First EFIC® Symposium Societal Impact of Pain - SIP

98
Eva Zebedin-Brandl
Dr. Eva Zebedin-Brandl PhD
Department of Pharmaceutical Affairs
Main Association of Austrian Social Security
Institutions
Pharmaco-economical aspects on the cost
of pain
Eva Zebedin-Brandl and Thomas Burkhardt
Pharmaceutical expenditure continued to rise
steadily in Austria during the 1990s and early
2000s despite a variety of reforms. As reviewed
in Godman et al (2008), recent reforms
and initiatives have moderated the growth rate.
Overall, health care in Austria seems well established,
and a total of 98% of Austrians are
covered by social (statutory) health insurance.
However, providing modern and comprehensive
medical care is inevitably and causally linked to
a constant rise in health care costs. This rising
financial burden is a common concern, coping
strategies vary among different European
states due to differences in health care structures
and administrative impact. In Austria, the
HVB (Main Association of Austrian Social Security
Institutions) publishes the Reimbursement
Code (EKO) for outpatient medicines, and
if new medicines apply for inclusion they are
subjected to pharmacological, medical/therapeutic
and health economic evaluation.
Treatment of pain has a unique position in each
health care system. Pain patients are confronted
both with severe and disabling physical
as well as psychological burdens. Good medical
care is the only way to avoid social marginalization.
Very often pain perception includes psychosomatic
and mental aspects. In this study
we basically distinguish between two main
treatment groups as representatives for pain
medication: classical NOAs (non-opioid analgesics)
and opioids. We aim to investigate the
impact of social factors on prescribing habits
and/or patients’ pain medication in these two
groups. First we are interested if there are
gross differences in the of the age distribution
between the two groups in Austria. Next we
are interested in the impact of recent social
reforms. This can easily be followed over time
and we hope to learn if and how greater availability
or the restriction of pain medication (e.g.
due to the introduction of generics) or the waiving
of prescription fees influence the rate of
utilization of pain medication. Another interesting
social aspect is the seasonal influence on
pain medication. We intend to analyze the
monthly fluctuations in utilization and try to
identify seasonal factors, e.g. use of antipyretics
for upper respiratory tract infections vs. opioids
for more severe pain. Data were provided by
the internal data warehouse of the HVB, which
houses reimbursement data for ambulatory
care from 2001-2009.