Trends in national pharmaceutical expenditure on diabetes in Ireland 2011-2015: a repeated cross-sectional study.

Autor:	O Neill KN; School of Public Health, University College Cork, Cork, Ireland kate.oneill@ucc.ie., Bennett KE; Division of Population Health Sciences, Royal College of Surgeons in Ireland, Dublin, Ireland., Mc Hugh SM; School of Public Health, University College Cork, Cork, Ireland., Fitzgerald AP; School of Public Health, University College Cork, Cork, Ireland.; Department of Statistics, University College Cork, Cork, Ireland., Kearney PM; School of Public Health, University College Cork, Cork, Ireland.
Jazyk:	angličtina
Zdroj:	BMJ open [BMJ Open] 2020 Oct 10; Vol. 10 (10), pp. e037382. Date of Electronic Publication: 2020 Oct 10.
DOI:	10.1136/bmjopen-2020-037382
Abstrakt:	Objectives: To explore trends in pharmaceutical expenditure on diabetes between 2011 and 2015, describing trends in expenditure on blood glucose-lowering medications and estimating the effect of cost-containment measures implemented during this time. Design: Repeated cross-sectional study of national pharmacy claims data in Ireland. Participants: Patients' dispensed items used in the treatment or management of diabetes. Primary and Secondary Outcomes: Total expenditure associated with diabetes was calculated by extracting data on all diabetes-related items dispensed to eligible patients. Costs were categorised into two groups. Diabetes-specific items include items used directly in diabetes treatment (WHO-Anatomical Therapeutic Chemical (ATC): A10, V07, V04) and diabetes-related include all other condition-related items (WHO-ATC: B01, C, H04, N03, N06). The impacts of two specific cost-containment measures, co-payments and reference pricing, were assessed using segmented linear regression analyses of interrupted time-series. Results: Total expenditure varied over the study period, peaking at €216 994 441 in 2012. Expenditure on diabetes-specific items increased steadily by 18% reaching €153 621 477 in 2015, with blood glucose-lowering medications accounting for 73% of this increase. During the same period, expenditure on diabetes-related items decreased by 32% to €50 835 856. The introduction of reference pricing for atorvastatin in November 2013 resulted in immediate costs savings of €2.4 million per yearly quarter (level-change p<0.001). Conclusions: The increasing expenditure on blood glucose-lowering medications negates the effect of recent cost-containment measures, presenting a significant challenge for the provision of diabetes care. Innovative policies are required to ensure high-quality diabetes care can be provided at an equitable, affordable and sustainable rate. Competing Interests: Competing interests: None declared. (© Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu