Patterns of prescription dispensation and over-the-counter medication sales in Sweden during the COVID-19 pandemic

Abstract

Introduction On February 26th 2020, a high alert was issued in Sweden in response to the diagnosis of the first few coronavirus disease 2019 (COVID-19) cases in the country. Subsequently, a decreased supply of essential goods, including medical products, was anticipated. We aimed to explore the weekly patterns of prescription dispensing and over-the-counter (OTC) medication sales in Sweden in 2020 compared with previous years, to assess the influence of the government restrictions on medication sales, and to assess whether there is evidence of medication stockpiling in the population. Methods Aggregated data on the weekly volume of defined daily doses (DDDs) of prescription medication dispensed and OTC sales from 2015 to 2020 were examined. From 2015–2019 data, the predicted weekly volume of DDDs for 2020 was estimated and compared to the observed volume for each ATC anatomical main group and therapeutic subgroup. Results From mid-February to mid-March 2020, there were increases in the weekly volumes of dispensed medication, peaking in the second week of March with a 46% increase in the observed versus predicted number of DDDs dispensed (16,440 vs 11,260 DDDs per 1000 inhabitants). A similar pattern was found in all age groups, in both sexes, and across metropolitan and non-metropolitan regions. In the same week in March, there was a 96% increase in the volume of OTC sold (2,504 vs 1,277 DDDs per 1000 inhabitants), specifically in ATC therapeutic subgroups including vitamins, antipyretics, painkillers, and nasal, throat, cough and cold preparations. Conclusion Beginning in mid-February 2020, there were significant changes in the volume of prescription medication dispensed and OTC drugs sold. The weekly volume of DDDs quickly decreased following recommendations from public authorities. Overall, our findings suggest stockpiling behavior over a surge in new users of medication.

Over the counter drugs and self-medication: A worldwide paranoia and a troublesome situation in India during the COVID-19 pandemic

“…A similar number (88.3%) was observed in Bangladesh, with most people using ivermectin, and even doxycycline without prescription [ 17 ]. So widespread was the scare among the masses that even countries like Sweden and Poland reported of people self-medicating themselves [ 7 , 18 ].…”

“…The developed countries have very few OTC drugs available for sale because of strict rules, easy and free basic healthcare for everyone, and control of the government over the sale of drugs. Despite this the sale of OTC drugs has not been stopped in developed countries like Sweden where the two-third increase was seen in the sale of OTC drugs during the COVID-19 pandemic [ 7 ]. The main reasons for this were stockpiling of medicines due to fear of lockdown, a strong desire to treat the symptoms of minor ailments themselves to avoid getting exposed to COVID-19 by visiting a hospital and using OTC drugs for prophylaxis against COVID-19 infection.…”

Antimicrobial use in Sweden during the COVID-19 pandemic: prescription fill and inpatient care requisition patterns

“…The Swedish Medical Products Agency issued early warnings of and instituted counter measures to foreseeable drug shortages [ 9 , 10 ] and unrecommended antimicrobial use accordingly [ 11 ]. However, unprecedented dispensing of chloroquine and hydroxychloroquine had already been detected on one hand [ 12 ], and on the other, antibiotic prescription fills were reportedly significantly lower during this first wave of the pandemic compared to the same period in pre-pandemic years [ 13 ]. The dynamics of these earlier observations and the impact of the pandemic on the use of other antimicrobial agents are limited and warrant further evaluation, particularly in light of the resurgence of COVID-19 cases since the summer of 2020.…”

Changes in dispensing of medicines proposed for re-purposing in the first year of the COVID-19 pandemic in Australia

“…Stockpiling has been observed internationally as well. [20,21] While to our knowledge there have been no reports of people with legitimate needs for these medicines being unable to access them, [22] nor increases in adverse events, stockpiling does put pressure on medicine supply and may exacerbate shortages. This is particularly true during crises such as the COVID-19 pandemic which led to disruptions of the global supply chain through lockdowns, understaffing and travel bans.…”