Nazarbayev Adilet, Nurbakyt Ardak, Omirbayeva Bibigul, Akhmetzhan Anuar, Kosherbayeva Lyazzat
Asfendiyarov Kazakh National Medical University, Almaty, Kazakhstan.
Salidat Kairbekova National Research Center for Health Development, Astana, Kazakhstan.
Clinicoecon Outcomes Res. 2024 Nov 13;16:827-837. doi: 10.2147/CEOR.S470632. eCollection 2024.
Limited information is available regarding the distribution of increasing pharmaceutical expenditures within large representative samples of national populations globally. The aim was to investigate the distribution of pharmaceutical costs in outpatient treatment and analyze the primary characteristics of users of expensive drugs within the healthcare system of Kazakhstan.
This study utilized data from the Information System for Outpatient Drug Supply, which includes nationally representative data from all regions of Kazakhstan, covering both rural and urban populations. The key explanatory variables in this study included age, gender, number of prescribed medications, disease categories based on ICD-10 codes, and insurance coverage status. These variables were selected to capture demographic, clinical, and healthcare access factors influencing prescription drug costs. In total, 2.2 million people, who were prescribed outpatient medications were included. High-cost users (HCUs) were characterized as individuals whose prescription drug expenses ranked within the highest 5%.
The distribution of pharmaceutical costs exhibits significant discrepancy, with 5% of the population receiving prescription drugs covered by the state budget and social medical insurance fund contributing to nearly three-quarters of all costs. Notably, these HCUs tended to be younger than low-cost drug users. HCUs, on average, consumed a greater quantity of medications compared to non-HCUs. Among children, the top diseases contributing to high costs were rare hereditary diseases and malignancies, while in adults, cancer and diabetes were the primary cost drivers.
There is a concentration of public drug program spending within a small percentage of beneficiaries with high drug costs in Kazakhstan. This discovery offers valuable insights for shaping policies tailored to this specific population, aiming to mitigate escalating costs and enhance the optimal use of medications.
在全球具有代表性的全国人口大样本中，关于不断增长的药品支出分布的信息有限。本研究旨在调查哈萨克斯坦医疗体系中门诊治疗的药品费用分布情况，并分析高价药品使用者的主要特征。
本研究使用了门诊药品供应信息系统的数据，该数据包括哈萨克斯坦所有地区具有全国代表性的数据，涵盖农村和城市人口。本研究的关键解释变量包括年龄、性别、处方药物数量、基于国际疾病分类第十版（ICD - 10）编码的疾病类别以及保险覆盖状况。选择这些变量是为了捕捉影响处方药费用的人口统计学、临床和医疗可及性因素。总共纳入了220万开具门诊药物处方的人群。高成本使用者（HCUs）被定义为处方药费用排名在前5%的个体。
药品费用分布存在显著差异，5%的人口接受国家预算和社会医疗保险基金覆盖的处方药，却贡献了近四分之三的所有费用。值得注意的是，这些高成本使用者往往比低成本药品使用者更年轻。与非高成本使用者相比，高成本使用者平均消耗的药物数量更多。在儿童中，导致高成本的主要疾病是罕见的遗传性疾病和恶性肿瘤，而在成年人中，癌症和糖尿病是主要的费用驱动因素。
在哈萨克斯坦，公共药品项目支出集中在一小部分药品成本高的受益者身上。这一发现为制定针对这一特定人群的政策提供了有价值的见解，旨在缓解成本上升并提高药物的最佳使用。
