Trends in the cost and utilization of psychotropic medicines for major psychiatric disorders in Bulgaria from 2013 to 2017

ABSTRACT

Background and objectives: Major psychiatric disorders require prolonged use of psychotropic medications and pose a significant economic burden. The purpose of the study is to examine the trend in outpatient utilization and public expenditures for reimbursed psychotropic medicines for major psychiatric disorders in Bulgaria from 2013 to 2017.MethodsData on the cost and utilization of reimbursed psychotropic medications for schizophrenia and affective disorders are collected retrospectively from the National Health Insurance Fund (NHIF) for the period 2013–2017. The diagnostic groups included in the analysis are based on ICD codes from F20.0 to F33.4. Psychotropic drugs are systematized according to ATC code and INN. Reimbursed pharmacotherapy costs are analyzed per year and diagnosis. Drug utilization is calculated for each year in defined daily doses per 1000 inhabitants per day (DDD/1000inh/day).ResultsThe number of patients decreased from 62 500 to 54 000, or from 834 per 1 00 000 in 2013 to 733 per 1 00 000 in 2017, or with a 3.5% decrease per year. The highest number (28,674 in 2013; 26,235 in 2017) and with the highest relative share (46%–49%) were patients with paranoid schizophrenia. The reimbursed pharmacotherapy cost showed a decreasing tendency from 35 to 31 million BGN in 2013 and 2017, respectively. In total 31 INN of medicines for psychotic disorders therapy were reimbursed. The utilization of all ATC groups is decreasing from 28.04 to 17.38 DDD/1000inh/day.ConclusionsThe number of reimbursed patients with major psychiatric disorders, as well as the cost of pharmacotherapy and utilization of psychotropic medicines decreased in the period 2013–2017. (AU)