PDB75 DIABETES MEDICATION MANAGEMENT IN SLOVENIA FROM THE PERSPECTIVE OF PRESCRIBERS AND REPRESENTATIVES OF REGULATORY BODIES

Abstract

The aim of the study was to get an insight into diabetes medication management from the perspective of prescribers and representatives of regulatory bodies in Slovenia. Focus panel was performed with 5 experts: two diabetologists, general practitioner and representatives of Health Insurance Institute of Slovenia and Agency for Medicinal Products and Medical Devices in January 2019. The discussion was audio-recorded and converted into a verbatim transcript. Two independent coders coded the transcript and derived main themes and subthemes of the discussion using NVivo 11. The main themes derived from the discussion were: general properties of antidiabetic medicines and new evidence on cardiovascular benefit of SGLT-2 inhibitors and GLP-1 agonists, medicine reimbursement and patient access to antidiabetic medicines in Slovenia, the role of healthcare professionals in diabetes care, diabetes pharmacotherapy and the quality of care in patients with diabetes. The experts agreed that patient access to antidiabetic medicines in Slovenia is comparable with other European countries. In their opinion the main issues in diabetes management in Slovenia are unequal access to diabetologists across Slovenian regions, prescribing restrictions that limit patient access to newer antidiabetic medications, untapped potential of primary level of healthcare and lack of reliable data on long-term outcomes of diabetes, especially on the incidence of lower extremity amputations. Suggestions for improvement of diabetes management in Slovenia were the need for change in prescribing restrictions in accordance with new evidence on cardiovascular benefit, development of national registry and quality indicators and optimization of activities at the primary level of healthcare. Overall, Slovenia provides satisfying patient access to antidiabetic medicines and healthcare for patients with diabetes; however, improvement in terms of prescribing restrictions, access to prescribers and monitoring of patient care by national registry is anticipated.