OBJECTIVE: To analyze utilization trends in GLP-1 RA in BH and regional differences in reimbursement status of these drugs.

METHODS: We have analyzed volume and value trends of registered GLP-1RA utilization based on available drug utilization reports and reimbursement lists from national drug agency and health insurance funds in period 2015-2019.

RESULTS:

In BH the first registered GLP-1 RA was liraglutide in 2011, followed by lixisenatide in 2014 and dulaglutide in 2015 and semaglutide in 2019. Time from marketing authorization to reimbursement was 3 years on average.

Total consumption in value and volume is constantly growing. In 2019 consumption of GLP-1RAs was 4.2 million euros, where liraglutide contributed with 3.3 mEUR, dulaglutide with 0.6 mEUR and lixisenatide with 0.3 mEUR.

Market leader is liraglutide followed by dulaglutide while lixisenatide is least prescribed in the class. Due to decentralized health care system and presence of 13 reimbursement lists access to GLP-1 RAs across the country is different. Different prescribing limitations are introduced like BMI, specialists` prescription only or hospitalization.

CONCLUSIONS:

Consumption of GLP-1RA drug class is growing and majority of them are registered in Bosnia and Herzegovina. Different delay in market access after granting national registration is noticed ranging from 1-4 years. Market leader is liraglutide. Majority of regional HIFs reimburse these drugs but under different prescribing limitations which are introduced in order to control prescribing costs, but still did not slow prescribing trends and uptake.

It is expected that prescribing and utilization of these drugs will continue to grow in next years, especially when new products grant market access.