Utilization and expenditure of anti-cancer medicines in Kosovo : findings and implications

Jakupi, Arianit and Godman, Brian and Martin, Antony and Haycox, Alan and Baholli, Indrit (2018) Utilization and expenditure of anti-cancer medicines in Kosovo : findings and implications. PharmacoEconomics - Open, 2 (4). pp. 423-432. ISSN 2509-4254 (https://doi.org/10.1007/s41669-017-0066-8)

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Introduction: The Ministry of Health (MoH) leads and organizes health policy in Kosovo, which includes procurement and provision of medicines. Cancer medicines are part of this. There are concerns with their affordability in view of growing costs and high profile. This is similar in Kosovo where anti-cancer medicines compose a special group of medicines, with most available medicines part of the Ministry of Health’s Essential List of Medicines. National drug utilization is available to guide future activities. However, there has been limited analysis of anti-cancer medicines to date. Such analyses are important to guide future care within limited resources. Consequently, the objective of this study is to undertake such research in Kosovo to provide future guidance. Method: Document utilisation and expenditure on anti-cancer medicines (ATC L) initially from 2011 to 2013, especially for anti-cancer medicines on the essential medicines list. In addition, document current systems for procuring and managing anti-cancer medicines in Kosovo. Results: There was appreciable variability in the utilization of anti-cancer medicines over the years, with low or limited use of some anti-cancer medicines on the essential medicine list. This is a concern in view of their documented effectiveness. From 2011 to 2013, € 16.49 million, or 13.5% of total expenditure, was spent on anti-cancer medicines (ATC L). The process of selection of new medicines begins with suggestions from doctors at the University Clinical Centre in Kosovo. Conclusion: The analysis has shown concerns with current utilization patterns for anti-cancer medicines in Kosovo. This needs to be addressed as part of improving the drug management process to optimize patient care within available resources. Future years and reforms will be assessed to improve current utilization and expenditure patterns.