Impact of pharmaceutical policy interventions on utilization of antipsychotic medicines in Finland and Portugal in times of economic recession: interrupted time series analyses

International Journal for Equity in Health

Anita K Wagner¹  Dennis Ross-Degnan¹  Silvia Valkova²  Sabine Vogler³  Aukje K Mantel-Teeuwisse⁴  Fang Zhang¹  Christine Leopold⁴ 

[1] Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, USA;IMS Institute for Healthcare Informatics, Pennsylvania, USA;Department of Health Economics, Gesundheit Österreich GmbH/Austrian Health Institute/WHO Collaborating Centre for Pricing and Reimbursement Policies, Vienna, Austria;Utrecht Institute for Pharmaceutical Sciences, WHO Collaborating Centre for Pharmaceutical Policy and Regulation, Utrecht, Netherlands

关键词: Utilization of medicines;    Interrupted time series;    Antipsychotic medicines;    Portugal;    Finland;   

Others  :  1146528
DOI  :  10.1186/1475-9276-13-53

 received in 2013-11-10, accepted in 2014-04-18,  发布年份 2014

【 摘 要 】

Objectives

To analyze the impacts of pharmaceutical sector policies implemented to contain country spending during the economic recession – a reference price system in Finland and a mix of policies including changes in reimbursement rates, a generic promotion campaign and discounts granted to the public payer in Portugal – on utilization of, as a proxy for access to, antipsychotic medicines.

Methodology

We obtained monthly IMS Health sales data in standard units of antipsychotic medicines in Portugal and Finland for the period January 2007 to December 2011. We used an interrupted time series design to estimate changes in overall use and generic market shares by comparing pre-policy and post-policy levels and trends.

Results

Both countries’ policy approaches were associated with slight, likely unintended, decreases in overall use of antipsychotic medicines and with increases in generic market shares of major antipsychotic products. In Finland, quetiapine and risperidone generic market shares increased substantially (estimates one year post-policy compared to before, quetiapine: 6.80% [3.92%, 9.68%]; risperidone: 11.13% [6.79%, 15.48%]. The policy interventions in Portugal resulted in a substantially increased generic market share for amisulpride (estimate one year post-policy compared to before: 22.95% [21.01%, 24.90%]; generic risperidone already dominated the market prior to the policy interventions.

Conclusions

Different policy approaches to contain pharmaceutical expenditures in times of the economic recession in Finland and Portugal had intended – increased use of generics – and likely unintended – slightly decreased overall sales, possibly consistent with decreased access to needed medicines – impacts. These findings highlight the importance of monitoring and evaluating the effects of pharmaceutical policy interventions on use of medicines and health outcomes.

【 授权许可】

   
2014 Leopold et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

Figure 2.

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