Browsing by Autor "Santiago Ortiz"

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Does price-cap regulation work for increasing access to contraceptives? Aggregate- and pharmacy-level evidence from Colombia
(2020) Tatiana Andia; César Mantilla; Álvaro Morales; Santiago Ortiz; Paul Rodríguez‐Lesmes
Background: Price caps through international reference pricing are widely used around the World, but not so commonly in over-the-counter markets (OTC). We study this type of regulation for the case of oral contraceptives in Colombia, which is a de facto OTC market. Objectives: We aim to establish whether the regulation triggered a competitive response within and across product categories (active pharmaceutical ingredients).We also study whether regulated products targeted to customers from high socio-economic status are now distributed in pharmacies from low socio-economic neighborhoods.Methods: First, we use a fixed effects linear panel model to estimate the change in prices and quantities associated with the new regulation for regulated and non-regulated products using administrative data at the wholesale level, according to three price tiers. Second, we conducted an audit study with 213 community pharmacies in the city of Bogotá, Colombia. We visited pharmacies twice, before and after the introduction of the price cap, collecting information on prices and availability of six selected brands. Findings: The wholesale-level analysis reveals a price reduction in regulated and non-regulated products with a regulated active ingredient. Traded quantities increase for the same product types, but only for those in the most expensive categories. Besides, the traded quantities of non-regulated products decrease.However, the traded quantities of non-regulated products in the Top, Intermediate, and Bottom price categories decreased. Although this price reduction is also transmitted to community pharmacies, the availability of the high-end and mid-range contraceptives included in our audit study decreases as well. We provide suggestive evidence that reduction in the availability of was larger in areas of low socio-economic status.Conclusions: Price cap regulations that might look as effective in lowering prices and expanding access at the aggregate level could conceal stocking patterns that negatively affect the product availability for the final consumer.
Extracting low-cost signals of perceived quality control in community pharmacies: a simulated client study of contraceptive dispensing in Bogotá
(Universidad de Antioquia, 2022) Tatiana Andia; César Mantilla; Álvaro Morales; Santiago Ortiz; Paul Rodríguez‐Lesmes
We determine whether community pharmacies in Bogotá produce differential quality signals, and if they are related to an objective quality measure: the compliance with prescription rules. In this quantitative descriptive study, we use the simulated client methodology (N=298) to assess whether Bogota’s community pharmacies comply with prescription rules related to contraceptive medications. We find that one per cent of the staff at the pharmacy asked for a prescription when the pills were requested. Five per cent of the staff asked additional questions that signal knowledge or interest in the correct delivery of pills. We do not find differences by socio-economic level or type of pharmacy ownership (i.e., large firm versus independent) regarding the request of prescriptions or further questions about the pills. Concerning the aesthetic signals of quality, independent pharmacies were less likely to display a diploma of their chemist, and the likelihood that their staff wore white coats was also lower. We conclude that Bogota’s community pharmacies differentiation is based on simple signals associated with a professional image, but not with actual procedures that guarantee the safety of consumers.
Extracting low-cost signals of quality control in community pharmacies: a simulated client study in Bogota
(2020) Álvaro Morales; Santiago Ortiz; César Mantilla; Paul Rodríguez‐Lesmes; Tatiana Andia
Datos para el artículo Extracting low-cost signals of quality control in community pharmacies: a simulated client study in Bogotá
First nationwide survey on Pseudomonas aeruginosa in Bolivia: susceptibility profiles, resistome, and genomic epidemiology
(American Society for Microbiology, 2025) Neisa Alvarado-Orosco; María A. Gomis-Font; Miquel Àngel Sastre-Femenía; Santiago Ortiz; Marcos Miguel Medina Arce; María José Barba; M. Duran; Sandra Grisel Vargas Nattez; Gabriela Cabellos Astorga; Pedro Alonso Slon Rodríguez
Information on the molecular epidemiology of Pseudomonas aeruginosa and antimicrobial resistance mechanisms is still limited in some South American countries. This study aims to decipher the population structure of 111 extensive drug-resistant P. aeruginosa isolates from a national study conducted in Bolivia during 2023-2024. The antibiotic susceptibility profiles were determined for 15 antipseudomonal agents. All isolates were subjected to whole-genome sequencing (WGS), and, through bioinformatics analysis, sequence types (ST), clonal relatedness, and acquired mutation-driven and transferable resistance mechanisms were elucidated. The most active antipseudomonal agents were colistin (98.2% intermediate, MIC50/90=1/2 mg/L) and cefiderocol (92.7% susceptible, MIC50/90=0.25/4 mg/L) according to the Clinical and Laboratory Standards Institute (CLSI). High resistance rates to ceftazidime/avibactam (79.3%), ceftolozane/tazobactam (82.9%), and imipenem/relebactam (71.2%) were documented. Carbapenemases were found in 60.3%, particularly including metallo-β-lactamases (MBL), such as SPM-1 (35%), VIM-2 (9%), the co-production of NDM-1 and DIM-1 (4%), or the new IMP variant IMP-111. Extended-spectrum β-lactamases (ESBLs) were detected in 12% of the isolates, including OXA-17 (7%), PER-1 (3%), and some GES variants. The most commonly detected clone was ST277 (35%) associated with SPM-1, followed by the ST309 (25%) producer of OXA-2 and various GES, and ST235 (20%) related with OXA-17 and new IMP-111. These clones harbored other acquired resistance genes, including emerging 16S rRNA methyltransferases, RmtD and RmtG. The high resistance rates for novel beta-lactams linked to an alarming spread of high-risk clones ST277 and ST235 and the very high prevalence of MBLs and ESBLs raise significant concern. This underscores the urgent need for establishing epidemiological surveillance and infection control strategies.
WCN24-1518 MORTALITY FROM SEVERE COVID-19-ASSOCIATED ACUTE KIDNEY INJURY COMPARED TO SEPSIS-ASSOCIATED ACUTE KIDNEY INJURY
(Elsevier BV, 2024) DIANACAROLINAVARGAS ANGEL; Camilo González; Kateir Contreras; Kelly Chacón; ANA ARANA; Santiago Ortiz; José Bareño Silva; Nancy Yomayusa