Utilization and price trends in some reimbursed cardiovascular medicines

Abstract

Cardiovascular (CV) medicines are of particular interest as cardiovascular diseases are the leading cause of mortality and morbidity worldwide. CV medicines are also among the most commonly prescribed reimbursed pharmaceuticals. They are targeted by the pharmaceutical manufacturers in terms of active development and marketing, and are also of interest to the health insurance authorities in connection with cost-containment measures. The aim of this study was to analyze the changes in utilization, measured in DDD/TID and prices of three groups of reimbursed cardiovascular medicines in Bulgaria (ACE inhibitors, HMG-CoA reductase inhibitors and inhibitors of AT-receptors) during 2005-2007 in respect to the introduction of generics or therapeutic competitors in the reimbursement list. Prescribing data for the observed medicines was derived from the official database of the National Health Insurance Fund (NHIF). Seven INN ACE inhibitors, 6 HMG-CoA reductase inhibitors (statins) and 5 inhibitors of AT-receptors (sartans), authorized for sale on the Bulgarian market and reimbursed by the NHIF were included. All therapeutic groups performed an increase in the total utilization measured in DDD/TID for the observed period. The total utilization of ACE inhibitors increased from 73.76 to 95.55, and to 137.7 DDD/TID. For the group of statins the total utilization increased from 2.57 to 3.96, and to 5.26 DDD/TID, while in the groups ofsartanes it increased from 1.89 to 3.81 and to 5.73. In general our study confirmed the similar analyses of the generics 'penetration influence on the prices and utilization of medicines with the same INN and within the therapeutic group. It also added more evidence about the important influence of the new therapeutic molecules, especially on the relatively new pharmacology groups such as sartans. We did observe a dynamic utilization of CV medicines that corresponds to the world tendencies.