NARCOTIC SUBSTANCES, PSYCHOTROPIC SUBSTANCES; MEDICAL PRESCRIPTION – NEWS, SUPPLEMENTS . Medical Prescription Medical prescription: no official form, only requirements Special form: Narcotic drugs, psychotropic drugs – schedules… Medicinal orders: no official form, only requirements Special Medicinal orders - Narcotic drugs, psychotropic drugs - given schedules E-prescription Medical Prescription Validity: • 14 days • 5 days • 1 day after prescribing • 6 month Insurance in CZE • Compulsory health care insurance system • Consists of not-for-profit health insurance companies • Health insurance company - freedom of choice, can be changed Insurance companies • 111 Všeobecná zdravotní pojišťovna ČR (VZP ČR) • 60 % of the population • Other health insurance companies, which are referred to as “employee insurance companies”: • 201 Vojenská zdravotní pojišťovna České republiky (VoZP ČR) • 205 Česká průmyslová zdravotní pojišťovna (ČPZP) • 207 Oborová zdravotní pojišťovna zaměstnanců bank, pojišťoven a stavebnictví (OZP) • 209 Zaměstnanecká pojišťovna Škoda (ZPŠ) • 211 Zdravotní pojišťovna ministerstva vnitra ČR (ZPMV ČR) • 213 Revírní bratrská pokladna, zdravotní pojišťovna (RBP) Patient information • Name • ID • Address • Telephone number - only with agreement of the patient • Year of birth - only if it isn't in the ID • Weight of preschool children - if it is unusual Patient ID YYXXDD/SSSC • YY – year of birth • XX=MM (month of birth) for male (numbers 01-12) • XX=MM+50 for female (numbers 51-62), • DD = day • SSS is a serial number separating persons born on the same date and C is a check digit. • 701020 - 20. 10. 1970 • The whole number must be divisible by 11. • For people born before 1 January 1954 the form is YYXXDD/SSS (without the check digit). • This enables the system to work until the year 2054. Medical Prescription Medical prescription: • 2 different medicinal products, • limit - 3 months therapy; • More than 3 months – prescription for repeating dispensing • 1 medicinal product – narcotic drugs or psychotropic given schedules Medical order: • No limit for medicinal products • 5 different medicinal products – narcotic drugs… Medical Prescription • Brand name, dosage form, strenght, package • INN of the substance, dosage form, strenght, package Name of the substance written in the Pharmacopoeia, synonym or abrevitation in the Pharmacopoeia - prepared medicinal products Medical Prescription - symbols • "Hradí nemocný" – not reimbursed • „!“ - over the maximum dose • "Nezaměňovat" - substitution restricted • "Neodkladná péče" or "Akutní péče" - non-contractual physician, urgent therapy Medical Prescription - symbols • "Zvýšená úhrada" - Increased maximum reimbursement from health insurance • "Neregistrovaný léčivý přípravek" - medicinal product without marketing authorisation • "Na doporučení odborného lékaře" - Recommendation of a specialist Medical Prescription - symbols • Main diagnosis - Increased maximum reimbursement from health insurance, Rx medicinal products with restricted dispensing Diagnosis - ICD • International Classification of Diseases (ICD) by the United Nations and World Health Organization • "standard diagnostic tool for epidemiology, health management and clinical purposes“ Medical Prescription • Prescription „with blue stripe“ • 1 original + 2 carbon copy • Original + 1st copy – in the pharmacy • 2nd copy – the physician • Medical order „with blue stripe“ • 1 original + 3 carbon copy • Original + 1st, 2nd – in the pharmacy • 3rd – the physician / health care facility Prescribers • Physicians – human, veterinary - providing preventive health care • Physicians not providing preventive health care (i.e. university employees, pensioners etc.) if: • Mini-license • Note in the prescription "for familiy mamber" or "Ad usum proprium" E-prescribing • More accurate prescriptions • Eliminating illegible prescriptions: • The Implementation of warning and alert systems • Improves medication safety E-prescribing • Improved quality and consistency of care • Better management of medications costs • Improved prescribing accuracy and efficiency • Actual information • Reduce time E-prescribing • Increase patient convenience and medication compliance. • Elimination of fakes • Feedback and Statistical reports E-prescribing Repository of E-prescription¨: Requirements • Integrity of data input Security and Privacy • Costs • Maintenance, and upgrades • System Downtime Central repository of e-prescription in CZE • Central repository of electronic prescriptions has been established as an organisational part of • Similar to the written prescritpion • 2018??? ADDICTIVE SUBSTANCES IN THE PHARMACY SINGLE CONVENTION ON NARCOTIC DRUGS • SINGLE CONVENTION ON NARCOTIC DRUGS, 1961 As amended by the 1972 Protocol by United nations • „Recognizing that the medical use of narcotic drugs continues to be indispensable for the relief of pain and suffering and that adequate provision must be made to ensure the availability of narcotic drugs for such purposes.