Pharmaceutical Expenditure and Burden of Non-communicable Diseases in Serbia

In the lowand middle-income countries some non-communicable diseases (NCDs), such are cardiac diseases, strokes, chronic lung diseases, certain cancers, and diabetes, tend to overtake the morbidity and mortality of poverty diseases (Adams and Butterly, 2015; Jakovljevic and Getzen, 2016). Such diseases, conditionally labeled as diseases of affluence (Nutrition Health Topics, 2016), are growing rapidly in the developing countries, making almost 80% of deaths due to NCDs (New WHO report: deaths from noncommunicable diseases on the rise, with developing world hit hardest, 2011). Until a century ago, infectious diseases were the leading cause of morbidity and mortality worldwide. For example, in the United States at the beginning of the twentieth century, the crude death rate for the infectious diseases amounted to 800 per 100,000 population per year, reaching nearly 1000 during influenza pandemic at the end of the WWII. Afterwards, significant drop in the morbidity and mortality due to infectious causes was noticed, mostly as a consequence of a variety of the conducted preventive measures in sanitation and hygiene area, vaccination strategies and the development of different antimicrobial agents (Achievements in Public Health, 1900–1999: Control of Infectious Diseases, 1999; Wang et al., 2016). Due to the globalization, the flow rate of people, ideas and financial capital increased worldwide (Jakovljevic et al., 2016). Non-communicable diseases have achieved high morbidity and mortality rates, first in the developed (affluent) and afterwards in the lowand middle-income countries, dislodging the rich-countries exclusivity premise. On the contrary, the wealthier people live, socially and economically, the better their health (Fair Society Healthy Lives, 2010). Morbidity and mortality rates are rising faster in developing countries; inequalities in health access within particular country favor the growth of such rates (Human Development Report 2013, 2013). The chronic illnesses make a profound impact on patients and society, regarding complex and expensive treatment strategies, decreased quality of life and working disability. Most of them are treatable, but not curable, which additionally prolongs the enormous influence on the health funds (Jakovljevic and Milovanovic, 2015; EU Reflection on Chronic Disease, 2016). The objectives of this study were to estimate the impact of drug utilization related to NCDs on Serbian health funds, and compare it with the Gross National Income (GNI) per capita values for the observed period.