PDB15 Use of Hypoglicemic Drugs in Serbia: Pharmacotherapeutic Versus Pharmacoeconomic Aspects

Abstract

To analyse the use of hypoglycemic drugs in Serbia from pharmacotherapeutic and pharmacoeconomic point. To see the influence of pharmacotherapeutic guidelines and cost on use of hipoglicemic drugs when compared with the countries with developed pharmacotherapy. Use of hypoglicemic drugs in Serbia was obtained from National Agency for drugs in Serbia (ALIMS). The costs of hypoglycemic drugs was obtained from Serbian reimbursment company. The use of drugs was expressed in DDD/1000 inh/day, and compared to the price of drugs in the cathegory. The total use of hypoglycemic drugs in Serbia (56 DDD/1000inh/day) was similar to the use of drugs in this cathegory in another countries. Use of insulins was lower in Serbia, probably because slightly different pharmacotherapeutic approach to DM Typ II in Serbia. The structure of oral hypoglycemics was similar in Serbia and in comparator countries (Norway, Finland). While metformin was the most often used hypoglicemic drug in countries with developed pharmacotherapy, in Serbia the most often used drugs were sulfonylurea drugs, with glibenclamide and gliclaside being in the first place. Gliclaside, being on the second place in Serbia, is the most expensive hypoglicemic drug (price per DDD 12.15 Serbian dinars). If gliclaside would be changed with another, less expensive drug, the national reimbursment company would spare significant amount of money. Glimepiride, the most often used and the cheaper sulfonylurea derivative in countries with developed phrmacotherapy, was on the third place in Serbia. The total use of hypoglycemics in Serbia is comparable to countries with developed pharmacotherapy, indicating the satisfiing level of the treatment of diabetes mellitus. However, the structure og hypoglycemics used is suboptimal from pharmacotherapeutic and from pharmacoeconomic point of wiev. Significant improvement are needed, which would improve pharmacotherapy and pharmacoeconomic aspect of use of this drugs.