Examination of the Consumption of Hypolipidemic Agents by Means of the Databases of
Health Insurance Companies
VLČEK J., MACEK K. 1 , MÜLLEROVÁ H., ŠTIKA L., KOČOVÁ M., HRABĚTOVÁ H., VITÁSEK Z. 2
Katedra sociální a klinické farmacie Farmaceutické fakulty Univerzity Karlovy, Hradec Králové 1 I. interní klinika FN, Hradec Králové 2 Zaměstnanecká pojišťovna Škoda, Mladá Boleslav |
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Summary:
Databases of health insurance companies can provide information on the motion of a drug in the
society. The present paper examines several databases of health insurance companies and analyzes
the development of the consumption of hypolipidemic agents in 1994 through 1998. So-called
evaluation databases making it impossible to identify a particular patient and the prescribing
physician were prepared for the evaluation. They were obtained from the VZP central health
insurance office, VZP district health insurance offices in Hradec Králové and Kladno, and the
Zaměstnanecká pojišťovna Škoda (Employees Health Insurance Company Škoda). It was not
necessary to blind the data in the first cohort, in the second one it was carried out by shortening the
identification numbers, and in others by introducing artificial identification codes. The consumption
was expressed in DDD and in the relative representation in the group. The consumption of the
principal groups of hypolipidemic agents (fibrates, statins, sequestrants of bile acids, and derivatives
of nicotinic acid) and the individual medicinal substances was evaluated. Relative values of
consumption were obtained by calculation to the magnitude of the denominator – the number of the
insured, or the number of patients to whom a hypolipidemic agent was prescribed. The consumption
was on the increase in all three databases, in four years increasing from approx. 0.4–4DDD/1000 of
the insured/day to 16–24DDD/1000 of the insured/day. At the beginning, the main share in the
consumption of hypolipidemic agents was represented by fibrates, approx. 90 %, but in four years
this share decreased to only 60 %, whereas in the period under study the share of statins increased
up to 30 %. Databases of health insurance companies do not significantly differ in the consumption
of hypolipidemic agents, which may give evidence of their validity. In the course of the study, an
increase in the consumption of hypolipidemic agents, primarily statins, was found. The shift in the
consumption of statins corresponds with the available information about the evidence of their
therapeutic effectiveness. The average consumption per one patient does not reach 1D DD, which is a signal that probably very few patients receive long-term treatment and that new patients emerge
during the year.
Key words:
examination of drug consumption – pharmacoepidemiology – hypolipidemic agents
– health insurance companies – databases
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