PDF(Sci-hub)
Abstract：
Conflicting information on potential benefits of drugs as well as reports on hypothetical harm of commonly used drugs in COVID-19 treatment have challenged clinicians and healthcare systems. We analyzed the change in ambulatory drug utilization before, during, and after the first wave of the pandemic in 2020.
We explored dispensing data of nearly 19 000 pharmacies at the expense of the statutory health insurance funds covering 88% of Germany\'s population. We analyzed utilization of publicly discussed drugs with conflicting information. Drug utilization as number of packages dispensed per week from January to June 2020, reflecting 314 million claims, was compared with 2019.
Utilization of hydroxychloroquine increased +110% during March 2020 and then slightly decreased until week April 13-19. Renin-angiotensin-aldosterone system inhibitors and simvastatin/atorvastatin increased, +78% and +74%, respectively, and subsequently decreased below 2019 levels. Utilization of azithromycin and all systemic antibiotics decreased continuously from March 2-8 until June to levels considerably lower compared to 2019 (June 22-28: azithromycin: -55%, all systemic antibiotics: -27%). Pneumococcal vaccines utilization initially increased +373%, followed by supply shortages. Paracetamol utilization showed an initial increase of +111%, mainly caused by an increase of over-the-counter dispensings.
Apart from the pandemic itself, the data suggest that dissemination of misinformation and unsound speculations as well as supply shortages influenced drug prescribing, utilization, and purchasing behavior. The findings can inform post-pandemic policy to prevent unfounded over- and underprescribing and off-label use as well as drug shortages during a public health crisis.
We explored dispensing data of nearly 19 000 pharmacies at the expense of the statutory health insurance funds covering 88% of Germany\'s population. We analyzed utilization of publicly discussed drugs with conflicting information. Drug utilization as number of packages dispensed per week from January to June 2020, reflecting 314 million claims, was compared with 2019.
Utilization of hydroxychloroquine increased +110% during March 2020 and then slightly decreased until week April 13-19. Renin-angiotensin-aldosterone system inhibitors and simvastatin/atorvastatin increased, +78% and +74%, respectively, and subsequently decreased below 2019 levels. Utilization of azithromycin and all systemic antibiotics decreased continuously from March 2-8 until June to levels considerably lower compared to 2019 (June 22-28: azithromycin: -55%, all systemic antibiotics: -27%). Pneumococcal vaccines utilization initially increased +373%, followed by supply shortages. Paracetamol utilization showed an initial increase of +111%, mainly caused by an increase of over-the-counter dispensings.
Apart from the pandemic itself, the data suggest that dissemination of misinformation and unsound speculations as well as supply shortages influenced drug prescribing, utilization, and purchasing behavior. The findings can inform post-pandemic policy to prevent unfounded over- and underprescribing and off-label use as well as drug shortages during a public health crisis.
摘要：
关于药物潜在益处的信息相互矛盾，以及关于COVID-19治疗中常用药物的假设危害的报道，对临床医生和医疗保健系统提出了挑战。我们之前分析了动态药物利用的变化，during,在2020年第一波大流行之后。
我们以覆盖德国88%人口的法定健康保险基金为代价，探索了近19000家药店的配药数据。我们分析了公开讨论的信息相互矛盾的药物的使用情况。药物利用率是2020年1月至6月每周分发的包裹数量，反映了3.14亿件索赔，与2019年相比。
羟氯喹的利用率在2020年3月期间增加了+110%，然后在4月13日至19日这一周之前略有下降。肾素-血管紧张素-醛固酮系统抑制剂和辛伐他汀/阿托伐他汀增加，+78%和+74%，分别,随后下降至2019年水平以下。从3月2日至8日，阿奇霉素和所有全身性抗生素的使用率持续下降，直到6月，与2019年相比，水平大大降低（6月22日至28日：阿奇霉素：-55％，所有全身性抗生素：-27%）。肺炎球菌疫苗利用率最初增加了373%，其次是供应短缺。扑热息痛的使用显示最初增加了+111%，主要是由于非处方药量的增加。
除了流行病本身，数据表明，错误信息和不可靠猜测的传播以及供应短缺影响了药物处方，利用率，和购买行为。这些发现可以为大流行后的政策提供信息，以防止在公共卫生危机期间毫无根据的过度和不足处方和标签外使用以及药物短缺。
我们以覆盖德国88%人口的法定健康保险基金为代价，探索了近19000家药店的配药数据。我们分析了公开讨论的信息相互矛盾的药物的使用情况。药物利用率是2020年1月至6月每周分发的包裹数量，反映了3.14亿件索赔，与2019年相比。
羟氯喹的利用率在2020年3月期间增加了+110%，然后在4月13日至19日这一周之前略有下降。肾素-血管紧张素-醛固酮系统抑制剂和辛伐他汀/阿托伐他汀增加，+78%和+74%，分别,随后下降至2019年水平以下。从3月2日至8日，阿奇霉素和所有全身性抗生素的使用率持续下降，直到6月，与2019年相比，水平大大降低（6月22日至28日：阿奇霉素：-55％，所有全身性抗生素：-27%）。肺炎球菌疫苗利用率最初增加了373%，其次是供应短缺。扑热息痛的使用显示最初增加了+111%，主要是由于非处方药量的增加。
除了流行病本身，数据表明，错误信息和不可靠猜测的传播以及供应短缺影响了药物处方，利用率，和购买行为。这些发现可以为大流行后的政策提供信息，以防止在公共卫生危机期间毫无根据的过度和不足处方和标签外使用以及药物短缺。
