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Trends in national pharmaceutical expenditure on diabetes in Ireland 2011-2015: a repeated cross-sectional study.

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

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Trends in national pharmaceutical expenditure on diabetes in Ireland 2011-2015: a repeated cross-sectional study.

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]

PMID: 33039996

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Trends in national pharmaceutical expenditure on diabetes in Ireland 2011-2015: a repeated cross-sectional study.

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Trends in national pharmaceutical expenditure on diabetes in Ireland 2011-2015: a repeated cross-sectional study.

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