Trends in national pharmaceutical expenditure on diabetes in Ireland 2011-2015: a repeated cross-sectional study
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
Health Research Board Leader Award (RL/2013/7)
Health Research Board Leader Award (RL/15/1579)
CommentsThe original article is available at https://bmjopen.bmj.com/
Published CitationO Neill KN, Bennett KE, Mc Hugh SM, Fitzgerald AP, Kearney PM. Trends in national pharmaceutical expenditure on diabetes in Ireland 2011-2015: a repeated cross-sectional study. BMJ Open. 2020;10(10):e037382.
Publication Date10 October 2020
- Data Science Centre
PublisherBMJ Publishing Group Ltd
- Published Version (Version of Record)