TRENDS IN PRESCRIBING AND UTILIZATION OF ANTIDIABETIC DRUGS IN PRIMARY HEALTH CARE IN ALBANIA DURING 2004-2014

Aim: To describe trends in out-of-hospital utilization and prescribing of antidiabetic drugs in Albania using the Anatomic Therapeutic Chemical Classification/ Defined Daily Dose -(ATC/DDD methodology). Methods: The study was retrospective and we analyzed the prescription and consumption of these drugs classes in the primary health care in Albania during 2004-2014. All data were collected from Health Insurance Institute (HII) and analysed reflecting the ambulatory and outpatient use for the period 2004-2014. The data about the consumption of drugs were expressed as a number of Defined Daily Dose (DDDs) /1000 inhabitants/day. For all the period under study 2004-2014, there were collected and analysed the data of import and domestic production of drugs, which altogether represent the real consumption of drugs in the country. These data were subsequently included in a comparative analysis with the utilization data according to the HII. Results: The consumption of all insulins were 1.80-5.64 DDD/1000 inhabitants/day (respectively 2004-2014). The consumption of insulin fast-acting were 0.47-2.59 DDD/1000 inhabitants/day (respectively 2004-2014). The consumption of insulin intermediate-acting were 0.38-0.70 DDD/1000 inhabitants/day (respectively 2004-2014). The consumption of insulin intermediate-acting combined with insulin fast-acting were 0.95-1.18 DDD/1000 inhabitants/day. The consumption of insulin long-acting were 0.00-1.41 DDD/1000 inhabitants/day. The most prescribed oral antidiabetic agent was metformin 3.04-7.45 DDD/1000 inhabitants/day (respectively 2004-2014). The consumption of glibenclamide was 3.55-5.76 DDD/1000 inhabitants/day (respectively 2004-2007). Conclusions: There is an increase in Antidiabetic drugs use from HII covering, while there is a significant increase in their use from out-of-pocket expenditure during 2004-2014. There can be noted a visible discrepancy between the consumption of antidiabetic drugs and the diabetes mellitus morbidity, which indicates that only a part of patients with diabetes mellitus do benefit from the reimbursement scheme.