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Helsana Arzneimittelreport 2020 Aussgabe 2020 Helsana- Arzneimittel- Report Ausgabe 2020 Helsana-Arzneimittelreport Geduld ist eine gute Eigenschaft. Aber nicht, wenn es um die Beseitigung von Missständen geht. Margaret Thatcher, ehem. Premierministerin des Vereinigten Königreichs (1925 – 2013) Der Helsana-Arzneimittelreport wird im Auftrag von Helsana vom Universitätsspital Basel (USB) und dem Institut für Pharmazeutische Medizin (ECPM) der Universität Basel erstellt. Unser Dank gilt den Mitarbeiterinnen und Mitarbeitern des USB und des ECPM für alle vorgenommenen Auswertungen und für die Erstellung des Reports. Helsana-Arzneimittelreport 2020 3 November 2020 Helsana-Arzneimittelreport für die Schweiz 2020 Auswertungsergebnisse der Helsana Arzneimitteldaten aus den Jahren 2016 bis 2019 Nadine Schur 1 Sibylle Twerenbold 2,3 Daphne Reinau 2,3 Matthias Schwenkglenks 1 Christoph R. Meier 2,3,4 1 Institut für Pharmazeutische Medizin (ECPM) Universität Basel & 2 Basel Pharmacoepidemiology Unit Abteilung Klinische Pharmazie und Epidemiologie Departement Pharmazeutische Wissenschaften Universität Basel & 3 Spital-Pharmazie Universitätsspital Basel & 4 Boston Collaborative Drug Surveillance Program (BCSDP) Lexington, MA, USA Helsana-Arzneimittelreport 2020 4 Helsana-Arzneimittelreport 2020 5 Inhaltsverzeichnis Vorwort .............................................................................................................................................................. 7 Préface .............................................................................................................................................................. 8 Preface .............................................................................................................................................................. 9 Zusammenfassung ........................................................................................................................................ 10 Résumé ........................................................................................................................................................... 14 Summary ......................................................................................................................................................... 18 1 Einleitung .............................................................................................................................................. 22 2 Methoden .............................................................................................................................................. 23 2.1 Datenquelle: Die Helsana-Gruppe ...................................................................................................... 23 2.2 Population und Studiensetting ........................................................................................................... 25 2.3 Analysen ............................................................................................................................................... 26 2.3.1 Anatomisch-therapeutisch-chemisches Klassifikationssystem (ATC-Klassifikation) ............................ 28 3 Ergebnisse allgemeiner Teil ............................................................................................................... 30 3.1 Gesamtmarkt der Medikamente in der Schweiz ............................................................................... 30 3.2 Bezüge und Kosten nach anatomischen Hauptgruppen (Ebene 1 der ATC-Klassifikation)........ 34 3.3 Bezüge und Kosten der wichtigsten therapeutischen Medikamentengruppen (Ebene 2 der ATC-Klassifikation) ....................................................................................................... 39 3.4 Bezüge und Kosten der wichtigsten Wirkstoffe (Ebene 5 der ATC-Klassifikation) ...................... 48 3.5 Präparate und Generika ...................................................................................................................... 55 3.6 Potentielle Innovationen und Biosimilars ......................................................................................... 59 3.6.1 Potentielle Innovationen 2019 ............................................................................................................... 60 3.6.2 Marktentwicklung der potentiellen Innovationen aus 2018 .................................................................... 63 3.6.3 Biosimilars .............................................................................................................................................. 66 Helsana-Arzneimittelreport 2020 6 4 Ergebnisse spezifischer Teil .............................................................................................................. 75 4.1 Medikation im Spitex Bereich: Verschreibungsmuster und Kostenentwicklung zwischen 2013 und 2019 ..................................................................................................................... 75 4.1.1 Einleitung ............................................................................................................................................... 76 4.1.2 Methoden ............................................................................................................................................... 77 4.1.3 Resultate und Diskussion ...................................................................................................................... 78 4.1.4 Fazit ..................................................................................................................................................... 103 4.2 Psychostimulanzien .......................................................................................................................... 105 4.2.1 Einleitung ............................................................................................................................................. 105 4.2.2 Methoden ............................................................................................................................................. 107 4.2.3 Resultate .............................................................................................................................................. 110 4.2.4 Diskussion und Fazit ............................................................................................................................ 124 4.3 Lipidsenker ......................................................................................................................................... 127 4.3.1 Einleitung ............................................................................................................................................. 127 4.3.2 Methoden ............................................................................................................................................. 129 4.3.3 Resultate .............................................................................................................................................. 132 4.3.4 Diskussion und Fazit ............................................................................................................................ 141 5 Schlusswort und Ausblick ................................................................................................................ 145 6 Literaturverzeichnis ........................................................................................................................... 146 7 Autoren ............................................................................................................................................... 154 8 Anhang ................................................................................................................................................ 158 8.1 Detaillierte Resultate: Bezüge und Kosten der wichtigsten therapeutischen Medikamentengruppen ..................................................................................................................... 158 8.2 Detaillierte Resultate: Bezüge und Kosten der wichtigsten Wirkstoffe ....................................... 160 8.3 Abbildungsverzeichnis ..................................................................................................................... 162 8.4 Tabellenverzeichnis ........................................................................................................................... 164 Helsana-Arzneimittelreport 2020 7 Vorwort In der mittlerweile siebten Auflage des Arzneimittelreports beleuchten wir den Schweizer Arzneimittelmarkt wiederum aus unterschiedlichen Perspektiven. Die Kosten für Medikamente beliefen sich 2019 auf 7.6 Milli- arden Franken. Damit hat sich die Kostenentwicklung für Arzneimittel stabilisiert. Eine eigentliche Trend- wende ist aber nach wie vor nicht in Sicht. Das Einsparpotential durch Biosimilars steigt weiter an. Leider wurde auch 2019 dieses enorme Einsparpo- tential für die obligatorische Krankenpflegeversicherung nicht genutzt, was vor allem dem Fehlanreiz bei den Vertriebsmargen geschuldet ist. Dringend notwendige Reformen in diesem Bereich bleiben weiterhin aus. Nach wie vor gehören die Krebs/Immunsystem-Mittel, gefolgt von Nervensystemmitteln und Stoffwechsel- präparaten zu den grössten Kostentreibern. Der Arzneimittelreport 2020 zeigt einmal mehr, dass die Kosten einzelner Arzneimittel ungebremst wachsen. Die Belastung des Gesundheitssystems muss bei der Preisbildung endlich eine Rolle spielen. Überraschend war, dass die Kosten für Impfstoffe gegenüber
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