Ambulatory treatment of arterial hypertension: The expenditures charged off health insurance funds

Abstract

Expenditures for the treatment of hypertension and its complication differ among countries and represent huge burden for National Health Funds. The aim of this study is to determine the expenditures charged off obligated health insurance funds and also the prescribing practice of ambulatory treatment of arterial hypertension (AH) in 2006. Retrospective study included 2764 patients with diagnosis AH (I10-I15) and its complications (I20, I21, I25, I50 and I69). Therapy was analyzed according to complexity (number of diagnosis) and frequency of the prescribed medications. The annual expenditures for antihypertensive drugs were compared with total expenditures from National Health Insurance Fund (NHIF) for prescribed medicines. Uncomplicated AH was diagnosed in 1856 (67,15%), while complicated AH in 908 (32,85%) patients. ACE inhibitors were the most frequently prescribed medications (37,01%). NHIF participated with 86,47% in total expenditures for the treatment of AH. More then 55% of total NHIF expenditures for prescribed medications gone on therapy AH. High percentage of patients with complications show late beginning of therapy, irregular visits to general practitioner and inadequate compliance. The expenditures of ambulatory treatment of AH demonstrate that NHIF participate in therapy expenditures with great amount, making the therapy available to patients.

Troškovi terapije arterijske hipertenzije (AH) i njenih komplikacija razlikuju se od zemlje do zemlje i istovremeno predstavljaju veliko opterećenje za nacionalne zdravstvene fondove. Cilj ove studije je određivanje troška farmakoterapije AH u ambulantnim uslovima za 2006.godinu na teret sredstava obaveznog zdravstvenog osiguranja, kao i propisivačke prakse. Retrospektivna studija je uključila 2764 pacijenta sa dijagnozom AH (I10-I15) i njenim komplikacijama (I20, I21, I25, I50 i I69). Terapija je analizirana po kompleksnosti (br. dijagnoza) i učestalosti propisivanja farmakoloških grupa lekova. Godišnji troškovi terapije AH su poređeni sa ukupnim izdvajanjem Republičkog zavoda za zdravstveno osiguranje (RZZO) za lekove na recept. Pacijenata bez komplikacija AH bilo je 1856 (67,15%), a pacijenata sa komplikacijama 908 (32,85%). Najpropisivanija grupa AH lekova su ACE inhibitori (37,01%). RZZO učestvuje sa 86,47% u ukupnim troškovima terapije AH. Preko 55% svih sredstava RZZO utrošeno je na medikamentoznu terapiju obolelih od AH. Visok procenat obolelih od komplikacija AH u Srbiji ukazuje na kasno započinjanje lečenja AH, neredovno javljanje lekaru, kao i nedovoljnu komplijansu. Analizom troška terapije pacijenata sa AH u ambulantnim uslovima pokazano je da RZZO u trošku terapije učestvuje sa visokim procentom, čineći terapiju AH dostupnu pacijentima.