A retrospective description of
DL of MH 354 from 01/01/2019 to 31/12/2019. Result: The structure of DL in 2019 including 603 drugs
divided into 27 groups of pharmacological effects. The cardiovascular group accounts for the largest
proportion (with 20.07% of the total item amount and 25.50% of the total value). Foreign drugs dominated
over domestic drugs with 56.05% of the total item amount and 74.47% of the total value. Brand-name
drugs accounted for 46.6% of the total item amount and 19.04% of the total value. Single-ingredient drugs
accounted for a large proportion with 82.09% of the total item amount and 83.65% of the total value. Oral
drugs dominate the total item amount with 349/603 drugs and also value with 50.62%. According to ABC/
VEN analysis method: According to ABC analysis: Grade A accounts for 19.4% of the total item amount
and 75% of the total value with 117 drugs divided into 14 groups with pharmacological effects, the most is
an antibiotic group. Grade B accounts for 18.08% of the total item amount and 15% of the value, with 109
drugs divided into 14 groups with pharmacological effects, the most being cardiovascular drugs. Grade C
accounts for 62.52% of the total item amount and 10% of the total value. According to VEN analysis: The
group of essential drugs (V) accounts for 12.11% of the total item amount and 12.5% of the total value.
The essential drugs group (E) accounted for 69.15% of the total item amount and 70.6% of the total value
of the drug. Common drugs (N) accounted for 18.74% of the total item amount and 16.9% of the total
value. According to the ABC/VEN matrix: The most important group (I) includes 05 sub-groups AV, AE, AN,
BV, and CN: 29.68% about total item amount, 78.2% about total value. The important group (II) includes
03 sub-groups BE, patient, and CE: 60.03% of the total item amount, 20% of the total value. The less
important group (III) includes 01 sub-group of CN: Accounting for 10.28% of the production capacity and
1.8% value. Conclusion: Analyzed DL used at Military Hospital 354 in 2019.
* Keyword: Drugs list; Military Hospital.
Corresponding author: Do The Khanh (dothekhanh79@gmail.com)
Date received: 27/4/2021
Date accepted: 25/5/2021
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INTRODUCTION
The drug market is increasingly rich and diverse,
with an increasing number of drugs. The selection
of the structure of the DL is the first activity that
holds a very important position to meet the rational,
safe and effective use of drugs, to ensure adequate
availability of good quality drugs, and to facilitate
prescribing, drug information activities and timely
control of adverse drug reactions in the hospital.
Military Hospital 354 is a 500-bed hospital under
the General Department of Logistics of the Vietnam
People’s Army. DL needs to meet professional
requirements and be cost-optimized, so DL analysis
has a positive and urgent meaning. The study was
conducted: To analyse of the structure of DL used at
the Military Hospital 354 in 2019 according to some
targets and ABC/VEN analysis method
SUBJECTS AND METHODS
1. Subjects
List of drugs at a hospital in 2019, Report on Use
of drugs at a hospital in 2019, Report on revenue
and expenditure of hospitals in 2019. Document on
the classification of VEN in DL of the hospital by
the Board of Medicines and Treatment in Hospital
in 2019.
2. Methods
* Study design: A retrospective descriptive study of
documents related to DL of Hospital from January
1, 2019, to December 31, 2019.
* General analysis of DL structure by a group of
pharmacological effects, origin, name, the number
of active ingredients, route of use, and professional
regulations.
* ABC analysis through 7 steps according to the
guidance of the Ministry of Health, giving drug
classifications:
- Grade A: Account for 10-20% of the total product,
accounting for 75-80% of the total value.
- Grade B: Account for 10-20% of the total product,
accounting for 15-20% of the total value.
- Grade C: Account for 60-80% of the total product,
accounting for 5 - 10% of the total value.
* VEN analysis through 6 steps according to the
guidance of the Ministry of Health, the classification
includes 3 drug groups:
Group V (Vital drugs): are drugs used in emergencies
or extremely important drugs necessary for the
medical examination and treatment of the hospital.
- Group E (Essential drugs): These are drugs used
in cases of less severe diseases but still important
diseases, accounting for a significant proportion in
the hospital’s disease pattern.
- Group N (Non-Essential drugs): are drugs used
in mild cases, the disease can be cured on its own,
the treatment effect is unclear, or the high cost is
not commensurate with clinical benefits.
* ABC/VEN matrix analysis:
Combine ABC analysis and VEN analysis by making ABC/VEN matrix table and dividing DL into 3 groups
in order of priority as follows:
Analysis V E N Classification level (group)
AAV AE AN The most important drugs (I): include subtypesAV,AE,AN,BV,CV
B BV BE BN The important drugs (II): include subtypes BE, BN, CE
C CV CE CN The less important drugs (III): include subtype CN
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- Group I: The essential drugs include AV, BV, CV, AE, AN drugs; they are the most expensive and
necessary drugs, should be prioritized procurement funds to ensure emergency and treatment needs
proactively.
- Group II: Important drugs include BE, CE, BN; they are essential or medium value drugs.
- Group III: Less essential drugs, including CN drugs, are drugs of low value and are unimportant.
RESULTS AND DISCUSSION
* GENERAL ANALYSIS OF DRUG LIST OF MILITARY HOSPITAL 354 - GENERAL DEPARTMENT OF
LOGISTIC IN 2019:
1. Structure of drug list according to pharmacological effects group
Table 1: Structure of the list of drugs by the pharmacological group.
