Pharmacoepidemiological research using French reimbursement databases: yes we can!

Martin-Latry, Karin; Bégaud, Bernard

doi:10.1002/pds.1912

Cited by 124 publications

(94 citation statements)

References 82 publications

(51 reference statements)

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“…Moreover, the analysis of the reimbursement database showed that Skenan was the first prescribed morphine sulfate in France during the period 2002–2007 [23]. This database includes dispensing of reimbursed drugs to all subjects enrolled in the general health insurance scheme, which covers approximately 74% of the French general population [24]. These data are not sufficient to explain why Skenan is the most abused morphine sulfate in France since morphine sulfate is widely prescribed for pain related to cancer.…”

Section: Discussionmentioning

confidence: 99%

Slow-Release Oral Morphine Sulfate Abuse: Results of the Postmarketing Surveillance Systems for Psychoactive Prescription Drug Abuse in France

Peyrière

Eiden²,

Micallef³

et al. 2013

Eur Addict Res

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Background: Few data are available concerning the diversion and abuse of morphine sulfate. In France, morphine sulfate abuse is currently investigated by the health authorities. The aim of our study was to provide data on morphine sulfate abuse in France, collected during the period 1996–2011. Methods: The French monitoring system for psychoactive medication abuse collected data from several sources: spontaneous reporting of cases of abuse or dependence (NotS; ‘Notifications Spontanées’), specific periodic surveys from specialized care centers (OPPIDUM; ‘Observation des Produits Psychotropes Illicites ou Détournés de leur Utilisation Médicamenteuse’), and community pharmacists (OSIAP; ‘Ordonnances Suspectes Indicateur d’Abus Possible’). Results: A total of 649 cases (75% men, median age: 34 years) were spontaneously reported: 578 cases of abuse and 71 cases of use as opiate maintenance treatment. The medication formulation was Skenan^® (614 cases), and Moscontin^® (35 cases). All surveys (NotS, OPPIDUM, and OSIAP) showed an overrepresentation of Skenan^® (87.9–94.6% of cases) that was intravenously injected in 60.4–61.2% of the cases. Data analysis showed that patients abusing morphine sulfate have a long history of drug abuse and a history of polydrug use. Conclusion: All the data presented in this study highlight the level of morphine sulfate abuse, specify the modalities of use (intravenous route), and show the risks associated with abuse (infectious diseases). This study outlines the usefulness of our epidemiological tools, and provides evidence supporting intensive surveillance.

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Section: Discussionmentioning

confidence: 99%

Slow-Release Oral Morphine Sulfate Abuse: Results of the Postmarketing Surveillance Systems for Psychoactive Prescription Drug Abuse in France

Peyrière

Eiden²,

Micallef³

et al. 2013

Eur Addict Res

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“…Indeed, Erasme includes a large population and most of the drugs marketed in France. Thus, this database has been extensively used for 20 years for epidemiologic and pharmacoepidemiologic research [24]. It is crucial to know the structure of a database, especially if it was not originally developed for pharmacoepidemiological research.…”

Section: Discussionmentioning

confidence: 99%

How reimbursement databases can be used to support drug utilisation studies: example using the main French national health insurance system database

Latry

Molimard

Bégaud

et al. 2010

Eur J Clin Pharmacol

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Introduction Reimbursement databases are potentially invaluable tools to develop and conduct pharmacoepidemiological studies on drug use. However, two types of factors that may influence the performance of a database can be distinguished: firstly, factors related to the constitution of the database, and secondly, factors related to the data. For the latter, we think that two are important: the presence of the drug in the database and the capacity to capture real-life use, both of which are influenced by the marketing status (e.g., OTC) and whether reimbursement is possible. Objectives To illustrate and discuss to what extent reimbursement databases are relevant tools to conduct drug utilization studies with regard to the data on drugs. Methods In order to illustrate the reliability of data in reimbursement databases, data from the main French national health insurance database (55 million individuals) were compared to national drug sales in France (units) during the same year. Results Depending on the ATC class, the capture in the database of drugs actually sold ranged from 32 to 81%. Discussion Capture of classes of drugs in the database may be explained by the specific characteristics of the French health insurance system (reimbursable drugs, OTC market share). These characteristics influence the studies that can be performed both in terms of the topic but also the methodology. This problem probably exists for the other reimbursement databases used worldwide. Conclusion Studies should be designed according to the strengths and weaknesses of reimbursement databases that were not originally developed for pharmacoepidemiology.

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“…Second, patients included in the study were a representative sample of the local population, as consecutive patients over a 7-month period within a given geographic area were included. Finally, the treatments studied here have a low or null proportion of over the counter, thereby implying a high degree of capture in the French national health insurance system database [18]. …”

Section: Discussionmentioning

confidence: 99%

“…It covers all the reimbursement data for all patients, including drugs and tests ordered by physicians and presented for reimbursement [16]. Organization of data collection and database has been described in detail previously [17, 18]. This database provides information on drug characteristics, number of purchases and dosage for each purchase.…”

Section: Methodsmentioning

confidence: 99%

Secondary Prevention Three and Six Years after Stroke Using the French National Insurance Healthcare System Database

et al. 2018

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Background: Secondary prevention is inadequate in the first 2 years after stroke but what happens after that is less documented. The aim of this study was to assess the use and the adherence to preventive drugs 3 and 6 years after experiencing a transient ischemic attack (TIA) or an ischemic stroke (IS). Methods: The population study was from the AVC69 cohort (IS or TIA admitted in an emergency or stroke unit in the Rhône area, France, for an IS or a TIA during a 7-month period). Medication use was defined as ≥1 purchase during the studied year and adherence as Continuous Measure of Medication Acquisition ≥0.8 using the French medical insurance health care funding database. Results: The study population consisted of 210 patients at 3 years and 163 patients at 6 years. Medication use at 3 and 6 years was, respectively, 80.9 and 79.8% for antithrombotics, 69.1 and 66.3% for antihypertensives, 60.5 and 55.2% for statins and 48.6 and 46.6% for optimal treatment defined as the treatment achieved by the use of the 3 drugs. Adherence to each class was good at 3 years and tends to decrease at 6 years. Conclusions: More than one patient out of 2 do not use the optimal preventive treatment.

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Pharmacoepidemiological research using French reimbursement databases: yes we can!

Abstract: The French reimbursement databases were greatly used over the last 20 years. They can provide data on exposure to drugs and can be used to study patterns of drug utilization although their limitations must be considered.

Cited by 124 publications

References 82 publications

Slow-Release Oral Morphine Sulfate Abuse: Results of the Postmarketing Surveillance Systems for Psychoactive Prescription Drug Abuse in France

Slow-Release Oral Morphine Sulfate Abuse: Results of the Postmarketing Surveillance Systems for Psychoactive Prescription Drug Abuse in France

How reimbursement databases can be used to support drug utilisation studies: example using the main French national health insurance system database

Secondary Prevention Three and Six Years after Stroke Using the French National Insurance Healthcare System Database

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