Regional Differences in Prescribing Patterns of Metamizole in Germany Based on Data from 70 Million Persons

Abstract

The non-opioid analgesic metamizole (dipyrone) is commonly used in Germany despite its narrow indications and market withdrawal from several countries. In this study we analyzed prescribing patterns of metamizole focusing on regional differences. The source of data was the “Information system for health care data” which includes data from the statutory health insurance funds for about 70 million Germans. We received aggregated data of individuals with at least one metamizole prescription in 2010 as well as the number of prescribed packages by age, sex, state and district along with the number of insured persons in each stratum. We calculated prescription prevalence stratified by age, sex, state and district. Among 68.4 million insured persons (mean age: 43.6 years; 53.0% female) 5.5 million received at least one metamizole prescription (8.1%, overall 12.2 million packages). Prevalence increased with age, and women received metamizole more often than men. In adults (total prevalence: 9.4%), levels varied between 7.0% (Saxony) and 11.1% (Schleswig-Holstein), whereas on a district level use ranged from 4.3% to 14.3%. In 2010, one of 12 individuals received metamizole at least once. Noticeable were the large regional variations which certainly cannot be explained by patient-related factors.

Prescribing Pattern of Analgesics in Colombia. Are there Differences between Capital Cities and Municipalities? A Cross-Sectional Study

“…They are currently not included in the list of essential medicines [ 33 ]. Some studies have shown that the frequency of use and prescription patterns of analgesics vary according to the geographical area of each country [ 34 – 36 ], which was also seen in this report. No published studies comparing the prescription patterns for analgesics between a country’s capital cities and municipalities were found; however, in Germany, Hoffmann et al .…”

“…They are currently not included in the list of essential medicines [33]. Some studies have shown that the frequency of use and prescription patterns of analgesics vary according to the geographical area of each country [34][35][36], which was also seen in this report.…”

Antidepressant drug use and regional prescribing patterns in Germany: results from a large population-based study

“…Previous analyses on regional variations in drug use in Germany in particular on a state level are scarce (Müller-Nordhorn et al , 2005; Kern et al , 2006; Windt, Glaeske and Hoffmann, 2013). A recent study that equally to our study was based on the DIMDI data showed east-west differences in prescribing patterns of metamizole (Hoffmann et al , 2020) similar to our results for an antidepressant. Nevertheless, observed east-west disparities depend on the kind of drug class that was considered.…”

Metamizole (dipyrone)

“…Míra analgetického účinku umísťuje metamizol do prvního stupně WHO analgetického žebříčku (10). Při jednorázovém nebo krátkodobém podávání u akutní bolesti je účinnost metamizolu srovnatelná nebo vyšší než účinnost paracetamolu a kyseliny acetylsalicylové ve stejných dávkách (11)(12)(13)(14)(15)(16).…”