Order Pharmacological group
Item amount Value
Amount
(n)
Percentage
(%)
Value
(milion VND)
Percentage
(%)
1 Cardiovascular Drugs 116 20.07 26,400.831 25.50
2 Anti-parasites, anti-infectives Drugs 89 15.40 27,022.027 26.10
3 Gastrotintestiral Drugs 67 11.59 13,904.438 13.40
4 Hormon and Drugs on the endocrine
system 56 9.69 13,562.780 13.10
5 Non-Steroidal Anti-Inflamatory đrugs,
Gout and osteoarthritis medications 42 7.27 4,876.389 4.71
6 Solutions regulating water, electrolyte
and acid - base balance 32 5.54 4,255.193 4.11
7 Vitamin and inorganic substances 22 3.81 1,138.859 1.10
8 Drugs for blood system 20 3.46 2,484.784 2.40
9 Anesthetics drugs 20 3.46 704.022 0.68
10 Drugs for respiratory system 17 2.94 869.674 0.84
11 Drugs for eyes, ears, nose, throat 16 2.77 579.783 0.56
12 Antipsychotic ddrugs 15 2.60 528.017 0.51
13 Muscle relaxers and muscle tone
enhancers drugs 10 1.73 2.433.018 2.35
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Order Pharmacological group
Item amount Value
Amount
(n
Percentage
(%)
Value
(milion VND)
Percentage
(%)
14 Anticonvulsants, antiepileptic drugs 08 1.38 745.435 0.72
15 Anti-allergy drugs and đrugs used in
cases of hypersensitivity 08 1.38 320.951 0.31
16 Antidote đrugs 07 1.21 848.968 0.82
17 Diuretic drugs 07 1.21 538.370 0.52
18 Drugs for treatment of dematologic
diseases 06 1.04 20.707 0.02
19 Other drugs under the Circular
30/2018 04 0.69 362.364 0.35
20 Drugs for diagnose 03 0.52 704.022 0.68
21 Disinfectant and sterilizer drugs 03 0.52 331.305 0.32
22 Drugs for Parkinson 03 0.52 248.478 0.24
23 Drugs for migraine 03 0.52 72.473 0.07
24 Drugs for cancer and conditioning
immunity system 02 0.35 10.353 0.01
25 Peritoneal dialysis solution 01 0.17 393.424 0.38
26
Drugs to promote delivery, stop
bleeding
postpartum and anti-premature birth
01 0.17 41.413 0.04
27 Traditional drugs 25 4.15 3,171.558 2.97
Total 603 100.00 106,704.230 100.00
The group of drugs that both accounts for the most
significant number of items and account for the
most considerable value are cardiovascular drugs,
parasitic drugs, anti-infections, gastrointestinal
drugs, hormones, and drugs impact the endocrine
system. The group of cardiovascular drugs
accounted for the highest number with 116 items,
corresponding to 20.01%, and anti-bacterial and
parasitic drugs with the highest value accounting
for 26.1%.
Cardiovascular disease is currently the leading cause
of death worldwide, more than cancer, whether in
developed or developing countries. There are some
circulatory system diseases such as hypertension,
heart disease due to causes, cerebrovascular
disease... Currently, cardiovascular disease is the
leading cause of death globally, accounting for 31%
of all deaths. In Vietnam, cardiovascular disease
was responsible for 31% of all deaths in 2016,
equivalent to more than 170,000 deaths [7].
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In DL, 25 traditional drugs and herbal medicines were
used with low value (2.97%). These are drugs with
ingredients extracted from plants such as Ginkgo
biloba, Panax notoginseng, Cardus marianus...
Some other herb medicines, such as Thien su ho
tam dan are widely used due to their noticeable
treatment effect for cardiovascular diseases and
are also trusted by doctors and patients. Moreover,
MH 354 has many patients with chronic diseases,
so herbal medicines play a perfect supportive role
in treatment. However, research results show that
traditional drugs and herbal medicines used at MH
354 account for only a small percentage, which is
reasonable and suitable for the treatment needs.
2. Structure of drug list according to the origin
Table 2: Structure of the list of consumed drugs by origin.
Criteria
Origin
Item amount Value
Amount
(n)
Percentage
(%)
Value
(milion VND)
Percentage
(%)
Domestic Drugs 265 43.95 27,238.667 25.53
Foreign Drugs 338 56.05 79,465.563 74.47
Total 603 100.00 106,704.230 100.00
The percentage of drug sales of domestically
produced drugs (43.95%) was lower than that of
drugs imported from abroad (56.05%), but the
difference was not much. However, in terms of
value, drugs imported from abroad (74.47%) have
a value of about 3 times higher than domestically
produced drugs (25.23%). Therefore, it can be
explained that because drugs imported from
abroad are usually BDG drugs, the cost is high,
and the cost of transportation and distribution is
also many times higher than that of domestically
produced drugs.
Table 3: Group of 10 countries with the highest imported drug value in 2019 in the drug list of Military
Hospital 354.
Order Country
Item amount Value
Amount
(n)
Percentage
(%)
Value
(milion VND)
Percentage
(%)
1Germany 40 11.83 10,462.382 13.17
2 India 24 7.10 10,064.175 12.66
3Bulgary 08 2.37 4,617.429 5.81
4 Switzerland 10 2.96 4,081.540 5.14
5 Poland 16 4.73 3,714.665 4.67
6Slovenia 09 2.66 3,595.147 4.52
7 Cyprus 09 2.66 3,393.527 4.27
8Korea 16 4.73 2,588.886 3.26
9 France 51 15.09 2,241.384 2.82
10 Hungary 25 7.40 1,847.162 2.32
Total 208 61.53 37,606.297 58.64