ClinicoEconomics and Outcomes Research (Nov 2024)
Characteristics of High-Cost Beneficiaries of Prescription Drugs in Kazakhstan: A Cross-Sectional Study of Outpatient Data from 2022
Abstract
Adilet Nazarbayev,1 Ardak Nurbakyt,1 Bibigul Omirbayeva,2 Anuar Akhmetzhan,1 Lyazzat Kosherbayeva1,3 1Asfendiyarov Kazakh National Medical University, Almaty, Kazakhstan; 2Salidat Kairbekova National Research Center for Health Development, Astana, Kazakhstan; 3Al-Farabi Kazakh National University, Almaty, KazakhstanCorrespondence: Anuar Akhmetzhan, Asfendiyarov Kazakh National Medical University, 88 Tole bi Street, Almaty, Kazakhstan, Email [email protected] and Objectives: 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.Methods: 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%.Results: 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.Conclusion: 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.Plain Language Summary: The pronounced skewness in the consumption of reimbursed outpatient drugs within the healthcare system of the Republic of Kazakhstan highlights the need for targeted cost containment strategies, in addition to broader measures such as price regulation and adjustments to reimbursement lists that impact the general population.The highest average costs in the high-cost group are observed in children under 5 years of age. Costs associated with chronic diseases (diabetes and others) rank in the top three, while when assessing costs in the high-cost user group, rare inherited diseases and cancer have a significant impact.Keywords: Pharmaceutical Expenditure, Prescription Drugs, Cost Distribution, Medicine user, High-cost patients
