engleski

A retrospective, observational, comparative and pharmacoeconimic study of benzodiazepine derivates utilization from 2014 to 2015 between Croatia and Sweden

OBJECTIVES Consumption of drugs affecting the nervous system, especially, benzodiazepine derivatives (N05BA) is continuously increasing in Croatia. The increase is present beside benzodiazepines are Rx only drugs. Following observed paradox, the objective of the study was to compare utilization of benzodiazepine derivatives between, two European Union countries, Croatia and Sweden for 2014 and 2015. Due to Anatomical Therapeutic Chemical classification system (ATC)/defined daily doses (DDD), it is possible to present and compare drug consumption. Substantial differences were expected. METHODS In this study, the ATC/DDD system was used as a tool for the drug, anxiolytics derivatives of benzodiazepines utilization research to improve the quality of drug use in Croatia. Observational, retrospective, non- interventional, phase 4, academic, non- sponsored study was performed. The wholesale data on benzodiazepine derivatives from Croatia and Sweden were collected. RESULTS Gross domestic product (GDP) per capita according to the World Bank is 46, 704 for Sweden and 21, 881 for Croatia. The population of Croatia was 4 284 8895 and 9 747 355 of Sweden. According to DDD per 1000 inhabitants in Croatia, DDD Nervous system (N) increased from 158.77 in 2014 to 165.14 in 2015 ; in Sweden, it also rose from 278 in 2014 to 285 in 2015. Further DDD of psycholeptics (N05) in Croatia rose from 98.92 in 2014 to 102.14 in 2015, but in Sweden, they decreased from 79 in 2014 to 78 in 2015. DDD in Croatia for anxiolytics (N05B) (72.5) mainly benzodiazepine derivatives (N05BA) (72.5) in 2014 increased to 74.48 and 74.41 in 2015, respectively. In Sweden, however, they remained the same ; 15 for anxiolytics and 11 for benzodiazepine derivatives in 2014 as well as 2015. In Croatia DDD for diazepam (N05BA01) was 34.37 in 2014, and 35.76 in 2015 ; followed by alprazolam (N05BA12) 25.51 in 2014 and 26.17 in 2015. In Sweden DDD for diazepam was 4 and alprazolam was 3 in 2014 and 2015, without changes. CONCLUSION Differences could be explained by the impact of poor, outdated and noncritical prescription of benzodiazepines in Croatia, poor psychotherapy management, lower socioeconomic status and low benzodiazepine price. Nonetheless, benzodiazepines cause dependence, emerging new problem. In Sweden, benzodiazepines are on “restricted release” drug list regarded as potentially inappropriate medications according to the Swedish National Board of Health and Welfare. Analyses of data enable us to highlight the problem of inappropriately high benzodiazepine derivatives utilization, enables to change prescribing habits and improve the quality of pharmacotherapy in Croatia.

Benzodiazepine derivatives, pharmacoeconomic study, diazepam, alprazolam

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