Antidepressant utilization in the Republic of Croatia from 2016 to 2020

Depresija je jedan od najčešćih mentalnih poremećaja. Procjenjuje se da na globalnoj razini od depresije boluje preko 280 milijuna ljudi. Na razini Hrvatske prevalencija depresije iznosi oko 6,6 %. Depresija ne samo da smanjuje kvalitetu života i funkcionalnost pojedinca, već predstavlja i ekonomski teret za zdravstveni sustav. Obzirom na uređenost zdravstvenog sustava u Republici Hrvatskoj, pacijentima s postavljenom dijagnozom depresije na raspolaganju su antidepresivi s osnovne ili dopunske liste lijekova Hrvatskog zavoda za zdravstveno osiguranje. U ovom je radu analizirano tržište antidepresiva u Hrvatskoj. Proučavan je broj registriranih lijekova, njihova cijena te potrošnja u razdoblju od 2016. do 2020. godine. U Hrvatskoj je u navedenom razdoblju bilo registrirano 18 molekula u različitim dozama. U 2016. na tržištu je bilo registrirano ukupno 98 različitih formulacija različitih proizvođača. Taj se broj do 2020. smanjio na 76. Cijene jediničnih oblika lijekova varirale su. Najvišu je cijenu imala tableta od 25 mg agomelatina (8,97 kn), a najnižu tableta od 10 mg amitriptilina (0,33 kn). Zaključeno je da je potrošnja antidepresiva rasla u analiziranom periodu. Najviše su propisivani selektivni inhibitori ponovne pohrane serotonina (sertralin i escitalopram), a najmanje triciklički antidepresivi. Obzirom na to da je financijski utrošak na terapiju antidepresivima godišnje iznosio 70-80 milijuna kuna, depresija predstavlja velik financijski teret za hrvatski zdravstveni sustav.Depression is one of the most common mental health issues. It is estimated that over 280 million people globally suffer from depression. The prevalence of depression in Croatia is around 6,6%. Depression does not only affect the quality of life and functionality of the patient but is also an economic burden for the health system. Considering the organization of the Croatian health system, all patients with diagnosed depression have access to antidepressants registered within Croatian Health Insurance Fund's registered drugs lists. This article analyses the antidepressants market in Croatia. The number of registered antidepressants, their price and consumption during the period from 2016 to 2020 have been studied. During the analyzed period 18 molecules were registered as antidepressants in different doses and forms in Croatia. In 2016 there were 98 different formulations registered by different brands. By 2020, the number of registered formulations was reduced to 76. Prices per pill varied during the analysis period. The highest price was noted for a 25 mg agomelatine pill (8,97 kn), and the lowest price was noted for a 10 mg amitriptyline pill (0,33 kn). It s concluded that the general consumption of antidepressants increased during the analysis period. Selective serotonin reuptake inhibitors (sertraline and escitalopram) were used most often, while tricyclic antidepressants were rarely used. Considering the fact that annually 70-80 million kunas is spent on depression therapy, depression presents a great financial burden for the Croatian health system