Revista Panamericana de Salud Pública
On-line version ISSN 1680-5348
Print version ISSN 1020-4989
MACHADO ALBA, Jorge Enrique and MONCADA ESCOBAR, Juan Carlos. Evolution of consumption of high-cost drugs in Colombia. Rev Panam Salud Publica [online]. 2012, vol.31, n.4, pp.283-289. ISSN 1680-5348. http://dx.doi.org/10.1590/S1020-49892012000400003.
OBJECTIVE: Determine the patterns of consumption of high-cost drugs (HCD) during the 2005-2010 period in a population of Colombian patients enrolled in the General System of Social Security in Health. METHODS: An observational descriptive study was conducted. The prescription data of formulas of any drug considered to be high-cost dispensed to all users (1 674 517) in 20 cities of Colombia between 2005 and 2010 were analyzed. The anatomical therapeutic classification was considered, and the number of patients as well as monthly invoicing for each drug, the daily dose defined, and the cost per 1 ;000 inhabitants/day were defined. RESULTS: Over the entire study period, the amount invoiced for HCDs increased by 847.4%. Antineoplastic and immunomodulator drugs accounted for 46.3% of the total invoicing. The other drugs were anti-infectives (15.2%), systemic hormonal preparations (9.5%), and drugs for the nervous system (9.1%). Most of these drugs were prescribed at the daily doses defined as recommended by the World Health Organization, but with high costs per 1000 inhabitants/day. CONCLUSIONS: In Colombia a crisis has occurred in recent years due to the high spending generated by the most expensive drugs. The progressive growth of pharmaceutical spending is greater than the increased coverage by the country's health system. The Colombian health system should evaluate how much it is willing to pay for the most expensive drugs for some diseases and what strategies should be implemented to cover these expenses and thus guarantee access to the insured.
Keywords : Cost control; financing, health; drug substitution; drug utilization; economics, pharmaceutical; health policy; Colombia.