Drug consumption in Slovenia. Samo Fakin, general director of ZZZS Piperska meeting,

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1 Drug consumption in Slovenia Samo Fakin, general director of ZZZS Piperska meeting, Ljubljana, March 2012

2 Health Insurance in Slovenia basic data 1. Compulsory health insurance (CHI) in Slovenia: Regulated by Law (Law on health care and health insruance) Health Insurance Institute of Slovenia (ZZZS) - single provider of CHI CHI covers entire population (cca 2 million of inhabitants) CHI follows basic principles - universal coverage, solidarity, equity, etc. Two large fields of benefits: - health services (including drugs) - cash benefits cost-sharing arrangements in the system (copayment, voluntary insurance) 2. Health Care Expenditures (2011: OECD-methodology ): All: mio ; 9,0 % GDP; PPP per capita Public: mio ; 6,4 % GDP; PPP per capita (73 %) Private: 924 mio ; 2,6 % GDP; 492 PPP per capita (27 %) 3. CHI/ZZZS expenditures (2011): mio ; 6,5 % GDP

3 Europe s health spending per capita, 2008 Denmark Luxembourg Ireland Netherlands Austria France Germany Sweden Finland United Kingdom Italy Spain Greece Slovenia Portugal Slovak Republic Czech Republic Estonia Hungary Poland Euro per capita Source OECD Health Data 2010

4 Health Insurance in Slovenia basic data ZZZS expenditures in 2011: ZZZS admin.costs 1,8% - other expend. 1,7% - drugs & medical dev. 16,4 % cash benefits: 9,8% HC services 70,3 %

5 Drugs consumption in Slovenia (2011) No. of drugs for prescription (no. of INN's): (601) - on Positive list (no. of INN s): (438) - on Intermediate list (no. of INN s): 713 (175) No. of prescriptions per capita: 7,9 No. of packs per capita: 18,6 Total prescription drugs expenditures : 462,5 mio - total expenditures: per capita: 225,4 - share of GDP: 1,3 % Public (ZZZS) expenditures: 301,7 mio - per capita: 146,9 - share of GDP: 0,9 %

6 Europe s pharmaceutical spending per capita Greece Ireland France Germany Austria Spain Italy Finland Sweden Luxembourg Denmark Portugal Netherlands Slovenia Slovak Republic United Kingdom Hungary Czech Republic Estonia Poland Euro per capita Source OECD Health Data 2010

7 Prescription drugs: consumption and expenditures Expenditures Consumption

8 Prescription drugs: expenditures as a share in compulsory and total health expenditures % Share in total health expenditures 22,0 20,8 20,8 20,4 20,0 18,0 18,1 18,4 18,9 18,7 18,4 18,4 18,6 18,3 16,0 14,0 15,3 16,5 13,7 13,8 14,8 14,8 15,3 15,0 15,6 15,9 14,2 13,9 13,6 13,3 13,2 12,0 Share in compulsory health expenditures 10, Delež v OZZ Delež v OZZ+PZZ Year

9 DID Antibiotics: Regional consumption in DDDs in KK MS LJ RA CE MB KP KR NM NG

10 Context actual challenges Longterm developmental trends (aging, changing health needs, new medical technologies, new drugs, patient mobility, new demands etc.) - putting constant pressures on the demand and supply side of the system and influencing expenditures Actual financial and economic crisis - influencing directly on the revenues and the level of available public resources Basic strategic question for public systems: how to mantain sustainabillity of the system in the context of longterm changes and actual crisis?

11 Conclusions (1) Sustainabillity: need to focus on key goals of public system (not only financial dimensions): stable financing of the system (non disturbed) access efficient and qualitative health care provision

12 Conclusions (2) Cost containment of drugs: strategies of ZZZS cost-effective inclusion/exclusion from compulsory health insurance coverage reference pricing, generic substitution, better availability of generic drugs etc. evidence-based inclusion of new drugs education and information strategies (qualitative data on prescribing, consumption and financing!): o physicians: rational prescribing, quality indicators etc. o general public: proper and safe drugs utilisation

13 We all need exhange of good practice models in this field - I wish you a successful workshop!