Revue médicale suisse
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Revue médicale suisse · Mar 2006
[Generic drug prescribing: pilot study on the impact of the new drug pricing system on costs and potential savings].
The impact of a systematic generic substitution and of the new drug pricing system (implemented in 2002 for cost saving reasons) on prescription cost was computed on the basis of prescriptions delivered in January 1999 for patients leaving our university hospital. A total of 3,099 prescriptions, representing 5,514 drugs, were delivered in one month, of which 335 (6%) were excluded (drug not available in 2002 or magistral preparations). Forced generic prescription would have saved 3,8% of global costs, while the new drug pricing system would have increased costs between 1,1% and 8,0%. In this specific setting, savings linked with forced generic drug prescription was weak (4 to 5%), and the expected savings of the new drug pricing system were not observed.
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Revue médicale suisse · Mar 2006
Review[The role of aspirin in the primary prevention of cardiovascular disease].
For persons without cardiovascular disease, the benefit of aspirin in primary prevention has been controversial until the recent publication of several major randomized controlled trials. Since then, several medical societies recommend that clinicians discuss aspirin prevention with adults at high cardiovascular risk. Patients with low cardiovascular risk are unlikely to benefit from aspirin, as potential harms (hemorrhagic strokes, gastrointestinal bleedings) may outweigh benefits. Aspirin should be recommended in primary prevention only in patients with a 10-year cardiovascular risk > or = 10% or in diabetic patients aged > or = 40 years with a concomitant cardiovascular risk factor, after assessing contraindications for aspirin and individual's preferences for the risks and benefits associated with aspirin.