Ambulatory utilization of anti-parkinsonian drugs in Albania during 2004-2014

To analyse utilization of Anti-Parkinsonian drugs in Albania using the Anatomic Therapeutic Chemical Classification-Defined Daily Dose (ATC/DDD methodology), in comparison to the Parkinson's morbidity for the period 2004-2014. Methods: The data were assembled from Health Insurance Institute (HII) and analysed for the period 2004-2014. The consumption of drugs was expressed as a number of Defined Daily Dose (DDDs) /1000 inhabitants/day. In addition, for all the period under study 2004-2014, there also analysed the data of import and domestic production of drugs, which represent the real consumption of drugs in the country. These data were subsequently involved in a comparative analysis with the utilization data according to the HII. Results: The values of consumption of Anti-Parkinsonian drugs were .1.45-1.53 DDD/1000 inhabitants/day respectively in 2004-2014. The combination of levodopa with benserazide has the highest value of prescription 0.47-0.75 DDD/1000 inhabitants/day 2004-2014. On the other hand the consumption of levodopa+carbidopa is 0.04-0.29 DDD/1000 inhabitants/day 2004-2014. This notable difference probably reflects the pressure and the marketing incentives used by the pharmaceutical companies. Furthermore, it turns out that the consumption of levodopa+benserazide based on HII data is superior to the consumption of this formulation based on Import data, which cannot be true. This finding probably reflects fictive prescriptions and the entry of drugs by contraband. It results also that a consistent part of Parkinson patients does not benefit from the reimbursement scheme (out-of-pocket expenditure). Conclusions: There is only a small increase in the national consumption of Anti-Parkinsonian drugs during these years, but the values still remain very low in comparison with other countries. It results that the consumption of anti-parkinsonian drugs flows out of the scheme at the level of around 30%.