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<DIV>Dans un e-mail daté du 22/02/2007 07:24:56 Paris, Madrid,
pharmwaste-request@lists.dep.state.fl.us a écrit :</DIV>
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style="BACKGROUND-COLOR: transparent" face=Arial color=#000000
size=2>Responding to "Measuring the amount...."</FONT></BLOCKQUOTE></DIV>
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<DIV>Dear Collegues,</DIV>
<DIV> </DIV>
<DIV>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.</DIV>
<DIV> </DIV>
<DIV>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 :</DIV>
<DIV> </DIV>
<DIV>- 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,</DIV>
<DIV> </DIV>
<DIV>- 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,</DIV>
<DIV> </DIV>
<DIV>- 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)</DIV>
<DIV> </DIV>
<DIV>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.</DIV>
<DIV> </DIV>
<DIV>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.</DIV>
<DIV> </DIV>
<DIV>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
<A href="http://www.imshealth.com/">http://www.imshealth.com/</A></DIV>
<DIV> </DIV>
<DIV>Ready to answer you questions and discuss again about this subject,</DIV>
<DIV> </DIV>
<DIV>Best regards,</DIV>
<DIV> </DIV>
<DIV>Jean Ulrich MULLOT</DIV>
<DIV>Pharmacist, Doctorant in Human and Environmental Risk Assessment (mainly
exposure assessment)</DIV>
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