(P-418) Optimization of Prescription Patterns: A Response to Control High Pharmaceutical Expenditure

Background: In Portugal (PT), expenditure on medicines and other pharmaceutical products on an outpatient basis represents the third largest share of health costs.

Objectives: To perform a cross-country comparison of consumption patterns in ambulatory high expenditure therapeutic groups between PT and six European countries and simulate potential cost-saving scenarios through the adoption of the different utilization patterns of studied countries.

Methods: Cross-country comparison of 2019 drug consumption patterns data from: PT, Denmark, England, Finland, the Netherlands, Norway and Spain. Analysis comprised the ATC groups: Oral Glucose Lowering Drugs (OGLD) - A10B, Insulins - A10A, Lipid Lowering Drugs (LLD) - C10, Antihypertensive Drugs (AHD) - C03, C07, C08 and C09, and Oral Anticoagulants (OA) - B01A. National data was taken by hmR Pharmacy Sales Information System, a national database with representative ambulatory sales data. Data regarding international consumption was retrieved from open-access databases from regulatory health authorities or health insurance organizations in each country. Cost-saving analysis were performed using the PT average annual cost per defined daily dose (DDD). The potential reduction in PT expenditure was estimated simulating other European countries consumption pattern scenarios (% DDD).

Results: PT has the lowest consumption rate of metformin, 31.1% (first-line uptake) and the highest consumption rate of OGLD-fixed-dose combinations (30.1%). PT consumption of LLD-fixed-dose combinations was the highest among studied countries (8.5% vs less than 3%). Overall cost-saving analysis showed that PT would have saved between 305 M€ and 53 M€ if it had the same prescribing pattern than the Netherlands and Norway, respectively, for the combined consumption of the 5 therapeutic subgroups analyzed.

Conclusions: Although Portugal has the lowest gross domestic product per capita among the studied countries, is the country with the highest uptake of newer and costly drugs. It is urgent to enhance rational use of medicines in order to reduce pharmaceutical expenditure without impact on the quality of healthcare