Comparison of drug prescribing before and during the COVID‐19 pandemic: A cross‐national European study

Abstract

Purpose The COVID‐19 pandemic had an impact on health care, with disruption to routine clinical care. Our aim was to describe changes in prescription drugs dispensing in the primary and outpatient sectors during the first year of the pandemic across Europe. Methods We used routine administrative data on dispensed medicines in eight European countries (five whole countries, three represented by one region each) from January 2017 to March 2021 to compare the first year of the COVID‐19 pandemic with the preceding 3 years. Results In the 10 therapeutic subgroups with the highest dispensed volumes across all countries/regions the relative changes between the COVID‐19 period and the year before were mostly of a magnitude similar to changes between previous periods. However, for drugs for obstructive airway diseases the changes in the COVID‐19 period were stronger in several countries/regions. In all countries/regions a decrease in dispensed DDDs of antibiotics for systemic use (from −39.4% in Romagna to −14.2% in Scotland) and nasal preparations (from −34.4% in Lithuania to −5.7% in Sweden) was observed. We observed a stockpiling effect in the total market in March 2020 in six countries/regions. In Czechia the observed increase was not significant and in Slovenia volumes increased only after the end of the first lockdown. We found an increase in average therapeutic quantity per pack dispensed, which, however, exceeded 5% only in Slovenia, Germany, and Czechia. Conclusions The findings from this first European cross‐national comparison show a substantial decrease in dispensed volumes of antibiotics for systemic use in all countries/regions. The results also indicate that the provision of medicines for common chronic conditions was mostly resilient to challenges faced during the pandemic. However, there were notable differences between the countries/regions for some therapeutic areas.

Trends in medication use at the onset of and during the COVID‐19 pandemic in the Republic of Ireland: An interrupted time series study

“…This may be attributable to intermittent supply shortages affecting ferrous fumarate during 2019 (noted as resolved in December 2019) and 2020 (resolved in August 2020) 19,20 . In our study, dispensing of medications for most common chronic conditions increased significantly, with generally similar increases across medication in most classes, and this was true of physical and mental health conditions and applied across oral medications, topical products, and inhalers, consistent with the literature 8,9,21 . This likely reflected individuals getting additional supplies of their regular medication due to concerns with regard to supply and fear of impending restrictions.…”

“…Potential evidence of stockpiling immediately before pandemic restrictions were implemented has also been identified in studies across multiple countries. 9 Respiratory medication for obstructive pulmonary disease as a subgroup, and individual medications, saw the largest peak in March 2020. The higher magnitude of peak for these medications may reflect greater precautions among people with existing respiratory conditions, given that COVID-19 is primarily a respiratory illness.…”

“…This study also identified increased dispensing of some medications, again proposed as potential stockpiling to reduce the need to visit healthcare professionals or to avoid medication shortages. 9 To date, how medication use changed in the Republic of Ireland following the onset of the pandemic has yet to be evaluated. Such an analysis provides a unique case given the strict and repeated lockdowns, of significant durations, and the length of data available now after the pandemic's onset.…”

The environmental impact of pharmaceuticals in Italy: Integrating healthcare and eco‐toxicological data to assess and potentially mitigate their diffusion to water supplies

“…The environmental risk was consistent throughout the years 2019, 2020 and 2021, with the only exception of sertraline in the sensitivity analysis (its risk was moderate in 2019 and 2020, and high in 2021). This consistency may be the result of a comparable consumption of these pharmaceuticals during the Covid‐19 pandemic 47 …”

“…This consistency may be the result of a comparable consumption of these pharmaceuticals during the Covid-19 pandemic. 47 The main challenges in this work concerned data retrieval, which required extraction from multiple heterogeneous sources. The FASS website provided information in Swedish, while some chapters of the OsMed reports were in Italian only.…”