IntroductIon Primary nonadherence to medication occurs when a patient does not fill a prescription and often leads to suboptimal patient outcomes, lost productivity, and increased net costs. Pilot introduction of electronic prescriptions (e-prescriptions) in Poland took place in 2018, enabling nationwide assessment of primary nonadherence. objEctIvEs To determine the prevalence and drivers of primary nonadherence in Poland. MEthods This retrospective analysis included data from all e-prescriptions issued in Poland in 2018. Primary nonadherence was defined as not filling a prescription within 1 month from the date of issuing. rEsuLts Out of all 119 880 e-prescriptions issued in Poland in 2018, 94 913 were filled, thus the primary nonadherence rate reached 20.8%. Although no differences in primary nonadherence were observed between sexes, age was found to have a significant effect, with older groups showing lower rates of primary nonadherence. In addition, slightly lower rates of primary nonadherence (17.0%) were found for e-prescriptions issued for selected drugs of key importance (n = 47 492). Multivariable analysis performed within this subset showed that those aged ≥75 years had the lowest odds for nonadherence (odds ratio, 0.55; 95% CI, 0.48-0.64). Differences in primary nonadherence rates were observed across therapeutic areas (lowest value in antibiotics, 14.3%), drug classes (lowest value in sulfonylureas, 13.2%), and individual drugs. Primary nonadherence rates were lower for drugs covered by the "Leki 75+" program, which makes them free of charge for those aged 75 years or older. concLusIons A high percentage of prescriptions issued in Poland are never filled. E-prescriptions allow the identification and analysis of drivers of this phenomenon. Our findings may help designing national health and medicine policies.

Background: In allergic conditions such as allergic rhinitis and urticaria, orally administered H 1 -antihistamines belong to first-line therapy and therefore, are widely prescribed. Due to the frequent, and often chronic, course of allergic diseases, adherence is of great importance. In 2018 a novel, nationwide e-prescription system was piloted in Poland, which allowed to analyze primary non-adherence to orally administered H 1 antihistamines.Objectives: To assess the primary non-adherence to orally administered H 1antihistamines in Poland, defined as not redeeming the drug issued on a particular eprescription within its validity period. Methods:The study was based on all e-prescriptions issued in Poland in 2018, issued for 119.880 drugs. The analysis included nine major orally administered H 1 antihistamines available in Poland.Results: Out of 2280 analyzed e-prescriptions on orally administered antihistamines, 1803 (79.1%) of them were redeemed. Therefore, the level of primary non-adherence reached 21%. Among women it reached 19.9%, but it was not significantly lower than among men (23.4%, p=0.064). The highest non-adherence (31.3%) was observed in the age group 19-39, whilst the highest adherence rate (84.6%) was observed in those 75 years or older. The most frequently prescribed second-generation antihistamine was bilastine-596 e-prescriptions with 23.7% primary non-adherence.Conclusions: More than 1 out of 5 e-prescriptions on orally administered H 1antihistamines were not redeemed in Poland in 2018. Age, but not gender, significantly influenced the degree of primary non-adherence to these drugs. To authors knowledge, this is the first real-life study on primary non-adherence to H 1 -antihistamines in Poland and one of the very few on this subject worldwide.

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event rate reduction was based on the rate ratio obtained from the ODEYSSEY outcomes study. Model inputs were retrieved from literature and validated by key-experts through face-to-face interviews. Results: The BI analysis demonstrated that the "with PCSK9i" scenario resulted in an increase of 6.1% (SAR 91.16 million) in the budget of Hypercholesterolemia management compared to the "without PCSK9i" scenario. The overall increase was partially offset by SAR 13.5 million reduction in CV events from 0.3% (year 1) to 1.5% (year 5). Conclusions: Introducing PCSK9i as an add-on therapy for the management of CHD patients with uncontrolled LDL-C would reduce CV events and could likely be associated with a steady increase in the MoH budget in KSA triggering restriction to certain patient pool and innovative entry agreement.