Topicality

Ukrainian pharmaceutical market has a stable growth rates during last year’s (on average on 15-20% per year) [5], this causes the presence of a large number of generics in it, in particular OHD. Formation of pharmaceutical assortment of drugs depends on many factors; one of the most important is the demand. OHD are prescription drugs and their demand is formed by doctors that prescribe these drugs. This is determines an interest in the person of physician, his individual characteristics.

The purpose:

to identify the influence of individual characteristic of doctors on the formation of pharmaceutical assortment of OHD by XYZ-analysis.

Research objectives:

1) carry out a sociological survey of practitioners (endocrinologists, therapeutists, family doctors),

2) conduct XYZ-analysis of OHD,

3) analyze the individual parameters of physicians (age, experience, specialization, category, academic degree and title),

4) identify the doctors’ commitment  to a specific country manufacturer of OHD.

The object of the study:

surveys of practitioners.

The research materials:

105 questionnaires of practitioners from Vinnytsa, Khmelnytsky and Ternopol areas (Podolsky region).

Research  methods:

sociological survey with questionnaires application, XYZ-analysis of OHD, analysis of individual parameters of practitioners according to questionnaires, frequency analysis of doctor’s commitment to certain countries producers of OHD.

Questionnaire of a sociological survey included 19 questions. These questions described individual parametrs of doctors (age, experience, specialization, category, academic degree and title), the international nonproprietary name (INN) and trade names of OHD that are prescribed by these doctors, doctor’s commitment to certain countries-producers of the OHD, the reasons for such commitment, accounting the patients’ purchasing power.

Тhe calculation of variation coefficients for the analyzed groups of drugs is the basis of XYZ-analysis. The smaller the variation coefficients, the greater the commitment of the consumer to this group of drugs [1,3]. Category X (coefficient of variation to 10%) includes drugs that are less susceptible to fluctuations in demand, their sale are easily predicted. Such drugs are characterized by high possibilities of sales forecast. For such drugs must be kept optimal reserves in pharmacies and apply methods of demand forecasting models and optimal sizing of the stock. Category Y (coefficient of variation is 10-25%) involves the drugs with some fluctuations in demand and medium sales forecast. Category Z (coefficient of variation greater than 25%) comprises the drugs with non regular consumption, their demand/sales cannot be predicted, trend any absence, low sales forecast accuracy. These include drugs that are brought to order or those which just appeared on the market and recently went on sale [2,4].

XYZ-analysis was implemented in three stages:

1. Determination of the coefficient of variation of the analyzed OHD
2. Grouping of OHD in accordance with the increase in the coefficient of variation
3. Drug distribution over categories:  X, Y, Z.  

 The coefficient of variation was calculated as the ratio of the standard deviation to the arithmetic mean of the measured values of drugs ​​by the formula:

V = σ/x, where

V- coefficient of variation

σ - standard  of deviation

x - arithmetical mean

 Results of the research

When analyzing questionnaires of the doctors it has been divide all OHD into 3 groups (X,Y and Z) and obtained the following results (Table 1).

 Table 1. Coefficients of variation of OHD

It has been found that the groups X are formed by 26 OHD with variation coefficients from 0,53 to 7,14; group Y –  by 6 OHD with variation coefficients from  14,28 до 16,67;  group Z – by only 1 OHD with variation coefficient 28,57.

It was interesting to describe physicians who form this assortment of OHD according to individual indicators (age, experience, specialization, category, academic degree and title) (Table 2).

Table 2. Characteristics of doctors by individual parameters

It was found that the OHD of the groups X and Y were formed by practitioners under the age of 30 years (47%), with work experience up to 5 years (40%), mostly – endocrinologists (73%), with the second qualifying category (33%), with high qualifying category (27%), and without qualifying category (26%). 14% of these doctors have scientific degree as PhD and associate professor. The group Z was formed by the doctors aged 51-60 years (60%), in 100% of cases there were endocrinologists with 11-20 years of experience on specialty (66%), with the second qualification category (67%), and with the high qualifying category without academic degrees and titles (33%).

