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ABSTRACT: Objectives
To explore trends in pharmaceutical expenditure on diabetes between 2011 and 2015, describing trends in expenditure on blood glucose-lowering medications and estimating the effect of cost-containment measures implemented during this time.Design
Repeated cross-sectional study of national pharmacy claims data in Ireland.Participants
Patients' dispensed items used in the treatment or management of diabetes.Primary and secondary outcomes
Total expenditure associated with diabetes was calculated by extracting data on all diabetes-related items dispensed to eligible patients. Costs were categorised into two groups. Diabetes-specific items include items used directly in diabetes treatment (WHO-Anatomical Therapeutic Chemical (ATC): A10, V07, V04) and diabetes-related include all other condition-related items (WHO-ATC: B01, C, H04, N03, N06). The impacts of two specific cost-containment measures, co-payments and reference pricing, were assessed using segmented linear regression analyses of interrupted time-series.Results
Total expenditure varied over the study period, peaking at €216 994 441 in 2012. Expenditure on diabetes-specific items increased steadily by 18% reaching €153 621 477 in 2015, with blood glucose-lowering medications accounting for 73% of this increase. During the same period, expenditure on diabetes-related items decreased by 32% to €50 835 856. The introduction of reference pricing for atorvastatin in November 2013 resulted in immediate costs savings of €2.4 million per yearly quarter (level-change p<0.001).Conclusions
The increasing expenditure on blood glucose-lowering medications negates the effect of recent cost-containment measures, presenting a significant challenge for the provision of diabetes care. Innovative policies are required to ensure high-quality diabetes care can be provided at an equitable, affordable and sustainable rate.
SUBMITTER: O Neill KN
PROVIDER: S-EPMC7552837 | biostudies-literature | 2020 Oct
REPOSITORIES: biostudies-literature
O Neill Kate N KN Bennett Kathleen E KE Mc Hugh Sheena M SM Fitzgerald Anthony P AP Kearney Patricia M PM
BMJ open 20201010 10
<h4>Objectives</h4>To explore trends in pharmaceutical expenditure on diabetes between 2011 and 2015, describing trends in expenditure on blood glucose-lowering medications and estimating the effect of cost-containment measures implemented during this time.<h4>Design</h4>Repeated cross-sectional study of national pharmacy claims data in Ireland.<h4>Participants</h4>Patients' dispensed items used in the treatment or management of diabetes.<h4>Primary and secondary outcomes</h4>Total expenditure a ...[more]