From the survey • The low number of respondents with diabetes other than type 1 diabetes stymies any discussion of access for all people with diabetes. • A minority of survey respondents reported having difficulties obtaining their diabetes products within the last two years – a pattern confirmed by healthcare professionals. o The small number of difficulties reported arose mostly due to occasional stock issues, which were resolved quickly and without causing disruption to treatment. • No significant differences were reported between respondents in terms of access issues. • Diabetes education and information about treatment was universal among the people surveyed but far less common among their relatives. • The majority of respondents reported not having to pay for their diabetes medicines or devices.
SLOVENIA
H HH
Healthcare expenditure profile (2011)2
Key background information: country health system
27%
Total health expenditure per capita: USD 2,218.50 Proportion of government expenditure on health: 13%
73%
Public expenditure Private expenditure Out-of-pocket expenditure represents 48% of private spending on health
Health system overview
- The mandatory health insurance, administered by the Health Insurance Institute of Slovenia (HIIS), covers the entire population. The care package is defined by law.3 - The majority of people also subscribe to voluntary health insurance, which provides additional coverage (through reduced co-payments and/or additional services).3 - Medicines and medical devices are supplied mainly by private actors,5 following Ministry of Health rules – and in line with EU regulation.3,5 A specific agency ensures the application of these regulations.3,4,5 - A quality issues reporting system is in place.6
Diabetes prevalence (2011)1
Key diabetes data
IDF Atlas
National Data
10.3% of 20-79 year-olds
Official records: 6.25% of the total population
Diabetes care procedure
- Diabetologists prescribe for people with type 1 diabetes and people with complications; GPs prescribe for other people with diabetes.6 - Diabetes associations, pharmacists and the manufacturers of medical devices are the principal providers of diabetes information and advice about treatment.6 - Diabetes supplies are dispensed mostly at pharmacies.6 Some medical devices can be dispensed by the manufacturer or importer.5
Presence of products at national level
• At least one product from each of the categories surveyed was reported authorised for sale and present in the country.5,6
Availability
Guidelines and specific prescription criteria
• Slovenia has national guidelines for diabetes care.1,5 • Control over the use of medicines and medical devices is maintained through reimbursement (see Affordability)5,6 o It appears that the prescription of diabetes products is mainly left to each physician’s medical judgement; a small number of products have specific prescription criteria. o DPP4 inhibitors can be prescribed only to people with type 2 diabetes.5 o Insulin pumps are to be primarily prescribed to people with type 1 diabetes, mainly children, pregnant women, and people with complications or poor blood glucose control with conventional insulin therapy.1,5,6 o Due to reimbursement constraints, blood glucose-monitoring devices are prescribed almost exclusively to people on insulin.5,6
Use 89
• According to the Health Insurance Institute of Slovenia’s data, 42.4% of people with diabetes are on oral medication, 12.8% on insulin, and 8.4% on a combination of both.1 • Pens are the most widely used insulin injection device.5