title: Cost of outpatient hypertension pharmacotherapy: comparative study between Bulgaria and Serbia.
abstract: OBJECTIVE
  To compare the prescribing practice and pharmacotherapy outpatient cost of hypertension and its common complications between two neighboring countries, Bulgaria and Serbia. The study questions focus on consistency of the prescribing practice with the treatment guidelines; comparability of the treatment patterns among both countries, and burden of hypertension cost to the population and third party payer in the countries under consideration.
  
  
  METHODS
  Retrospective study, one year time horizon is for outpatient therapy.
  
  
  RESULTS
  Patients with arterial hypertension in Bulgaria are most often on monotherapy (61% vs 6% in Serbia), as well as those with complications (66% vs 0% Serbia). In both countries the first choice of therapy are the ACE inhibitors (37.01% in Serbia and 41% in Bulgaria) and then follows the calcium antagonists, beta-blockers, and diuretics. The weighed monthly cost of hypertension and complicated hypertension is almost doubled in Serbia (12.56 vs 8.23 EUR for hypertension, and 13.39 vs 8.23 EUR) and prevailing part is reimbursed (88% vs 44% in Bulgaria).
  
  
  CONCLUSIONS
  Our study confirms that hypertension and its complications therapy consumes a huge amount of financial resources. In both countries under consideration the therapy is corresponding with the European treatment guidelines. The international cost comparisons are possible but they depend on many external factors as the regulatory measures, prescribing habits and reimbursement policy and should be analysed within this framework.
authors.affiliation: Faculty of Pharmacy, Medical University. Sofia ( Bulgaria ).
authors.forename: Anna
authors.initials: A
authors.lastname: Ivanova
authors.affiliation: Institute for Social Pharmacy and Pharmacy Legislation. Faculty of Pharmacy, Belgrade University. Belgrade ( Serbia ).
authors.forename: Dragana
authors.initials: D
authors.lastname: Lakic
authors.affiliation: Republic Institute for Health Insurance. Belgrade ( Serbia ).
authors.forename: Vesna
authors.initials: V
authors.lastname: Andric
authors.affiliation: Faculty of Pharmacy, Medical University. Sofia ( Bulgaria ).
authors.forename: Guenka
authors.initials: G
authors.lastname: Petrova
keywords: Hypertension. Drug Costs. Health Expenditures. Serbia. Bulgaria