gms | German Medical Science

28th Annual Meeting of the German Drug Utilisation Research Group (GAA)

Gesellschaft für Arzneimittelanwendungsforschung und Arzneimittelepidemiologie

11.11. - 12.11.2021, digital

Corona pandemic-related differences in drug prescriptions within the outpatient treatment of the Statutory Health Insurance in Schleswig-Holstein from 2019 until 2020

Meeting Abstract

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Gesellschaft für Arzneimittelanwendungsforschung und Arzneimittelepidemiologie e.V. (GAA). 28. Jahrestagung der Gesellschaft für Arzneimittelanwendungsforschung und Arzneimittelepidemiologie. sine loco [digital], 11.-12.11.2021. Düsseldorf: German Medical Science GMS Publishing House; 2021. Doc21gaa15

doi: 10.3205/21gaa15, urn:nbn:de:0183-21gaa156

Published: November 10, 2021

© 2021 Schuster et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.


Outline

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Background: The Covid-19 pandemic is a major challenge for life scientists, physicians, politicians and many other social groups. The corona pandemic affects the supply of drugs. This has an effect on the health of patients, esp. on the resistance to infection and therefore on the course of the pandemic. Drug prescription data in outpatient treatment (regulated by § 300 SGB V (Volume V of the Social Insurance Code in German Law)) are nowadays not only used for administrative purposes but also for epidemiological analysis, which is essential for the negotiations between the contract partners (statutory health insurance (SHI) funds, the association of SHI-accredited physicians and hospitals) as well as contract controlling and the counselling of physicians.

Materials and Methods: Approx. 2 m. patients with 25 m. patient-related prescriptions in Schleswig-Holstein have to be combined with the master data (pharmaceutical database of ~200,000 products). The number of patients having at least one drug prescription, the total costs and the costs per patient in comparison of 2019 and 2020 are monthly considered. The drug classification used is the international ATC-system (Anatomic Therapeutic Chemical) with German specifications provided by the German Institute of Medical Documentation and Information (DIMDI) which is now a part of the Federal Institute for Drugs and Medical Devices (BfArM). The large amounts of data have been reorganized, joined and analyzed with the help of script languages (perl, awk).

Results: In March, an anticipatory effect and stockage could be observed both in the number of prescription patients and costs. The costs per prescription patient also had a maximum, which could almost be observed again in December because stocks were independent of the corona pandemic. April saw the biggest decline in the number of prescription patients. An interim recovery could be observed in June. Throughout 2020 drug costs rose below-average (3.6%). The number of prescription patients per month decreased by 2.8%. Apart from changes in the demand profile over time, the corona pandemic had limited impact.

It is also interesting to see if significant changes can be observed at the ATC drug group level. For this purpose, the 5 strongest deviations upwards and downwards are considered, whereby only ATC4 drug groups are included, for where there were at least 1,000 prescription patients in 2019 and the expenditures accounted for at least 1 million Euros (0.07% of the total expenditure). Apparent in Table 1 [Tab. 1] is the clear drop in the prescriptions for cold medicines.

The largest decreases are found in the ATC group R05D (–46.0%, COUGH SUPPRESSANTS, EXCL. COMBINATIONS WITH EXPECTORANTS), J01F (–39,6%, MACROLIDES, LINCOSAMIDES AND STREPTOGRAMINS), R05C (–34,4%, EXPECTORANTS, EXCL. COMBINATIONS WITH COUGH SUPPRESSANTS), J01C (–28,5%, BETA-LACTAM ANTIBACTERIALS, PENICILLINS) and J01M (–27,6%, QUINOLONE ANTIBACTERIALS). Three of these groups are subgroups of the ATC3-group J01 (ANTIBACTERIALS FOR SYSTEMIC USE) and two of them are derived from R05 (COUGH AND COLD PREPARATIONS).

The largest increases can be found in the Pseudo-ATC group QS36 (+39,0%, CYTOSTATIC MIXTURES), the ATC group C03B (+24,7%, LOW-CEILING DIURETICS, EXCL. THIAZIDES), S01L (+17,8%, OCULAR VASCULAR DISORDER AGENTS9, H05B (+10,9%, ANTI-PARATHYROID AGENTS) and M03A (+10,6%, MUSCLE RELAXANTS, PERIPHERALLY ACTING AGENTS).

Conclusion: Throughout 2020 drug costs rose below-average (3.6%). The number of prescription patients per month decreased by 2.8%. Apart from changes in the demand profile over time, the corona pandemic had limited impact on drug prescriptions. If the timely detection of new diseases, e.g. in the cardiovascular or oncological area, combined with effects on the supply of pharmaceuticals, was reduced by the pandemic, cannot be determined from the data examined. This requires a combined investigation based on drug and diagnostic data, which will be the subject of further research.

Figure 1 [Fig. 1]


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