BACKGROUND: Multiple reforms have been introduced in the Republic of Srpska to enhance prescribing efficiency. OBJECTIVES: First, assess their influence on utilization and expenditure on proton-pump inhibitors, statins and renin-angiotensin inhibitor drugs. Second, assess whether the Republic can obtain low prices for generics. Third, suggest additional reforms that could be introduced. METHODS: Observational study of all ambulatory care patients between 2003 and 2010. Defined daily doses (DDDs) and DDDs per 1000 inhabitants per day used for measuring changes in utilization. Reimbursed expenditure used as health insurance perspective. RESULTS: Increasing utilization in all three classes. Utilization of angiotensin-receptor blockers principally limited by prescribing restrictions. Reimbursed expenditure/DDD in all three classes decreased by up to 82% in 2010 versus 2004, appreciably improving prescribing efficiency for the statins. Increased utilization of esomeprazole at higher reimbursed expenditure/DDD, and similarly angiotensin-converting enzyme-inhibitor combinations at higher expenditure versus single drugs, limited the ability to fully capitalise on these reductions. CONCLUSION: Multiple measures helped lower expenditure/ DDD, providing hope to countries with small populations. Additional measures are planned to further improve prescribing efficiency in the Republic of Srpska.
BACKGROUND: Multiple reforms have been introduced in the Republic of Srpska to enhance prescribing efficiency. OBJECTIVES: First, assess their influence on utilization and expenditure on proton-pump inhibitors, statins and renin-angiotensin inhibitor drugs. Second, assess whether the Republic can obtain low prices for generics. Third, suggest additional reforms that could be introduced. METHODS: Observational study of all ambulatory care patients between 2003 and 2010. Defined daily doses (DDDs) and DDDs per 1000 inhabitants per day used for measuring changes in utilization. Reimbursed expenditure used as health insurance perspective. RESULTS: Increasing utilization in all three classes. Utilization of angiotensin-receptor blockers principally limited by prescribing restrictions. Reimbursed expenditure/DDD in all three classes decreased by up to 82% in 2010 versus 2004, appreciably improving prescribing efficiency for the statins. Increased utilization of esomeprazole at higher reimbursed expenditure/DDD, and similarly angiotensin-converting enzyme-inhibitor combinations at higher expenditure versus single drugs, limited the ability to fully capitalise on these reductions. CONCLUSION: Multiple measures helped lower expenditure/ DDD, providing hope to countries with small populations. Additional measures are planned to further improve prescribing efficiency in the Republic of Srpska.
Authors: Brian Godman; Bjorn Wettermark; Menno van Woerkom; Jessica Fraeyman; Samantha Alvarez-Madrazo; Christian Berg; Iain Bishop; Anna Bucsics; Stephen Campbell; Alexander E Finlayson; Jurij Fürst; Kristina Garuoliene; Harald Herholz; Marija Kalaba; Ott Laius; Jutta Piessnegger; Catherine Sermet; Ulrich Schwabe; Vera V Vlahović-Palčevski; Vanda Markovic-Pekovic; Luka Vončina; Kamila Malinowska; Corinne Zara; Lars L Gustafsson Journal: Front Pharmacol Date: 2014-06-17 Impact factor: 5.810
Authors: James C Moon; Brian Godman; Max Petzold; Samantha Alvarez-Madrazo; Kathleen Bennett; Iain Bishop; Anna Bucsics; Ulrik Hesse; Andrew Martin; Steven Simoens; Corinne Zara; Rickard E Malmström Journal: Front Pharmacol Date: 2014-10-08 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