http://luuvinh82.tigblog.org/ What's on the minds of young leaders from around the globe? en-us http://luuvinh82.tigblog.org/post/256575
Doctors give “coded” prescription, to be read by indicated pharmacists

Ms. HTH from Son La came to room No. 4, Outpatient Department, Bach Mai hospital with low CD4 count - 73 cells on Feb 23, 06. Here, the doctor gave her an ARV prescription which read “formula 3 x 1 month” and of the name of another medicine, without any counseling or explanation or instruction how to take the medicine. The only instruction that the doctor gave to Ms. H was where to buy the medicine.

Of course, only that indicated pharmacy that could “decode” the “formula” written by the doctor. This pharmacy sold Ms. H Viramun 200mg and Combivir (the 2 in 1 ARV medicine in replacement of Lamivudine 150mg and Zidovudine 30mg).
A month later, on Mar 20, 2006, Ms. H visited the same room and was given the prescription “formula 3 x2 months” together with 3 other types of medicine. The doctor again instructed Ms. H to buy medicine in the same pharmacy. Ms. H had to pay up to 1,900,000 VND for one-month treatment, nearly double the normal price. After that when joining the Buyer Club organized by the Bright Future Network, she had to pay only 698,000 VND for the above prescription. Everyone knows that lives of PLWH is hard. They have to face great financial difficulties. Medical expenditure of 1,900,000 VND/per month is too high for even people with stable income. The way the doctor gave such “coded” prescriptions, which prevent patient from checking the price or select appropriate medicine producers for a reasonable price is unacceptable.



Doctor give wrong prescription



Lately, on Jul 26, 2007, Ms. H came back to the same room. This time, finding a different doctor in the room, Ms. H told the doctor the name of the medicine that she had been prescribed and that her CD4 index had increased to 180. Nevertheless, this doctor prescribed Ms. H three types of ARV which are different from those prescribed before. They are Stavudine 30mg, Efavirenz 200mg and Indinavir 400mg. In an interview with us, a doctor treating HIV/AIDS said this prescription is not in accordance with the treatment regime stipulated by the Ministry of Health. Moreover, the ARV treatment method recommended currently is that patients must be treated with ARV for their whole life and take an exactly dose, at fixed hours, and that effective regimen should be maintained as long as possible and if switching is necessary, it must be done strictly according to the guidance. As for patients treated with ARV, the improper change in medicine can lead to drug-resistance and ineffective treatment.



Patients become victims - not uncommon



Mr. Phạm Quốc Hùng, steering member of the Bright Future Network expressed frustration while sharing Ms. HTH is not an unique case. Quite a number of patients with HIV had got prescription with “formula 1”, “formula 2” and had to pay higher price in the pharmacies indicated by the doctors. Worse, in some cases, the patients are sold different types of medicine for the same “formula 1” in two different purchases. Mr. Hung added now there currently remain a lot of PLWH lacking knowledge about HIV/AIDS treatment and unable to have access to any self-help group or counseling service. Some others are afraid that their HIV status would be disclosed when participating in free treatment programs. Sadly, instead of providing patients with counseling and information about HIV or referring them to a self-help group or institutions that can support them, some doctors seem to prescribe irresponsibly. Their patient “victim” consequently, have to take the medicine every day the drugs which are not prescribed correctly or spend more money than they need to, which has forced many to stop taking the medicine due to running out of money, resulting in many negative effects for their health.



Which action will the agencies responsible for AIDS control take towards the people who are seeking benefits from HIV/AIDS patients and increase the risk of drug resistance?

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