In the current and exceptional health context, this work quantifies the evolution of the use of drugs prescribed in association or not with Covid-19 in France since the beginning of the panpidemic.
Based on reimbursement data from the National Health Data System (SNDS), the number of users by therapeutic class was measured each week from the beginning of January to the end of March 2020, and this observed number was compared to the “expected” number of consumers for the period since March 2020.
Weeks 12 (March 16-22, 2020) and 13 (March 23-29, 2020), which correspond to the first two weeks of confinement, were marked by very strong growth of prescription drugs delivery in pharmacies for the treatment of chronic disease (medicines for cardiovascular pathologies, diabetes, mental disorders in particular). This increase is much higher than what would have been expected in the usual situation, with an increase in the number of patients having had a delivery reaching + 20 to + 40% depending on the therapeutic classes. Thus, nearly 600,000 additional people went to the pharmacy for the delivery of an antihypertensive agent in week 12 and +470,000 additional people in week 13. The numbers reach 230,000 and 175,000 respectively for antidiabetics, and 270,000 and 220,000 for statins. For the drugs of mental disorders the increase was of a lesser amplitude but nevertheless reached + 22% for the antidepressants in week 12, that is to say +182,000 people, and + 21.5% for the antipsychotics in week 13, that is + 50,000 people. The increase also concerned HIV antiretrovirals (+ 32% in week 12), antiparkinsonian drugs (+ 20%), antiepileptics (+ 25%), products based on levothyroxine (+ 41%), treatments for diseases obstructive breathing (+ 46%), and proton pump inhibitors (+ 17%). Oral contraception also saw a marked increase (+ 45.3% in week 12, + 140,000 women).
Conversely, the dispensing of drugs whose administration requires a health professional decreased in weeks 12 and 13. This includes vaccines (- 50 to – 70% for HPV vaccines, MMR and tetanus vaccines and – 23% for penta / hexavalent vaccines for infants on week 13), anti-VEGF indicated by intraocular injection in the treatment of age-related macular degeneration (- 13% on week 12 and – 40% on week 13), IUDs with progestogen (- 10% in week 12 and – 59% in week 13) and products intended for medical diagnostic procedures (preparations for colonoscopy, iodized products for scanner, contrast media for MRI) dropped 20% in week 12 and 60% in week 13.
For drugs linked to Covid-19, paracetamol deliveries were higher than expected, starting in February 2020, reaching an increase of 1.5 million people in weeks 12 and 13. However, NSAID deliveries fell sharply in week 13 (- 60%, or -500,000 people). This phenomenon is largely explained by the drop in the delivery of ibuprofen drugs (widely used for its antipyretic properties), probably in connection with the warning concerning the use of anti-inflammatory drugs issued by health authorities. The number of people with a prescription for Chloroquine / Hydroxychloroquine has increased significantly, particularly in Île-de-France and Provence-Alpes-Côte d’Azur areas: from the end of February for chloroquine, with a peak on February 27; and from week 10 for hydroxychloroquine (+ 21% in week 10 then + 70% and + 145% in weeks 12 and 13).
Our results highlight a phenomenon of “storage” for the treatments of chronic pathologies during the second half of March as observed in other areas of consumption. Having enough active drugs, however, does not mean that the fine therapeutic adaptations of the doses necessary for certain treatments, such as insulin, anticoagulants and antihypertensive drugs have been made. There is a very strong decrease in products that require administration by a healthcare professional, in particular vaccines – possibly reflecting a delay in the vaccination schedule – but also products for colonoscopies, scanners and MRIs. These non-performed examinations, essential for diagnosing certain cancers or serious illnesses, could lead to delays in treatment if the situation were to continue.
In addition, this study provides specific information on the products prescribed in connection with SARS-CoV-2 infection (paracetamol, chloroquine, hydroxychloroquine and azithromycin). This follow-up from reimbursement data is important and will be continued in the next weeks.
Find the study report about the drug use in France during the Covid-19 pandemic – Update on the first two weeks of confinement.