Croatia has 4.8 million inhabitants, 11,800 physicians, 2000 pharmacists, two now shareholding, pharmaceutical companies (about 6500 employees, total sales of about $350 million). There are a number of problems due to the war (GNP fell from $3800 to about $1500), occupation of 25% of its territory, 0.5 million refugees and lack of resources (US$139/capita for health, about $40 i.e. 30%!! for drugs) Ð about three times less than before the aggression. The drug situation is controlled with the help of: (1) donations (approximate value of $600 million since 1991 from Europe and US), (2) (essential) drug formularies Ð 250 for outpatients, and 580 generic names for various levels of hospital use, (3) special eorts to purchase drugs of good quality at a reasonable price (a kind of tender), (4) control of prescribing (prescriptions, specialists referral) especially by GPs. A new Medicines Act is in preparation and about 1000 generic names are on the market.
Drug education Ð Pharmaca: the Croatian journal of pharmacotherapy has been published since 1962, there are several Drug bulletins (one published since 1975); special chapters on clinical pharmacology in textbooks, translation of three editions of Laurence's textbook with special commentary and adaptation to local needs; ADR spontaneous and intensive monitoring (WHO programme) with a personal feedback to the reporters and regular articles on drug use in a number of periodicals. Data on drug consumption indicates that there is room for improvement of prescribing. There is an enthusiasm for `vasoactive drugs' Ð after dipirydamole came oxpentifylline and antimicrobials are always overprescribed. All these problems will hopefully decrease when the war ®nally stops and when industry (especially tourism) starts being fruitful again. In any case the importance of teaching of pharmacotherapy at the under-and postgraduate level should be recognized.