title: [Pharmacoeconomic indicators of cardiovascular drug utilization in the Republic of Croatia and city of Zagreb in 2008].
abstract: BACKGROUND
  In comparison with original drugs, generic drugs have the same efficacy but considerably lower price and should therefore be preferred to original drugs on prescribing. The aim of the present study was to assess outpatient utilization and rationality of cardiovascular drug prescribing in the City of Zagreb and Republic of Croatia based on the generic to original drug prescribing ratio.
  
  
  METHODS
  Data on the financial indicators and number of cardiovascular drug packages issued in 2008 were obtained from the Croatian Institute of Health Insurance. These data were used to calculate the number of defined daily doses (DDD) and number of DDD per 1000 inhabitants per day (DDD/1000/day). The index of generic/original drug utilization was determined for Zagreb and Croatia as a measure for assessment of prescribing rationality; the significance of difference was determined by X2-test.
  
  
  RESULTS
  The rate of prescribing original cardiovascular drugs was significantly higher in Zagreb as compared with Croatia as a whole. The index of prescribing generic versus original drugs was 1.20 (249/208 DDD/1000/day) in Zagreb and 1.65 (249/151 DDD/1000/day) in Croatia. Difference in the utilization of generic drugs between Zagreb and Croatia as determined by X2-test (the level of statistical significance was set at P<0.05) was statistically significant (P=0.021). The highest differences were recorded in the most widely prescribed drug groups, i.e. ACE inhibitors with the generic/original drug index of 1.38 in Zagreb and 2.02 in Croatia; and hypolipemics with the generic/original drug index of 0.96 in Zagreb and 1.34 in Croatia. According to financial indicators, the generic/original drug index was 1.44 in Croatia and only 0.96 in Zagreb.
  
  
  CONCLUSIONS
  The significantly greater influence of pharmaceutical industry marketing in Zagreb entailed the significantly higher rate of original drug prescribing, which is associated with considerably greater drug expenses. Measures to stimulate prescribing generic drugs should be launched at the national level.
authors.affiliation: Zagreb Institute of Public Health, School of Medicine, University of Zagreb, Zagreb, Croatia. danijela.stimac@stampar.hr
authors.forename: Danijela
authors.initials: D
authors.lastname: Stimac
authors.forename: Ivanka
authors.initials: I
authors.lastname: Stambuk
mesh_terms: D002317:Cardiovascular Agents / Q000191:economics / Q000627:therapeutic use*; D017523:Croatia; D016527:Drug Costs; D004363:Drug Utilization; D016568:Drugs, Generic / Q000191:economics / Q000627:therapeutic use*; D006801:Humans
chemical_list: D002317:Cardiovascular Agents; D016568:Drugs, Generic