Objective:
To compare the prescribing practice and pharmacotherapy outpatient
cost of hypertension and its common complications between two
neighboring countries, Bulgaria and Serbia. The study questions
focus on consistency of the prescribing practice with the treatment
guidelines; comparability of the treatment patterns among both
countries, and burden of hypertension cost to the population and
third party payer in the countries under consideration.
Methods: Retrospective study, one year time horizon is for outpatient
therapy.
Results: Patients with arterial hypertension in Bulgaria are most
often on monotherapy (61% vs 6% in Serbia), as well as those with
complications (66% vs 0% Serbia). In both countries the first
choice of therapy are the ACE inhibitors (37.01% in Serbia and
41% in Bulgaria) and then follows the calcium antagonists, beta-blockers,
and diuretics. The weighed monthly cost of hypertension and complicated
hypertension is almost doubled in Serbia (12.56 vs 8.23 EUR for
hypertension, and 13.39 vs 8.23 EUR) and prevailing part is reimbursed
(88% vs 44% in Bulgaria).
Conclusion: Our study confirms that hypertension and its complications
therapy consumes a huge amount of financial resources. In both
countries under consideration the therapy is corresponding with
the European treatment guidelines. The international cost comparisons
are possible but they depend on many external factors as the regulatory
measures, prescribing habits and reimbursement policy and should
be analysed within this framework.
