Last year, citizens spent a record 198 million euros on medicines from the budget and out of pocket, and more than a third of that amount, 75 million, was for therapy that is mainly used against malignant diseases.
Of the total amount allocated for medicines, the Health Insurance Fund covered 69,46 percent, while the remainder of around 60,6 million was paid by citizens directly out of pocket.
The consumption of medicines for the year increased financially by 26 million euros, and the reasons for this, according to the authorities, are the extension of life expectancy, changes in lifestyle that lead to a greater number of people suffering from chronic and new diseases, as well as the development and appearance of new medications on the market.
According to a report by the Montenegrin Institute for Medicines and Medical Devices (CInMED), there has also been an increase in the amount of medicines consumed, by 4,39 percent. Thus, in 2024, 1.426 defined daily doses of medicine were consumed per 1.000 inhabitants per day, with the highest number of medicines for cardiovascular diseases.
Consumption is also increasing due to new drugs
The most significant financial increase in 2024 compared to the previous year was recorded by medicines belonging to the group for the treatment of the musculoskeletal system (23,67 percent). The reason, according to CInMED, is the procurement of a medicine for the treatment of spinal muscular dystrophy. This is a severe and hereditary neurological disease that affects one in 10.000 newborns, and the medicine that Montenegro acquired last year represents a revolutionary discovery in the treatment of the disease.
According to the CInMED report, an increase in consumption was also recorded in the respiratory system treatment group. This, they say, is partly the result of an increased consumption of cystic fibrosis drugs by 38,74 percent compared to 2023. Montenegro only started purchasing the drug for several dozen patients suffering from this genetic, progressive disease two years ago.
However, consumption is also growing in the group of medicines for the treatment of sensory organs, anti-infectives, medicines that act on diseases of the digestive system and metabolism, the cardiovascular system, as well as medicines for the genitourinary system and sex hormones.
Consumption of antineoplastics and immunomodulators, which are mainly anti-cancer drugs, increased by about 20 percent in the year.
Vitamin D and aspirin most used
The most commonly used medicine purchased by citizens in pharmacies is acetylsalicylic acid (aspirin) for pain relief and fever reduction, followed by cholecalciferol (vitamin D3) and pantoprazole for reducing stomach acid secretion. In fourth place is ramipril for high blood pressure, and in fifth is diclofenac.
In Podgorica, Nikšić and Berane, the most used drug is cholecalciferol (vitamin D3), and in Bijelo Polje and Bar, acetylsalicylic acid.
Financially, the most expensive drug being sold in pharmacies is against cystic fibrosis (four million), followed by dapagliflozin for the treatment of diabetes, heart failure, and kidney disease.
The most commonly used drug in hospitals was denosumab, for the treatment of conditions related to bone loss, and a medication against blood clots... The drug that spent the most money in hospitals was the immunotherapy drug - pembrolizumab, on which around 13 million euros were spent.
Year-on-year growth trend
According to a previous report by CInMED, for the period from 2019 to 2023, the consumption of medicines has shown an upward trend in the last five years. Comparative data shows that in Montenegro, around 2019 million euros were allocated for medicines in 101, which means that the financial consumption of medicines has increased by almost 100 percent in just five years.
"Although the European Health Consumer Index (EHCI) found that higher spending in the healthcare system does not correlate with better access to healthcare, the data on per capita drug consumption is still linked to accessibility, especially of newer pharmacological therapies," CInMED believes.
Comparative data showed that in 2023, Montenegro consumed 1360,13 daily doses of the drug per capita, Serbia 2215,84, and Croatia 1.540,60.
13,8 million euros is the largest single sum allocated for a single drug, namely pembrolizumab, which is an immunotherapeutic and helps reduce malignant tumors.
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