@conference{
author = "Ivanova, A. D. and Lakić, Dragana and Andrić, Vesna and Petrova, Guenka",
year = "2008",
abstract = "OBJECTIVES: Pharmacotherapy costs represents huge burden
for health institutions. The aim of the study is to compare pre-
scribing practice and cost of outpatient hypertension pharmaco-
therapy between Bulgaria and Serbia. METHODS: A one year
retrospective study from the point of view of the health system
was performed, based on the collected reimbursed prescriptions
with diagnosis AH (I10–I11) and for its complications—heart
failure (I.50); sequelae of cerebrovascular disease (I.69); angina
pectoris (I.20). Therapy was analysed according to the complex-
ity (mono-, di-, etc.), frequency of prescribed medicines, reim-
bursed drug prices, and patient co-payment. To calculate the cost
of the outpatient therapy was build a decision tree model match-
ing the frequency of particular brand name prescribing, their
prices, and complexity of therapy. RESULTS: The relative share
of uncomplicated hypertension is comparable (67% in Serbia
and 65% in Bulgaria). The ACE inhibitors are the first choice for
hypertension treatment in both countries. Hypertension mono-
therapy differs significantly (47% in Bulgaria and 6% in Serbia),
while di-therapy is comparable (35% and 30%). Among the
complications prevails prescriptions for angine pectoris (70% in
Serbia and 42% in Bulgaria) and heart failure (7% and 26%).
The complications are usually treated with more than one medi-
cine in Serbia while the monotherapy in Bulgaria is 66%. By
including the cost and prevalence of mono-, di- etc therapy in the
“decision tree” model we receive that the waged monthly cost of
outpatient pharmacotherapy per patient with uncomplicated
hypertension account for €12.56 in Serbia and €6.90 in Bulgaria.
The total monthly cost of hypertension considering the chance of
having complications is €13.39 in Serbia and €8.23 in Bulgaria.
Patient co-payment in Bulgaria is higher. CONCLUSIONS: Inter-
national cost comparisons are possible but depend on many
external factors as regulatory and price control measures, pre-
scribing habits, reimbursement policy.",
publisher = "Elsevier Science Inc",
journal = "Value in Health",
title = "Cost of outpatient hypertension pharmacotherapy-comparative study between Bulgaria and Serbia",
volume = "11",
number = "6",
pages = "A391",
doi = "10.1016/S1098-3015(10)66331-0"
}