engleski

Recent Policies to Enhance Prescribing Efficiency in Croatia ; Their Impact and Future Guidance

Background: Croatia has recently introduced reforms to reduce the drug budget deficit without compromising the quality of care. This includes reference pricing for existing drugs in classes where these are seen as essentially similar. This builds on existing reforms, which had already improved prescribing efficiency for both the PPIs and statins. Objectives: Document the influence of recent reforms on the utilisation and expenditure of PPIs and statins. These build on earlier results in recent Pan-EU CNC publications. Methods: Retrospective observational drug utilisation study documenting the influence of recent reforms on utilisation patterns and reimbursed expenditure of PPIs (A02BC) and statins (C10AA) from 2000 to 2010, using 2010 DDDs. Only administrative databases used, and reforms validated with data providers. Previous publications only went up to 2008. Results: Under the new reforms, (a) the reference price for existing drugs (ATC Levels 3 and 4) is based on the lowest price of products with a market share of at least 5% by expenditure during the preceding 12 months, with patients paying the price difference for a more expensive product, (b) there are strict controls for the marketing of drugs including mandatory recording of all promotional expenses and limiting the contact time between pharmaceutical companies and physicians, (c) health insurance expenditure decreased by 13% from 1.7bn Kuna to 1.5bn Kuna ( 0.2bn) first 6 months 2010 vs. similar period in 2009. We fully expect to see similar reductions in expenditure/ DDD for PPIs and statins alongside associated improvements in prescribing efficiency following the recent reforms. This though remains to be substantiated. Conclusions: The recent reforms have reduced drug expenditure in Croatia. We expect there will be similar further improvements in prescribing efficiency for both the PPIs and statins following the recent initiatives. As a result, provide guidance to other countries struggling with resource pressures.

drug policy; prescribing

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