OBJECTIVE: The Swedish Dental and Pharmaceutical Benefits Agency is re-assessing the value of all drugs included in the reimbursement scheme in order to make the most efficient use of resources. Their recent review of antihypertensive drugs included 46 substances with total annual sales of euro230 million (euro25/capita). This resulted in reimbursement restrictions for 26 substances, e.g. all angiotensin receptor blockers (ARBs). METHODS: We used the Swedish prescribed drug register to evaluate the initial effects on prescribing patterns using a before-and-after design, comparing utilization and expenditure with corresponding periods previous years. RESULTS: The proportion of the Swedish population being dispensed antihypertensive drugs increased by 0.5%-units to 16.5% in September-December 2008 compared to the same period in 2007. Patients initiated on ARBs decreased by 24%, whilst increasing for ACE inhibitors (ACEI) and calcium channel blockers, by 14% and 12%, respectively. The proportion initiated on ARBs prescribed an ACEI within 24 months prior to an ARB increased from 51% to 67%, with a substantial regional variation (extremal quotient 31; coefficient of variation 36%). The total expenditure decreased by 4.7% to euro73 million in September-December 2008 compared to the same period in 2007. CONCLUSIONS: Reimbursement restrictions had a positive impact on enhancing the efficiency of antihypertensive prescribing. Resources released can be used to improve care in the future.
OBJECTIVE: The Swedish Dental and Pharmaceutical Benefits Agency is re-assessing the value of all drugs included in the reimbursement scheme in order to make the most efficient use of resources. Their recent review of antihypertensive drugs included 46 substances with total annual sales of euro230 million (euro25/capita). This resulted in reimbursement restrictions for 26 substances, e.g. all angiotensin receptor blockers (ARBs). METHODS: We used the Swedish prescribed drug register to evaluate the initial effects on prescribing patterns using a before-and-after design, comparing utilization and expenditure with corresponding periods previous years. RESULTS: The proportion of the Swedish population being dispensed antihypertensive drugs increased by 0.5%-units to 16.5% in September-December 2008 compared to the same period in 2007. Patients initiated on ARBs decreased by 24%, whilst increasing for ACE inhibitors (ACEI) and calcium channel blockers, by 14% and 12%, respectively. The proportion initiated on ARBs prescribed an ACEI within 24 months prior to an ARB increased from 51% to 67%, with a substantial regional variation (extremal quotient 31; coefficient of variation 36%). The total expenditure decreased by 4.7% to euro73 million in September-December 2008 compared to the same period in 2007. CONCLUSIONS: Reimbursement restrictions had a positive impact on enhancing the efficiency of antihypertensive prescribing. Resources released can be used to improve care in the future.
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Authors: Brian Godman; William Shrank; Morten Andersen; Christian Berg; Iain Bishop; Thomas Burkhardt; Kristina Garuoliene; Harald Herholz; Roberta Joppi; Marija Kalaba; Ott Laius; Julie Lonsdale; Rickard E Malmström; Jaana E Martikainen; Vita Samaluk; Catherine Sermet; Ulrich Schwabe; Inês Teixeira; Lesley Tilson; F Cankat Tulunay; Vera Vlahović-Palčevski; Kamila Wendykowska; Bjorn Wettermark; Corinne Zara; Lars L Gustafsson Journal: Front Pharmacol Date: 2011-01-07 Impact factor: 5.810
Authors: Rickard E Malmström; Brian B Godman; Eduard Diogene; Christoph Baumgärtel; Marion Bennie; Iain Bishop; Anna Brzezinska; Anna Bucsics; Stephen Campbell; Alessandra Ferrario; Alexander E Finlayson; Jurij Fürst; Kristina Garuoliene; Miguel Gomes; Iñaki Gutiérrez-Ibarluzea; Alan Haycox; Krystyna Hviding; Harald Herholz; Mikael Hoffmann; Saira Jan; Jan Jones; Roberta Joppi; Marija Kalaba; Christina Kvalheim; Ott Laius; Irene Langner; Julie Lonsdale; Sven-Äke Lööv; Kamila Malinowska; Laura McCullagh; Ken Paterson; Vanda Markovic-Pekovic; Andrew Martin; Jutta Piessnegger; Gisbert Selke; Catherine Sermet; Steven Simoens; Cankat Tulunay; Dominik Tomek; Luka Vončina; Vera Vlahovic-Palcevski; Janet Wale; Michael Wilcock; Magdalena Wladysiuk; Menno van Woerkom; Corrine Zara; Lars L Gustafsson Journal: Front Pharmacol Date: 2013-05-14 Impact factor: 5.810