RESUMEN
Depression is one of the leading causes of disability worldwide, affecting 121 million people in whole world. In many developed countries, the number of prescriptions for antidepressants increased steeply during the 1990s. The objective of the present study was to evaluate the antidepressant prescribing patterns in all regions of Lithuania during 2003-2004, to analyze the use within different antidepressant groups, and to examine trends in age- and gender-specific antidepressant use. Antidepressants were classified into three groups according to Anatomic Therapeutic Chemical (ATC) Classification specifying the defined daily doses. The results of our study show an increase in the use of reimbursed antidepressants except tricyclic in 2004 when compared to 2003. Increase in the use of selective serotonin reuptake inhibitors and other nontricyclic antidepressants is probably related to their better tolerability, improved risk-benefit ratio, and less toxicity in overdose. There was no increase in the percentage of consumed selective serotonin reuptake inhibitors in elderly patients when compared with younger ones, despite elderly patients are most likely to benefit from reduced sedation, less antimuscarinic and less cardiac toxicity of selective serotonin reuptake inhibitors. The prevalence of the antidepressant use is the highest among middle-aged people (40-59 years), while the young (under 20) and elderly (older than 70) patients receive mostly selective serotonin reuptake inhibitors. Additional studies should be carried out in order to assess drug-prescribing patterns in accordance with the guidelines of depression treatment in Lithuania considering diagnosis, dosage, and duration of treatment.
Asunto(s)
Antidepresivos/uso terapéutico , Depresión/tratamiento farmacológico , Prescripciones de Medicamentos/estadística & datos numéricos , Adulto , Factores de Edad , Anciano , Antidepresivos/administración & dosificación , Antidepresivos/economía , Antidepresivos de Segunda Generación/administración & dosificación , Antidepresivos de Segunda Generación/economía , Antidepresivos de Segunda Generación/uso terapéutico , Antidepresivos Tricíclicos/administración & dosificación , Antidepresivos Tricíclicos/economía , Antidepresivos Tricíclicos/uso terapéutico , Depresión/economía , Prescripciones de Medicamentos/economía , Femenino , Humanos , Reembolso de Seguro de Salud , Lituania , Masculino , Persona de Mediana Edad , Inhibidores Selectivos de la Recaptación de Serotonina/administración & dosificación , Inhibidores Selectivos de la Recaptación de Serotonina/economía , Inhibidores Selectivos de la Recaptación de Serotonina/uso terapéutico , Factores de TiempoRESUMEN
OBJECTIVE: To evaluate trends in the use of antidepressant drugs in Lithuania between 2002 and 2004 and to perform cost-minimization and reference price analysis enabling more rational use of financial resources of national health system. MATERIAL AND METHODS: The data on sales of antidepressant drugs in Lithuanian over a 3-year period (2002-2004) were obtained from IMS Health Inc. database. Data were calculated by defined daily dose (DDD) methodology and expressed in DDDs per 1000 inhabitants per day. DU90% was used as the quality indicator of the drug prescribing. The pharmacoeconomic analysis of antidepressant drugs was performed by cost-minimization and reference price methodology. RESULTS: The consumption of antidepressants in Lithuanian increased by 30.55% over a 3-year period (2002-2004) reaching the value of 10.00 DDDs/1000 inhabitants/day. Since 2002, the proportion of use of selective serotonin reuptake inhibitors has increased by 27.82%, and the use of tricyclic antidepressants has declined by 10.78%, while the use of other (newer) antidepressant drugs expanded almost three times. The expenditures of antidepressant drugs have reached 26 million Lt in 2004, of which 68.15% were costs for selective serotonin reuptake inhibitors. Choosing the second lowest price in different antidepressant drug class, it is estimated the possible savings of 4.34 million Lt lowering the total expenses by 16.5% (1 euro=3.4528 Lt). CONCLUSIONS: The findings suggest that the use of total antidepressant drugs continues to increase because of the increased use of selective serotonin reuptake inhibitors and other (newer) antidepressant drugs. In comparison with the data in other countries, the consumption of antidepressant drugs in Lithuania is low.