Trends in the Use and Costs of Medications for Respiratory Management Included in the 2022 Benefit Plan of the Colombia Health System.

Abstract

The Colombian Ministry of Health updated the Health System Benefit Plan (BP) as of 2022. The subsequent economic impact on medicines for respiratory management remains unknown. To describe the dispensing trends and costs of medicines for respiratory management included in the 2022 Health System Benefit Plan in Colombia. The aim of this longitudinal observational study was to quantify the trends in the use and costs of medicines for respiratory management included in the new BP. Dispensations from January 2021 to June 2023 from the database of a pharmaceutical manager with information on 9.2 million members of the Colombian Health System were analyzed, and descriptive analyses were performed. Medications were dispensed to 42,370 patients, who had a mean age of 60.8 <mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML"><mml:mo>&#xb1;</mml:mo></mml:math> 26.2 years. Among these medications, the greatest increases in the percentages of patients to whom they were dispensed were observed for the combinations formoterol/budesonide (+156.1%), vilanterol/fluticasone (+239.7%), and vilanterol/umeclidinium (+292.1%). The total cost estimated for the October-December quarter of 2021 was USD$2,404,035, whereas that estimated for the April-June quarter of 2023 was USD$4,651,828, representing an increase of 94% in the invoiced value; this increase was attributable primarily to the invoicing of long-acting &#x3b2;-agonists/inhaled glucocorticoids (LABAs/ICSs) (+190%) and LABAs/LAMAs (long-acting antimuscarinics) (+119%). After the 2022 Benefit Plan update for respiratory conditions such as asthma and chronic obstructive pulmonary disease, increases in the dispensing and direct pharmaceutical costs of the newly included therapies were observed. These temporal changes suggest modifications in prescribing and dispensing patterns, potentially reflecting greater access to recommended first-line therapies, although causal attributions to the Benefit Plan update cannot be established, given the descriptive nature of this study.