Trends in publicly and privately prescribed anxiolytics in Croatia: do we need a new regulatory framework.

OBJECTIVES

The study aimed to analyse changes in the prescribing trends of anxiolytics in Croatia over the past 15 years, focusing on changes in prescribing patterns and the average cost per defined daily dose (DDD) and to evaluate how frequently patients covered by the Croatian Health Insurance Fund (CHIF) received private prescriptions for anxiolytics.

METHODS

Data on total consumption of anxiolytics in Croatia were obtained from two sources: the IMS database and the CHIF database for the period from 2006 to 2022.

KEY FINDINGS: The total usage of anxiolytic drugs increased from 61.13 DDD/1000 in 2006 to 82.78 DDD/1000 in 2022, an increase of 35.42%, while the financial expenditure in the same period decreased by 15.57%. Diazepam is the anxiolytic drug with the highest prescription rate, with an increase of 67.42%. The highest increase overall was in the total consumption of alprazolam, despite a decrease from 21.22% in 2011 to 16.53% in 2022 in private prescriptions, indicating a substantial increase in prescriptions covered by insurers.

CONCLUSIONS

Despite being either not recommended by clinical guidelines or of doubtful efficacy in many cases, prescribing of anxiolytics is common. There is a noticeable increase in anxiolytic drug use in Croatia during the investigated period, while the total financial expenditure has decreased due to price pressure on medications imposed by the national insurer. The high rate of private prescription of anxiolytics is observed. An enhanced national regulatory framework for prescribing anxiolytics in Croatia is needed.