Consumption of Antibacterials for Systemic Use in Slovakia: A National Study and the Quality Indicators for Outpatient Antibiotic Use.

Tomas Tesar,Lucia Masarykova,Martin Wawruch,Monika Cicova,Slavka Porubcova,Lubica Lehocka

doi:10.3390/antibiotics10101180

Tomas Tesar, Lucia Masarykova + Show 4 more

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https://doi.org/10.3390/antibiotics10101180

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Journal: Antibiotics	Publication Date: Sep 28, 2021
Citations: 1	License type: CC BY 4.0

Affiliation: Comenius University Bratislava

Abstract

This paper aims to analyse the consumption of antibiotics in the Slovak health care system from 2011 to 2020. The data source on the consumption of antibiotics is sales data from SUKL and NCZI. The study employed the ATC/DDD Index and focused on the consumption of antibiotics in the primary care sector. Total antibiotic consumption decreased from 19.21 DID in 2011 to 13.16 DID in 2020. Consumption of beta-lactamase-sensitive penicillins, expressed as a percentage of the total consumption of antibiotics, decreased from 8.4% in 2011 to 4.2% in 2020. Consumption of the combination of penicillins, including beta-lactamase inhibitor, expressed as a percentage of the total consumption of antibiotics, increased from 16.2% in 2011 to 17.9% in 2020. Consumption of third- and fourth-generation cephalosporins, expressed as the percentage of the total consumption of antibiotics, increased from 2.0% in 2011 to 4.6% in 2020. Consumption of fluoroquinolones, expressed as the percentage of the total consumption of antibiotics, decreased from 10.7% in 2011 to 8.6% in 2020. Overall, antibiotic consumption significantly changed in Slovakia from 2011 to 2020. The ratio of the consumption of broad-spectrum to the consumption of narrow-spectrum penicillins, cephalosporins and macrolides decreased from 14.98 in 2011 to 13.38 in 2020.

Highlights

The basic concept of the Slovak health care system includes mandatory public insurance and a general benefits package for citizens [1].There is a pluralistic system of health insurance companies, with three health insurance companies operating: the state-owned Všeobecná zdravotná poist’ovna (General Health Insurance Company) and the private companies Dôvera (Trust) and Union, which covered 56.25%, 31.98% and 11.76% of the Slovak population, respectively, in 2021.Act No 363/2011 sets the regulations for pharmacoeconomic evaluation and external price referencing in the reimbursement of antibiotics for the primary care sector from health insurance funds [2].The “maximum retail price” of antibacterials for systemic use may not rise above the average of the three lowest prices of the same antibiotic across the European Union
Antibiotic consumption significantly changed in Slovakia from 2011 to 2020
In Slovakia, a 47.17% drop can be seen in the consumption of beta-lactam and penicillin antibacterials from 2011 to 2020

Summary

Introduction

The basic concept of the Slovak health care system includes mandatory public insurance and a general benefits package for citizens [1].There is a pluralistic system of health insurance companies, with three health insurance companies operating: the state-owned Všeobecná zdravotná poist’ovna (General Health Insurance Company) and the private companies Dôvera (Trust) and Union, which covered 56.25%, 31.98% and 11.76% of the Slovak population, respectively, in 2021.Act No 363/2011 sets the regulations for pharmacoeconomic evaluation and external price referencing in the reimbursement of antibiotics for the primary care sector from health insurance funds [2].The “maximum retail price” of antibacterials for systemic use may not rise above the average of the three lowest prices of the same antibiotic across the European Union. The basic concept of the Slovak health care system includes mandatory public insurance and a general benefits package for citizens [1]. Act No 363/2011 sets the regulations for pharmacoeconomic evaluation and external price referencing in the reimbursement of antibiotics for the primary care sector from health insurance funds [2]. The “maximum retail price” of antibacterials for systemic use may not rise above the average of the three lowest prices of the same antibiotic across the European Union. With the aim of facilitating price erosion after the patent expiry of original antibiotics, the 2018 legislation came out with mandatory discounts for generic antibiotics. The first off-patent antibiotic entering the Slovak market must achieve a 45% initial price reduction compared to the original antibiotic, the second off-patent antibiotic must achieve an additional 10% price reduction compared to the first and the third off-patent antibiotic must achieve an additional 5% price reduction compared to the second [3]

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