[Bisphosphonate use and related pharmaceutical issues II].
Bisphosphonates have basic role in decreasing progression of malignant bone processes as well as in the prevention and therapy of osteoporosis. Use of bisphosphonates is common in Hungary since 20 years. In the past decade their reimbursement has been changed several times, the use of generics decreased the price of bisphosphonates. In this paper we analyze the consumption of prescribed bisphosphonates in Hungary.


METHODS
Prescription data of the National Health Insurance Fund of Hungary.


METHODS
We analysed the prescribed bisphosphonates between 2006-2014. We examined the type and amount of bisphosphonates used by years. After identifying therapy areas of use, we calculated the years of therapy from the DOT data. From this data we estimated the mean bisphosphonate therapy costs and costs falling for the patients. Changes in the reimbursement system regarding these medications was analysed.


RESULTS
Bisphosphonate years of therapy was decreasing in osteoporosis over the 9 years examined. In oncology bisphosphonate use shows stability in drug consumption. In both therapeutic areas the proportion in therapy choice of specific bisphosphonates has changed. Bisphosphonate reimbursement costs paid by the Hungarian reimbursement system was approx. 8 billion HUF in osteoporosis and 4,7 billion HUF in oncology in 2006. Changes of the reimbursement strategy, the compulsory generic use and decreasing consumption in osteoporosis has significantly reduced the overall costs by 2014.


CONCLUSIONS
According to our results bisphpsphonate use in oncology is moderate in Hungary, a decreasing consumption can be detected in osteoporosis, that is still expected to decrease. The use of generics reduced bisphosphonate therapy costs and also overall health care costs. In osteoporosis patients cost have substantially lowered.
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Mészáros
D000284:Administration, Oral; D019386:Alendronate / Q000191:economics / Q000627:therapeutic use; D050071:Bone Density Conservation Agents / Q000008:administration & dosage / Q000191:economics / Q000627:therapeutic use; D001859:Bone Neoplasms / Q000188:drug therapy / Q000191:economics; D004002:Clodronic Acid / Q000191:economics / Q000627:therapeutic use; D015986:Confounding Factors, Epidemiologic; D004164:Diphosphonates / Q000008:administration & dosage / Q000191:economics / Q000627:therapeutic use; D016527:Drug Costs / Q000706:statistics & numerical data; D011307:Drug Prescriptions / Q000706:statistics & numerical data; D016568:Drugs, Generic; D006801:Humans; D006814:Hungary; D000077557:Ibandronic Acid; D007093:Imidazoles / Q000191:economics / Q000627:therapeutic use; D009313:National Health Programs; D010024:Osteoporosis / Q000188:drug therapy / Q000191:economics; D000077268:Pamidronate; D012189:Retrospective Studies; D000068296:Risedronic Acid / Q000191:economics / Q000627:therapeutic use; D000077211:Zoledronic Acid
D050071:Bone Density Conservation Agents; D004164:Diphosphonates; D016568:Drugs, Generic; D007093:Imidazoles; D004002:Clodronic Acid; D000077211:Zoledronic Acid; D000068296:Risedronic Acid; D000077268:Pamidronate; D000077557:Ibandronic Acid; D019386:Alendronate