Abstract
Healthcare systems spend considerable proportions of their budgets on pharmaceutical treatment of hypertension, hyperlipidemia, and diabetes mellitus. From data on almost all residents of Austria, a country with mandatory health insurance and universal health coverage, we estimated potential cost savings by substituting prescribed medicines with the cheapest medicines that were of the same chemical substance and strength, and available during the same time. Data from 8.3million persons (98.5% of the total Austrian insured population) from 2009-2012 were analyzed. Real prescription costs for antihypertensive, lipid-lowering, and hypoglycemic medicines achievable by same-substance, same-strength drug substitution were computed for each active ingredient, and per gender and 1-year age category of patients. In 2012, health insurance providers spent <euro>231.3million, <euro>77.8million, and <euro>91.9million for antihypertensive, lipid-lowering, and diabetes medications, of which <euro>52.2million (22.6%), <euro>15.9 million (20.5%), and <euro>4.1 million (4.5%), respectively, could have been saved by same-substance drug substitution. Highest potential savings were calculated for amlodipine (<euro>8.0 million, 65.4%), simvastatin (<euro>12.2 million, 59.3%), and metformin (<euro>2.4 million, 54.6%), respectively. Higher savings for men than for women resulted from differing prescribed cumulative dosages and proportions of patients with co-payment waiver. Potential cost savings in antihypertensive and lipid-lowering drugs increased from 2009-2012. Our study highlights the cost-savings potential from arguably the most acceptable of interventions, simply switching to the cheapest available same-substance, same-strength product. In 2012, this strategy could have reduced costs for antihypertensive, lipid-lowering, and hypoglycemic treatment by up to 18.0%.
Published Version
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