Pharmacoepidemiological Assay and Cost-Minimization Analysis of Oral Antidiabetic Medications and Insulins in Lithuania

Abstract

Objectives: To conduct pharmacoepidemiological research and cost-minimization analysis of oral antidiabetic medications and insulins in Lithuania. Methods: Medications were grouped according to the ATC classifi cation system. Our research results were reported in DDDs per 1000 inhabitants per day (DDD/TID). Calculations of drug prices and total expenditures on antidiabetic medications were made by using data from National Patient Funds Price List in 2006–2009 years. Reference pricing methodology was used to accomplish our cost-minimization analysis. Results: Total consumption of hypoglycaemic agents increased by 33% from 21.54 DDD/TID in 2006 to 28.72 DDD/TID in 2009. Utilization of insulin increased by 30% reaching the value 9.43 DDD/TID in 2009 and oral antidiabetic medications increased by 35%—19.29 DDD/TID in 2009. Total expenditures on hypoglycaemic agents increased by 23% from LTL 57.138 mlln in 2006 to LTL 70.531 mlln in 2009 (1EUR = 3.4528LTL). Single DDD prices ranged from 0.70 LTL/DDD to 5.01 LTL/DDD of oral antidiabetics, and from 5.67 LTL/DDD to 2.97 LTL/DDD for insulins. With reference to meta-analysis and NICE recommendations, considering the similar effi cacy and safety within drug classes, cost-minimization analysis using the reference-based pricing could be implemented and total expenditures could be decreased by 27% (saving LTL 19 mlln. yearly). Conclusions: Our fi ndings suggest that implementation of reference-based pricing could be a strong fi scal measure helping to rationalize increasing direct health care expenditures by 27%.