Medicine Availability and Prescribing Policy for Non-Communicable Diseases in the Western Balkan Countries

Published on Nov 8, 2017in Frontiers in Public Health
· DOI :10.3389/fpubh.2017.00295
Tanja Pekez-Pavlisko1
Estimated H-index: 1
Maja Račić3
Estimated H-index: 3
(University of East Sarajevo),
Srebrenka Kusmuk1
Estimated H-index: 1
(University of East Sarajevo)
Background: During the transition processes, the Western Balkan countries were affected by conflicts and transition related changes. Life expectancy in these countries is lower, while the mortality from non-communicable diseases is higher in comparison with western and northern parts of Europe. The primary aim of this study was to analyze the treatment possibilities for the most common non-communicable diseases in the Western Balkan countries. The secondary aim was to understand and compare the policies regarding prescribing-related competencies of family physicians. Methods: In June and July 2017, a document analysis was performed of national .positive medicines lists, strategic documents and clinical guidelines for the treatment of the most frequent non-communicable diseases; arterial hypertension, diabetes, hyperlipidemia, asthma and chronic obstructive pulmonary disease. All text phrases that referred to medicines prescribing were extracted and sorted into following domains: medicine availability, prescribing policy and medication prescribing - related competencies. Results: Possibilities for treatment of arterial hypertension, diabetes, hyperlipidemia, asthma and chronic obstructive pulmonary disease vary across the Western Balkan countries. This variance is reflected in the number of registered medicines, a number of parallels and number of different combinations, as well as restrictions placed on family physicians in prescribing insulin, inhaled corticosteroids, statins and angiotensin II receptor blockers (ARBs), without consultant’s recommendation. Conclusions: Western Balkan countries are capable of providing essential medicines for the treatment of NCDs, with full or partial reimbursement. There are some exceptions, related to statins, the new generation of oral antidiabetic agents and some of the antihypertensive combinations. Prescribing-related competencies of family physicians are limited. However, this practice is not compliant with the practices of family medicine, its principles, and primary care structures, and may potentially result in increased healthcare financial ramifications to both the system and patients due to frequent referrals to the specialists.
  • References (35)
  • Citations (1)
János Kornai32
Estimated H-index: 32
(Harvard University),
Karen Eggleston22
Estimated H-index: 22
(Harvard University)
The citizens of Eastern Europe have witnessed an unprecedented social and economic transformation during the past decade of transition from socialism to market-based economies. We describe the legacy of socialism and summarize the current state of the health sector in ten Eastern European countries, including financing, delivery, purchasing, physician incomes and the widespread phenomenon of under-the-table payments. The proposals for reform, derived from explicit guiding principles, are based o...
16 Citations Source Cite
Published on Nov 1, 1968in Canadian Family Physician 1.83
Shardt A1
Estimated H-index: 1
2 Citations
Published on Oct 3, 2011in The Medical Journal of Australia 4.23
Smita Shah19
Estimated H-index: 19
Susan M. Sawyer51
Estimated H-index: 51
+ 5 AuthorsChristine Jenkins43
Estimated H-index: 43
Objective: To evaluate the effectiveness of the Practitioner Asthma Communication and Education (PACE) Australia program, an innovative communication and paediatric asthma management program for general practitioners. Design: Randomised controlled trial. Setting: General practices from two regions in metropolitan Sydney. Participants: 150 GPs, who were recruited between 2006 and 2008, and 221 children with asthma in their care. Intervention: GPs in the intervention group participated in two 3-ho...
21 Citations Source Cite
Published on Oct 1, 2013in Journal of Hypertension 3.15
Giuseppe Mancia131
Estimated H-index: 131
Robert Fagard102
Estimated H-index: 102
+ 22 AuthorsAnna F. Dominiczak93
Estimated H-index: 93
List of authors/Task Force members: Giuseppe Mancia (Chairperson) (Italy), Robert Fagard (Chairperson) (Belgium), Krzysztof Narkiewicz (Section co-ordinator) (Poland), Josep Redon (Section co-ordinator) (Spain), Alberto Zanchetti (Section co-ordinator) (Italy), Michael Bohm (Germany), Thierry Christiaens (Belgium), Renata Cifkova (Czech Republic), Guy De Backer (Belgium), Anna Dominiczak (UK), Maurizio Galderisi (Italy), Diederick E. Grobbee (Netherlands), Tiny Jaarsma (Sweden), Paulus Kirchof (...
