engleski

The analysis of statins usage in Croatia during the five-year period

Statins are used in primary and secondary prevention of cardiovascular disease. The goal of this study was to analyze the outcome of the introduction of generic forms of statins on the reimbursement drug list paid by the Croatian Health Insurance Institute (CHII) and the effects of corrections of the reference prices of this drug group for the five-year period in the relation to the financial expenditure. The data was obtained from the CHII, which maintains records regarding drugs issued by Croatian pharmacies. For the investigated period from 2003 to 2007, annual volumes of prescribed statins were presented in defined daily doses (DDD) and the expense is presented in Euros (€ ). An average cost per DDD was calculated for each drug of the group. During the five-year period from 2003 to 2008, the volume of prescribed group of statins increased 163 % (from 33.294.052 to 87.616.126 DDD) while the share of branded drugs decreased significantly (from 77.02% to 38.62%). The related expense showed an increase by 18 %. The average cost per DDD dropped for 52% (from 0.69 € /DDD in 2003 to 0.33 € /DDD in 2007). Simvastatin and atorvastatin were the two most often prescribed statins representing more than 90% of total expense. The cost per DDD for simvastatin fell for 58% (from 0.65 to 0.27 € /DDD). The cost per DDD for atorvastatin fell 53% (from 0.68 to 0.32 € /DDD). During the period 2003-2007, the whole group of statins showed a continuous increase in prescribed DDD. The average cost per DDD gradually declined after the introduction of generic substitutions to the reimbursement drug list which resulted in lowering reference prices accordingly. Therefore the overall growth of financial expenditure was slowed down considerably. For the entire period simvastatin and atorvastatin remained the most prescribed statins.

statins; generics; reference prices; national reimbursement list

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