Analysis of drug utilization and rational drug use in treatment of essential arterial hypertension in Bulgaria

Analysis of drug utilization and rational drug use in treatment of essential arterial hypertension in Bulgaria

Oral presentation

Nikolay Nachev1, Stefka Stoyanova1, Antoan Rangelov1, Emanuil Yordanov1, *Emil Hristov1, Iva Parvova2, Valentina Petkova3
1Faculty of Chemistry and Pharmacy, Sofia University “St. Kliment Ohridski”, Sofia
2Clinic of Rheumatology, Department of Rheumatology, Medical University - Sofia, Bulgaria
3Faculty of Pharmacy, Medical University - Sofia, Bulgaria

Aim: To analyze drug utilization and rational drug use in treatment of essential arterial hypertension in Bulgaria by using quantitative and qualitative parameters at national level. To assess generic penetration as a part of rational drug use. Materials and methods: Design – retrospective study of publicly accessible data from registries of National health insurance fund for the period January – December 2017. The analyses are in accordance with ATC/DDD methodology of WHO. The data was processed via descriptive statistical methods. Results: The analyzed population includes 185 671 patients with essential arterial hypertension– 13.33% of all hypertensive patients. The expenses for 2017 are 9 796 940.12 BGN (Bulgarian leva; 1 Euro=1.95585 BGN). The expense per patient per year is 52.76 BGN, monthly expense is 4.40 BGN, daily expense is 0.14 BGN. The sum of 9 796 940.12 BGN is divided into two groups – expenses for monoproducts 65.88% and expenses for combined products 34.12%. Blockbusters are INNs Lercanidipine and Nebivolol. The total expenses for uncomplicated essential arterial hypertension are 1.22% of the total expenses. With this resource 1.6 DDD/per patient/per day is provided. Discussion: In Bulgarian therapeutic practice the most prescribed products are beta-blockers Nebivolol and Bisoprolol, calcium antagonist Lercanidipine and centrally acting antiadrenergic agents Rilmenidine and Moxonidine. Sartanes are represented mainly by Valsartan. In all section analyses the considerable use of Lercanidipine is evident. Reference (original) medicinal products are mainly prescribed, while the marketshareof generic products, both in terms of costs and DDD, is significantly lower.
Keywords: Arterial hypertension, drug utilization, defined daily dose