376 Citations Source Cite
Published on Jul 1, 2010in Regulatory Toxicology and Pharmacology 2.81
Siniša Tomić7
Estimated H-index: 7
Anita Filipović Sučić2
Estimated H-index: 2
Adrijana Ilić Martinac2
Estimated H-index: 2
European legislation for medicines places the emphasis on an assessment of quality, safety and efficacy during the procedure for the granting of marketing authorisations for medicines, in order to protect patient health. The integrated European regulatory system involves the participation of a network of experts from the agencies of the member states that takes part in the European procedures for the authorisation of medicines. On the way to full membership in the EU, candidate countries and pot...
3 Citations Source Cite
Published on Sep 1, 2005in Milbank Quarterly 6.00
Barbara Starfield78
Estimated H-index: 78
(Johns Hopkins University),
Leiyu Shi41
Estimated H-index: 41
(Johns Hopkins University),
James Macinko37
Estimated H-index: 37
Evidence of the health-promoting influence of primary care has been accumulating ever since researchers have been able to distinguish primary care from other aspects of the health services delivery system. This evidence shows that primary care helps prevent illness and death, regardless of whether the care is characterized by supply of primary care physicians, a relationship with a source of primary care, or the receipt of important features of primary care. The evidence also shows that primary ...
2,242 Citations Source Cite
Published on Apr 1, 2013in European Journal of Health Economics 2.60
Mihajlo Jakovljevic26
Estimated H-index: 26
(University of Kragujevac)
The past 23 years of post-socialist restructuring of health system funding and management patterns has brought many changes to small Balkan markets, putting them under increasing pressure to keep pace with advancing globalization. Socioeconomic inequalities in healthcare access are still growing across the region. This uneven development is marked by the substantial difficulties encountered by local governments in delivering medical services to broad sectors of the population. This paper present...
69 Citations Source Cite
Mihajlo Jakovljevic26
Estimated H-index: 26
(University of Kragujevac),
Natasa Djordjevic10
Estimated H-index: 10
(University of Kragujevac)
+ 1 AuthorsSlobodan Jankovic16
Estimated H-index: 16
(University of Kragujevac)
Introduction: South-eastern European socioeconomic transition followed by extensive health systems reforms has completely changed the pharmaceuticals market landscape in the region. Serbia, as the largest Western Balkans market, may serve as an example of such changes. Methods: Descriptive trend analysis of national-level dispensing of medicines in Serbia 2004–2012 was performed. Results: Total public health expenditure in Serbia increased sharply in less than a decade (€1,175,158,679 to €1,847,...
26 Citations Source Cite
Published on Jan 1, 2000in BMJ 23.56
Nicholas Mays33
Estimated H-index: 33
Catherine Pope42
Estimated H-index: 42
This is the first in a series of three articles In the past decade, qualitative methods have become more commonplace in areas such as health services research and health technology assessment, and there has been a corresponding rise in the reporting of qualitative research studies in medical and related journals.1 Interest in these methods and their wider exposure in health research has led to necessary scrutiny of qualitative research. Researchers from other traditions are increasingly concerne...
2,306 Citations Source Cite
Published on Oct 1, 1994in The Lancet 53.25
Barbara Starfield78
Estimated H-index: 78
(Johns Hopkins University)
606 Citations Source Cite
  • References (35)
  • Citations (1)
Cited By1
Published on Mar 5, 2018in Frontiers in Public Health
Maria Kamusheva3
Estimated H-index: 3
(Sofia Medical University),
Mariya Vassileva + 2 AuthorsGuenka Petrova9
Estimated H-index: 9
(Sofia Medical University)
Background: Policy makers face a lot of challenges in the process of drug reimbursement decision making, especially in the context of entering the market of more and more innovative medicinal products. The aim of the current study is to make an overview of the reimbursement system development and to evaluate the access of innovative medicines, which have entered the EU market in the period 2015-2017, in Bulgaria as a reference example for the middle-income European country. Methods: A literature...
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