Outpatient utilization of medicines in the Republic of Srpska in 2009-2017
Abstract
Background: Monitoring and measuring of the medicines use enables to assess quality use of medicines. The aim of this study was to analyze utilization patterns of medicines use and to compare the results with other countries.
Methods: A retrospective, observational study to analyse outpatient medicines use between 2009 and 2017. Data on medicines utilization were retrieved from the national database in the Public Institute of Health. Medicines utilization was calculated and analyzed using the Anatomical Therapeutic Chemical/Defined Daily Dose (ATC/DDD) methodology. The results were expressed in defined daily doses per 1000 inhabitants per day (DDDs).
Results: Total medicines utilization increased, from 448 DDDs (2009) to 1036 DDDs (2017). Cardiovascular medicines were the most used, and their share in the total utilization increased from 36,6% (2009) to 44,4% (2017). The most used were angiotensin-converting enzyme inhibitors, plain and in combinations with diuretics, namely enalapril. The share of medicines used in diabetes in the total utilization increased from 3,9% (2009) to 5,1% (2017). Metformin and glimepiride accounted about 83% of the blood glucose lowering medicines group (A10B). Of antithrombotic medicines, the most used were platelet aggregation inhibitors excluding heparin (B01AC), namely acetylsalicylic acid whose use tripled since 2009. Non-steroid antiinflamatory and antirheumatic medicine were the most used, namely diclofenac.
Conclusion: The trend of increased medicines utilization was observed by this study. This finding is comparable with other countries. Variations between countries in the preferred medicines within a class as well as the extent of medicines use were observed. These differences were probably consistent to, but not solely attributable to, differences in local guidelines and reimbursement policies.
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