gms | German Medical Science

Background and aim: Medication claims data of several statutory health insurances (SHIs) have been increasingly used for research purposes over the last years. However, these data might have several limitations, e.g. private prescriptons (Privatverordnungen) are undocumented because these information are not recorded in insurance claims data. Any doctor can provide private prescriptions for prescription drugs. They are fully funded by the patient. This may be a reason why physicians prescribe drugs that are associated with abuse and dependence more frequently on private prescriptions. The aim of this study was to analyse the amount of private prescriptons of zolpidem and zopiclone (Z-drugs) over a period of 15 years in Germany.

Material and method: We compared utilization data from statutory health insurance claims with wholesale sales data from community pharmacies for the years 1993–2007. The differences between both databases were assumed to be private prescriptions [1].

Results: Throughout 1993 and 2007, purchased packages of zolpidem (1.4 million to 3.7 million) and zopiclone increased (0.8 million to 3.9 million). A rising proportion of additional private prescriptions for zolpidem resp. zopiclone has been written between 1993 (+6 resp. +6%), 1999 (+43% resp. +34%) and 2007 (122% resp. 72%).

Conclusions: Z-drugs, and especially zolpidem, are increasingly dispensed on private prescriptions over the last years. However, transactional data captured at the point as drugs move from wholesalers to pharmacies are only a proxy of use. Private prescriptions are not recorded in SHI claims data. This should be considered when analysing drugs that might have an abuse and dependence potential.