Sweden is known as a country with a high life expectancy and the fantastic welfare system. It serves as a shining example to politicians in other European countries writes André Sjöblom, expert of the Swedish dose dispensing wholesalers – Svensk Dos.
In 2019, the life expectancy of the average Swedish person increased to 82.72 years, a 0.18% increase from 2018. Living longer increases the risk of illness and disease, requiring medication.
Medicines can help people maintain a healthy life, but often patients do not adhere to what the doctor or pharmacist recommends. The reason behind this is that as people get older, it is more frequent that they need to be prescribed a variety of medicines to be taken at once. The Swedish National Board of Health and Welfare 2018 report shows an increase of nearly 10% on the number of drugs that a person over 75 years old is prescribed since 2005. This is due to the advances in medicines where patients are better diagnosed, more treatments to various illnesses exist and people have more confidence in doctors. The survey also shows that 85% of this category of patients use at least one drug every day, while one in two patients take at least four drugs daily,1 which makes the medication adherence even more challenging.
Out of these poly-medicated elderly patients over the age of 75 years, approximately 35,000 patients must be admitted to hospitals each year as a result of incorrect drug use and too many die unnecessarily. The costs to the Swedish government, in the form of health care and sick leave due to incorrect use of medicines, is estimated around SEK 10-20 billion every year, which is around the same amount that all European nations need daily to comply with the Paris deal and cut emissions to net zero by 2050.
Elderly patients are not the only hospitalized due to non-adherence to medication or dosage errors. Every year, 30,000 people in Sweden suffer from strokes. High blood pressure, high cholesterol levels and diabetes are some of the risk factors for stroke. Many of those who take medication for these maladies often do not consume their medicines properly, increasing the risk of having a stroke. The costs for a patient that suffer a stroke is estimated at approximately SEK 750,000 and the government pays approximately 30 times that each year. For each patient that avoids the stroke due to compliance to its medication, the state can employ 20 nurses with an average salary each year. Hospitalization of chronic obstructive pulmonary disease (COPD) is also recurrent in Sweden and costs the government huge sums in health care expenditures. Today, there are between 500,000 and 700,000 people suffering from COPD in Sweden4. Nearly 1 in 2 patients who take COPD and asthma drugs do not adhere to their treatment. Combatting this trend could save more than SEK 9 billion in direct healthcare costs5 each year, which can be reinvested in health technology.
The costs that the government invests annually in the healthcare of patients that do not adhere to their medication can be easily saved with implementing dose dispensing at national level. Patients and healthcare providers both can gain from the use of such a tool, especially because recent findings from the Swedish Institute of Health and Medical Economics shows that dose dispensing saves about 11 minutes per dose patient per week for nurses. This means better care for patients as the nurses can dedicate more time to their treatment. ~
The reason why many people forget to take their medicines or take them incorrectly is because they have to take several drugs at various times many times a day. Dosage or dose-dispensing system makes medication adherence easier. In dose dispensing, all daily doses of medicines are packed in pouches for each patient in most of the cases with the help of an automated dose dispensing machine, which ultimately verifies that the patients adhere correctly to its health care plan. Patient safety improves with each dose taken on time and as prescribed. In countries such as the Netherlands or the UK, dose dispensing has been proved to be an effective way to simplify medicine management for healthcare professionals and to streamline and reduce overall healthcare costs. Provided dose dispensing is recommended by all doctors in Sweden, billions of krones can be saved and reinvested in health technologies and tools that help diagnose malignant tumors invisible to the naked eye, that cannot be treated with daily pouches.
We call for national and European authorities to take more concrete measures to reduce the wrong medication and to create greater security for patients. The dose dispensing systems could take a bigger role in the healthcare chain – but it requires more resources for information and advice as well as closer collaboration between all players in the health-care chain.