engleski

Bisphosphonates usage in Croatia: the effects of new pricing regulation

The aim of this study was to detect changes in bisphosphonates usage and the effects of new pricing regulation concerning generic and new original bisphosphonates introduction on the national reimbursement list. Drug utilization and financial expenditure data were analysed for the bisphosphonates prescribed by general practitioners. The data were obtained from the Croatian National Health Insurance Institute for the period 2001–2007. Utilization data are presented in DDD/1000 inhabitants/ day (DDD/1000), while expenditure data are presented in Euros and Euros/DDD. In the period 2001–2007, the usage of bisphosphonates increased 2.62 times (from 1.58 to 5.72 DDD/1000). The usage increased until 2005 but since then there have not been any significant differences. The related expenditure increased 2.21 times from 2001–2006, and in 2007 decreased 30%, so the overall growth in expenditure was 1.22 times. For the entire period original alendronate remained the most frequently prescribed bisphosphonate (ranging from 50.05% in 2001 to 95.9% in 2004.), it had the highest financial share (96.75% in 2001 to 60.06% in 2007). After the introduction of new original and generic bisphosphonates the expenses decreased ; for original alendronate 38.93% (1.13 Euro/DDD in 2001 to 0.69 Euro/DDD in 2007) and for other original bisphosphonates 82.73% (6.66 Euro/DDD in 2005 to 1.15 Euro/ DDD in 2007). The usage of bisphosphonates in Croatia increased during the investigated period, but financial expenditure decreased after 2006 with introduction of the new pricing system which regulates prices of the new original bisphosphonates and also stimulates generics with lower prices on the Croatian drug market.

generic bisphosphonates; financial expenditure; drug utilization

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