“ SINGLE CONVENTION ON NARCOTIC DRUGS • „Recognizing that addiction to narcotic drugs constitutes a serious evil for the individual and is fraught with social and economic danger to mankind.“ SINGLE CONVENTION ON NARCOTIC DRUGS • Acknowledgment: the competence of the United Nations in the field of narcotics control • Cooperation - within the framework of that Organization SINGLE CONVENTION ON NARCOTIC DRUGS • Schedule I. • Substances with addictive properties, presenting a serious risk of abuse • Degree of control: very strict SINGLE CONVENTION ON NARCOTIC DRUGS • Schedule I. • Requirement of a medical prescription for the supply or dispensation of drugs to individuals; SINGLE CONVENTION ON NARCOTIC DRUGS • Schedule II. • Substances normally used for medical purposes and given the lowest risk of abuse SINGLE CONVENTION ON NARCOTIC DRUGS • Schedule II. • Drugs are regulated only less strictly than Schedule I drugs • Medical prescriptions for the supply or dispensation of these drugs to individuals are not obligatory forms. SINGLE CONVENTION ON NARCOTIC DRUGS • Schedule III. • Preparations of substances listed in Schedule II, under conditions written in the commentary SINGLE CONVENTION ON NARCOTIC DRUGS • Schedule IV. • The most dangerous substances, already listed in Schedule I, • particularly harmful • extremely limited (or none) medical or therapeutic value Convention on Psychotropic Substances of 1971 The objectives: • to limit the use of these substances to medical and scientific purposes • some psychotropic substances may have therapeutic value, but they also present a dangerous risk of abuse. Convention on Psychotropic Substances of 1971 • Schedule I • Substances presenting: • high risk of abuse, • posing a particularly, serious threat to public health • which are of very little or no therapeutic value Convention on Psychotropic Substances of 1971 Schedule I • Degree of control: • Very strict; • use is prohibited except for scientific limited medical purposes Convention on Psychotropic Substances of 1971 Schedule II Substances: • presenting a risk of abuse, • posing a serious threat to public health • low or moderate therapeutic value • Degree of control: strict, special medical prescription form Convention on Psychotropic Substances of 1971 Schedule III Substances: • presenting a risk of abuse, • posing a serious threat to public health • which are of moderate or high therapeutic value Convention on Psychotropic Substances of 1971 Schedule III • Degree of control: • available for medical purposes Convention on Psychotropic Substances of 1971 Schedule IV Substances presenting: • a risk of abuse, • posing a minor threat to public health • with a high therapeutic value Convention on Psychotropic Substances of 1971 Schedule IV • Degree of control: • These substances are available for medical purposes Convention against Illicit Traffic Narcotic drugs and Psychotropic substances • Wien, 1988 Comprehensive measures against: • drug trafficking, • Precursors / chemicals. Convention against Illicit Traffic Narcotic drugs and Psychotropic substances Drug precursors are chemicals that have primarily a wide variety of legitimate and important industrial uses but that may be diverted from legal trade to the manufacturing of illicit drugs. Convention against Illicit Traffic Narcotic drugs and Psychotropic substances Necessary: to monitor certain substances, including precursors, chemicals and solvents, which are used in the manufacture of narcotic drugs and psychotropic substances, Convention against Illicit Traffic Narcotic drugs and Psychotropic substances Licensing Convention against Illicit Traffic Narcotic drugs and Psychotropic substances • category 1 covers the most sensitive substances • category 2 covers less sensitive substances • category 3 covers chemicals that can have different types of uses in the manufacturing process Precursors • •Regulation (EC) No 273/2004 of the European Parliament and of the Council on drug precursors