Influence of prescribing restrictions and other demand-side measures to enhance renin-angiotensin prescribing efficiency in Europe: implicatiosn for other countries: implications for the future

L. Voncina, T. Strizrep, Brian Godman, M. Bennie, I. Bishop, S. Campbell, V. Vlahovic-Palcevski, L. L. Gustafsson

Research output: Contribution to journalArticle

53 Citations (Scopus)

Abstract

European countries strive to enhance prescribing efficiency. This includes renin-angiotensin drugs following the availability of generic angiotensin-converting enzyme inhibitors (ACEIs). Aims: To compare angiotensin receptor blocker utilization and expenditure patterns in Austria and Croatia following prescribing restrictions, as well as with other European countries introducing different supply- and demand-side measures. Lastly, to appraise the impact of generic losartan in Croatia on utilization of patented angiotensin receptor blockers. Method: Observational retrospective study principally between 2001 and 2007, using defined daily doses and (sic)/1000 inhabitants/year. Demand-side measures were based on the four 'E's-education, engineering, economics and enforcement. Results: Greater intensity of follow-up of prescribing restrictions in Croatia enhanced utilization of ACEIs versus Austria. There was high utilization of ACEIs in Scotland following intensive demand-side measures, similar to Austria and Croatia. Demand-side measures in Spain (Catalonia) and Sweden also appeared to moderate angiotensin receptor blockers utilization. The combination of measures helped stabilize expenditure on renin-angiotensin drugs when adjusted for population sizes despite appreciable increases in volumes. The only exception was Portugal, with less intensive measures. Conclusion: Multiple and intensive demand-side measures enhanced prescribing efficiency. The more intense follow-up of ARB prescribing restrictions in Croatia had a greater influence on subsequent utilization patterns than Austria. Both findings confirm earlier studies. Reforms also favorably enhanced the prescribing of generic losartan once available.
LanguageEnglish
Pages471-481
Number of pages11
JournalExpert Review of Pharmacoeconomics and Outcomes Research
Volume11
Issue number4
DOIs
Publication statusPublished - Aug 2011

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Croatia
Angiotensins
Renin
Austria
Angiotensin Receptor Antagonists
Angiotensin-Converting Enzyme Inhibitors
Losartan
Health Expenditures
Portugal
Scotland
Population Density
Sweden
Pharmaceutical Preparations
Spain
Observational Studies
Retrospective Studies
Economics
Education

Keywords

  • prescribing restrictions
  • united kingdom
  • demand-side reforms
  • blood-pressure
  • generics
  • initiatives
  • quality of care
  • guidelines
  • metaanalysis
  • renin-angiotensin drugs
  • simvastatin
  • implementation
  • hypertension
  • prevention
  • efficiency
  • demand-side measures
  • enhance renin-angiotensin
  • prescribing efficiency
  • europe
  • implications

Cite this

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abstract = "European countries strive to enhance prescribing efficiency. This includes renin-angiotensin drugs following the availability of generic angiotensin-converting enzyme inhibitors (ACEIs). Aims: To compare angiotensin receptor blocker utilization and expenditure patterns in Austria and Croatia following prescribing restrictions, as well as with other European countries introducing different supply- and demand-side measures. Lastly, to appraise the impact of generic losartan in Croatia on utilization of patented angiotensin receptor blockers. Method: Observational retrospective study principally between 2001 and 2007, using defined daily doses and (sic)/1000 inhabitants/year. Demand-side measures were based on the four 'E's-education, engineering, economics and enforcement. Results: Greater intensity of follow-up of prescribing restrictions in Croatia enhanced utilization of ACEIs versus Austria. There was high utilization of ACEIs in Scotland following intensive demand-side measures, similar to Austria and Croatia. Demand-side measures in Spain (Catalonia) and Sweden also appeared to moderate angiotensin receptor blockers utilization. The combination of measures helped stabilize expenditure on renin-angiotensin drugs when adjusted for population sizes despite appreciable increases in volumes. The only exception was Portugal, with less intensive measures. Conclusion: Multiple and intensive demand-side measures enhanced prescribing efficiency. The more intense follow-up of ARB prescribing restrictions in Croatia had a greater influence on subsequent utilization patterns than Austria. Both findings confirm earlier studies. Reforms also favorably enhanced the prescribing of generic losartan once available.",
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Influence of prescribing restrictions and other demand-side measures to enhance renin-angiotensin prescribing efficiency in Europe: implicatiosn for other countries : implications for the future. / Voncina, L.; Strizrep, T.; Godman, Brian; Bennie, M.; Bishop, I.; Campbell, S.; Vlahovic-Palcevski, V.; Gustafsson, L. L.

In: Expert Review of Pharmacoeconomics and Outcomes Research , Vol. 11, No. 4, 08.2011, p. 471-481.

Research output: Contribution to journalArticle

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