Doctors’ commitment to a certain country-manufacturers of OHD has been studied (Table 3).

 Table 3. Degree of  practitioners’ commitment to a country-manufacturers of  OHD

It has been established that the doctors of Podolsky region of Ukraine who formed groups X and Y were largely committed to the German (93%) and French (60%) manufacturers, and the doctors who formed group Z were largely committed to the manufacturer of Poland (63%) and Ukraine (49%). At the same time, only 14% of the doctors who formed groups X and Y were committed to the Poland and Austria manufacturers and 40%  – to the Ukraine manufacturers.

Discussion

Тhe calculation of variation coefficients for the analyzed groups of drugs is  the basis of XYZ-analysis. The reasons of differences in the values variation of coefficients could have been caused by doctor’s commitments to certain drugs, doctors’ experience, interests, drugs belonging to known producing firms, presence/deficit of drugs in the pharmaceutical market; medical representatives’ work with doctors, publications in specialized magazines, etc.

It has been found that the group X includes OHD that have the highest sustainable preference of doctors: Glucophage, Dianorm-M, Victoza, Diaformin® Pharmak, Siofor, Glucovance, Amaryl, Maninil, Glibomet, Ongliza, Glurenorm, Diabeton MR, Metfogamma, Pioz, Glikomet, Yanumet, Januvia, Diaglizid MR, Diapirid, Amapirid, Dianormet, Dibizid M, Duotrol, Metformin Sandoz, Oltar, Triprayd. Group Y had some tendencies of preferences and was formed by the following OHD: Glibenclamide Pharmak, Diaglizid, Pioglar, Glutason, Glimepiride-Lugal Diabrex. Group Z was formed by only one drug Glirid.

In group description the groups of the doctors who prescribed oral hypoglycemic drugs in groups X and Y no differences were revealed in individual parameters, which allowed to combine them in one group. Individual parameters of the doctors who formed X and Y groups were  the following: age was 30 years (47%), work experience was up to 5 years (40%), in 73% of cases they were the endocrinologists, 33% of them had the second qualification category, 27% – the highest, in the 26% – without qualification category. Approximately 14% of these doctors have PhD degree and academic title of associate professor. Individual parameters of doctors who formed the groups Z were following: age was 51-60 years (60% of cases), they were endocrinologists (in 100% of cases) with experience in the specialty 11-20 years (66% of cases), 67% of them had the second qualification category, 33% of them had a higher qualification category and in 100% of cases they were without scientific degrees and titles.

Results of the survey of practitioners show stable position of Germany and  France manufacturers of doctors that are prescribed OHD: 93% Germany manufacturers and 60% France manufacturers form groups X and Y of OHD. In comparison with the manufacturers of these drugs of Germany and  France the manufacturers Ukraine, Poland and Austria had unstable position in the pharmaceutical market of Ukraine Podolsky region: 40%, 14% and 14%, respectively of odoctors that are prescribed OHD of groups X, Y.

The cause of such distribution, in the opinion of the respondents, is the high efficiency of OHD of groups X and Y (80%), rare adverse reactions (60%), presence of these OHD in state treatment standards (33%), constant presence of these OHD in pharmacies (27%) and their affordability (7%).

Conclusions

1). OHD of X and Y groups were formed by younger practitioners with shorter work experience, mostly endocrinologists of the second qualification category without academic degrees and titles; Z group were formed by only older endocrinologists with longer work experience of the second qualification category without scientific degrees and titles.

2). The main reason for the commitment of doctors to OHD manufacturers of Germany and France was a high efficacy of these drugs.

3). A more stable position of manufacturers of Germany and France in the pharmaceutical market of Podolsky region of Ukraine. 

4). Most of the physicians in selecting OHD take into consideration the purchasing power of the population.