Abstract

Objectives

The retail market represents 60% of the pharmaceutical market in Chile. Medicines for diabetes, dyslipidemia, and hypertension are among the most commonly used by the Chilean population, and these conditions have been central to health policies aimed at improving access and coverage. This study aimed to analyze the effects of the implementation of the Explicit Health Guarantees program and the Pharmaceutical Fund on retail sales of drugs for hypertension, diabetes, and dyslipidemia.

Methods

Drugs related to the 3 conditions were classified using Anatomical Therapeutic Chemical codes. Interrupted time-series analyses were conducted to identify changes in retail sales trends (physical and monetary units) between 2000 and 2020. Key drugs for each condition were also analyzed in greater detail.

Results

From 2000 to 2020, hypertension drugs dominated sales in physical units, whereas since 2016, diabetes drugs have led in monetary terms. After the Explicit Health Guarantees program was introduced in 2005, sales in physical units rose for diabetes (trend) and dyslipidemia drugs (trend and level). Monetary sales declined for hypertension (level and trend) and dyslipidemia (level) and increased for diabetes (trend). In 2014, with the Pharmaceutical Fund, sales in physical units decreased for dyslipidemia (trend) and increased for hypertension (level). In monetary terms, dyslipidemia sales declined (trend), and hypertension sales rose (level and trend). Brand-name drug preference in retail remains strong, even when multiple unbranded generics are available, such as metformin, losartan, and atorvastatin.

Conclusions

Despite public-sector policies, retail sales of these drugs increased over time, although growth slowed during the second decade.