Examination of the Consumption of Hypolipidemic Agents by Means of the Databases ofHealth Insurance Companies

Overview

Databases of health insurance companies can provide information on the motion of a drug in thesociety. The present paper examines several databases of health insurance companies and analyzesthe development of the consumption of hypolipidemic agents in 1994 through 1998. So-calledevaluation databases making it impossible to identify a particular patient and the prescribingphysician were prepared for the evaluation. They were obtained from the VZP central healthinsurance office, VZP district health insurance offices in Hradec Králové and Kladno, and theZaměstnanecká pojišťovna Škoda (Employees Health Insurance Company Škoda). It was notnecessary to blind the data in the first cohort, in the second one it was carried out by shortening theidentification numbers, and in others by introducing artificial identification codes. The consumptionwas expressed in DDD and in the relative representation in the group. The consumption of theprincipal groups of hypolipidemic agents (fibrates, statins, sequestrants of bile acids, and derivativesof nicotinic acid) and the individual medicinal substances was evaluated. Relative values ofconsumption were obtained by calculation to the magnitude of the denominator – the number of theinsured, or the number of patients to whom a hypolipidemic agent was prescribed. The consumptionwas on the increase in all three databases, in four years increasing from approx. 0.4–4DDD/1000 ofthe insured/day to 16–24DDD/1000 of the insured/day. At the beginning, the main share in theconsumption of hypolipidemic agents was represented by fibrates, approx. 90 %, but in four yearsthis share decreased to only 60 %, whereas in the period under study the share of statins increasedup to 30 %. Databases of health insurance companies do not significantly differ in the consumptionof hypolipidemic agents, which may give evidence of their validity. In the course of the study, anincrease in the consumption of hypolipidemic agents, primarily statins, was found. The shift in theconsumption of statins corresponds with the available information about the evidence of theirtherapeutic 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 emergeduring the year.

Key words:
examination of drug consumption – pharmacoepidemiology – hypolipidemic agents– health insurance companies – databases