[Comparison of utilization of cardiovascular drugs in the Czech Republic and in Wales]

To compare and describe the trends in the consumption of selected groups of cardiovascular drugs in several districts of the Czech Republic and counties of Wales in the period of 1997-2000.

A retrospective analysis of prescription data from General Medical Insurance Company (three districts in the Czech Republic) and data from the Health Solutions Wales (3 counties of Wales). The data were analyzed during seven half-year intervals from January 1997 till June 2000. The authors investigated the consumption of antihypertensives, diuretics, beta-blockers, calcium channel blockers, ACE inhibitors, hypolipidemic drugs, digoxin and acetylsalicylic acid classified according to ATC classification. The drug consumption was expressed at defined daily doses (DDD) and standardized per 1,000 insured individuals and day for the Czech districts and per 1,000 inhabitants and day for the Welsh counties (DID).

The total consumption of the cardiovascular drugs under study in the last half-year of the investigated period of time (1/00) proved to be highest in CZ2 (40.2 DID), the value being by 40% higher than in CZ1 (348.6 DID) and by 11% higher than in CZ3 (386.9% DID). The rates of consumption in the Welsh counties during this period of time were 338.8 DID (W1), 307.9 DID (W2) and 298.0 DID (W3), respectively. Diuretics proved to be used at the highest rate in both countries. The consumption of thiazides and loop diuretics in the Czech districts during 1/00 represented 67.6% and 16.7% of the all diuretic consumption on the average, whereas the corresponding values in Wales were 42.3% for thiazide preparations and 46.7% for the loop diuretics. An increase in the consumption of new drugs such as ACE inhibitors, calcium channel blockers of 2nd generation and statins was noted in both countries. The statins represented 33.5% of total prescription of hypolipidemic drugs in the Czech districts, whereas their consumption in the Welsh districts represented 88.1% consumption of these drugs.

The most significant differences were found in the consumption of diuretics and hypolipidemic drugs. The results of consumption studies could highlight the differences in drug utilization and thereby stimulate discussion on optimization of drug selection.