[Pharmwaste] Re: Pharmwaste Digest, Vol 16, Issue 24

[JuMullot at aol.com]

Dans un e-mail daté du 22/02/2007 07:24:56 Paris, Madrid,  
pharmwaste-request at lists.dep.state.fl.us a écrit :

Responding to "Measuring the amount...."


Dear Collegues,
 
I'm a european (French) doctorant, following your discussions in this forum  
since several month and I would like to share my opinion about the  
measurment/modelling of pharmaceutical amounts in aquatic ressources.
 
In europe also, it is quite easy to find consumption data in financial  units 
($ or euros) but it is something very very difficult to find a robust  
correlation between financial units and amounts (in mass of active ingredient  for 
example) for the following reasons :
 
- public prices are controlled (in france) but not for hospitals, clinics  
and health centers (in this case, prices are free of regulatory control). For  
example, you can pay a lot for a molecule in the pharmacy store just located in 
 your street but the same molecule can be provided for no charge at the 
hospital  pharmacy where you can be hospitalized ... but an other hospital pharmacy 
can  pay a different price because they do not negociate,
 
- for a same active ingredient you can have different presentations and/or  
routes of administration and the prices can be very different between these  
presentations,
 
- between the sales and the environment you have humans that can metabolize  
the active ingredient and pharmacokinetic data are not always avalaible and/or 
 of good quality for modelling purposes (and there are interindividual  
variations of pharmacokinetic data)
 
In my opinion, this is a reason why mesured environmental concentrations  and 
predicted environmental concentrations do not often correlate,  especially 
when calculated with amounts derived from financial  informations.
 
For these reasons I'm actually trying to build a model at the hospital  scale 
with daily amounts delivered in patients (in g of active  ingredient), daily 
water consumptions and PBPK data as main  variables and we compare measured 
concentrations in hospital wastewater  (proportional sample) with calculated 
concentrations for several API of each  major therapeutic class (about 15 target 
molecules) and for different hospitals.  First data will be avalaible in few 
months ... for integration in other models  from urban wastewater to other 
environmental compartments.
 
To my knowledge a firm, called "IMS Health" can provide data of API  
consumption in mass amounts but you should pay for that. The website adress is  
_http://www.imshealth.com/_ (http://www.imshealth.com/) 
 
Ready to answer you questions and discuss again about this subject,
 
Best regards,
 
Jean Ulrich MULLOT
Pharmacist, Doctorant in Human and Environmental Risk Assessment (mainly  
exposure assessment)
 
   
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