Arch Hellen Med, 35(6), November-December 2018, 791-801
Analysis of out-of-hospital pharmaceutical prescribing and Health Insurance System expenditure
Ε. Dalakaki,1 S. Karakolias,1 C. Kastanioti,1,2 N. Polyzos1
OBJECTIVE To analyze the prescribing patterns of physicians based on the specialty and geographical region, and the mix (brand, generics) of pharmaceutical products for the years 2013–2015.
METHOD The study was based on the out-patient e-prescribing data for all the 2013, 2014 and 2015 Greek National Health Service prescriptions. Analysis was made according to the following elements: The geographical region, the prescribing physician's specialty, and the therapeutic class and the patent status of the drug.
RESULTS Total drug prescription was approximately 180 million packages for 2015 compared with 199 million for 2013. There was a decrease in the number of prescriptions each year of study (by 6.8% in 2014 and 2.6% in 2015), with a corresponding reduction in total state pharmaceutical expenditure of 11.8% and 3.2%, respectively. On the other hand, the patients' co-payment increased by 8.1% between 2013 and 2014, while in 2015 it returned to the 2013 level. As a result, the pharmaceutical reimbursement of social security fund (EOPYY) decreased significantly in 2014 (by approximately € 1.67 million) and in 2015 with a 21% reduction compared with 2013. At the geographical region level the per capita drug expenditure accounted for between € 228.8 and € 277 per resident in 2015, much higher than the average expenditure in 2014 (from € 197.2 to € 244.6 per resident). Comparing the e-prescription values by specialty it was found that 54% of the total out-patient pharmaceutical expenditure was prescribed by internists and general practitioners (GPs). When assessing how often physicians prescribed a generic medicine rather than a specific brand in their current practice, it was found that 22% of the total expenditure, in terms of volume, fell under "on patent drugs" while the share of generic and off-patented market was 78% in 2015. An increase was demonstrated in the average co-payment rate from 23% in 2013 to 26.8% in 2014.
CONCLUSIONS In summary, in Greece the e-prescription information system provides sufficient (in terms of volume and value) data for effective monitoring and evaluation of pharmaceutical consumption.
Key words: EOPYY (Pharmaceutical reimbursement of social security fund), e-prescription, Generics, Pharmaceutical expenditure.