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Abstract:
Yugoslavia has a modern drug legislature and a selective drug market. With about 910 substances and 1250 brand names the number of drugs is among the lowest among the European countries. Most products on the market satisfy high criteria of safety to efficacy ratio. Still, the regional health insurance authorities of the Federal republics of Serbia and of Croatia limited the number of drugs to be reimbursed by the insurance scheme. The reason for this move and its justification is given by--the inertia of the complicated procedure of withdrawal from the market of a drug which is obsolete or considered today not possess the ascribed efficacy, existence of unjustly high expectations regarding the efficacy of certain drugs by both the medical profession and the layman and which lead to overprescribing (i.e. vitamin combinations, laxatives and drugs, cerebrovascular insufficiency), and--the responsibility of the public health administration for setting priorities in spending of the available funds. The allocation of funds available for medicinal drugs have been without any kind of regulation and control until now. The introduction of limitations in the reimbursement of price for certain drugs is the first measure initiated to stimulate the optimal use of drugs. As the optimal drug use is considered the therapy with the most favorable safety/efficacy and cost/efficiency ratios. The other measures available and which ought to be initiated are those based on the drug utilization studies. The prescriptions are already computerized im most settings, so the feedback of information ot the prescribing physicians could be possible after adequate analysis of the data. The team of clinical pharmacologist already active in drug utilization studies is available and ready to meet the challenge of improving therapeutic practices.