EPI-PHARE publishes the results of a pharmaco-epidemiological study on the dispensation of reimbursed prescription drugs in pharmacies during the lockdown and post-lockdown periods, from March 16 to September 13, 2020.
Based on the data from the French National Health Data System (SNDS), this study aims to characterize the consumption behavior of the population towards drugs prescribed in town, whether or not linked to Covid -19, in the particular context of the Covid-19 epidemic and confinement. Based on the analysis of 3 billion prescriptions lines, it compares, for 58 therapeutic classes, the number of people who have had a dispensation of reimbursed prescription drugs in pharmacies every week since March 2020 with the “expected” number estimated on the basis of the same period in 2018 and 2019.
This report, which covers the period of national lockdown (weeks 12 to 19 from March 16, 2020 to May 10, 2020) and post-lockdown until September 13, 2020, shows that the Covid-19 pandemic with all its organizational consequences structures in the healthcare sector and on the population in general has profoundly destabilized the consumption of drugs in France.
At the beginning of the lockdown from March 16 to 29, a phenomenon of storage for drugs of chronic cardiovascular pathologies and diabetes (patients already treated) was observed. This phenomenon of storage was followed by under-consumption before a return to more standardized consumption in most therapeutic classes at the end of the lockdown, with the notable exception of statins and anticoagulants with a sharp drop in deliveries on this period of lockdown and post-lockdown. For anticoagulants, this decrease is probably linked to the postponement of many surgical procedures requiring this type of treatment. The initiation of treatments for cardiovascular pathologies and diabetes (new patients), however, declined sharply during lockdown. Over a six-month period from mid-March, the drop in initiations reached or exceeded -10% compared to the previous year for statins, furosemide in the treatment of heart or renal failure, anti-aggregants platelets, converting enzyme inhibitors initially suspected of promoting Covid-19 and anticoagulants. A more or less significant deficit in the initiation of treatments (new patients) is observed according to the other therapeutic classes, for example the decrease in the initiation of insulin (-2%) and antihypertensives in general (-4%) was low.
Overall, for the chronic pathologies already treated there was no noticeable lack of medication, probably because patients were allowed to use “expired” prescriptions but also thanks to the use of teleconsultations. Certain drugs such as NSAIDs (not recommended with Covid-19), antiulcer drugs such as proton pump inhibitors, oral corticosteroid therapy, paracetamol and antibiotics (J01 class) have on the other hand seen a marked collapse in their deliveries. However, two therapeutic classes of drugs for mental disorders, anxiolytics and hypnotics, have seen their consumption and initiation persistently increased during and after lockdown. This increase likely reflects the significant psychological impact of the Covid-19 epidemic and its social, professional and economic consequences.
This study also confirms a very sharp decrease in the delivery and use of products that require administration by a healthcare professional, such as vaccines and products for medical diagnostic. This collapse in consumption over the entire period of lockdown and after has not been remedied to date and the delay cannot be made up in 2020. The fall in consumption of products for medical diagnostics by imaging , essential for diagnosing certain cancers or serious diseases on the rise, lead the entire oncology and specialty medicine sectors with significant delays in treatment.
Since the start of the lockdown, EPI-PHARE has been monitoring the consumption of the entire population in France of prescription drugs dispensed in cities in France, using data from the National Health Data System (SNDS). This monitoring using health insurance reimbursement data is essential and will be continued until a return to a normalized situation. It is important in several fields, in particular for vaccines and products intended for diagnosis and prevention, for chronic diseases at risk of severe complications, for psychiatric diseases, or other diseases at risk of decompensation by lockdown.
Find the report of the study on the Drug use in France during the Covid-19 pandemic – Update until September 13, 2020