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Evaluation of drug deliveries and refunds for obstructive airway diseases in France between 2012 and 2017 - 01/08/21

Doi : 10.1016/j.resmer.2021.100854 
Philippe Tuppin a, , Anne-Sophie Aguade a, Sylvie Guillo b, Christelle Gastaldi a, Camille Taillé c
a Caisse Nationale d'Assurance Maladie (CNAM), Paris, France 
b Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, AP-HP, Sorbonne Université, Hôpital Pitié Salpêtrière, Département de Santé Publique, Centre de Pharmacoépidémiologie (Cephepi), Unité de Recherche Clinique PSL-CFX, Paris, France 
c Groupe Hospitalier Universitaire AP-HP Nord-Université de Paris, Hôpital Bichat, Service de Pneumologie et Centre de Référence constitutif des Maladies Pulmonaires Rares; Inserm UMR 1152; Paris, France 

Corresponding author at: Caisse Nationale de l'Assurance Maladie (CNAM) - Direction de la stratégie des études et des statistiques, 26-50, avenue du Professeur André Lemierre, F-75986 Paris Cedex 20, FranceCaisse Nationale de l'Assurance Maladie (CNAM)Direction de la stratégie des études et des statistiques26-50, avenue du Professeur André Lemierre, F-75986 Paris Cedex 20France
En prensa. Manuscrito Aceptado. Disponible en línea desde el Sunday 01 August 2021

ABSTRACT

Background

The aim of this survey was to investigate variations of drugs for obstructive airway diseases delivery rates and refunds at a national level which are rarely reported.

Methods

The French national health data system (56 million, 87% of the population) was used to identify insurance beneficiaries with at least one drug delivery (Anatomical Therapeutic Classification R03) per year between 2012 and 2017.

Results

At least one drug delivery in 2017 was identified for 7.5 million people (12.9%). High proportions of people with at least one, two or three drug deliveries were observed between the ages of 0 to 2 years (22%, 10%, 5.5%), then decreased between the ages of 18 and 40 years (9.3%, 3.8%, 2.3%) and increased again in people 75 years and older (17.8%, 11.9% 9.9%), with strong variations between years. In 2017, the proportions of people with at least one delivery, either alone or in combination with other drugs, were 68% for inhaled corticosteroids (ICS) (median 1; IQR 1-4), 59% for short-acting beta2-agonists (SABA) (1; 1-3), 42% for long-acting beta2-agonists (LABA) (2; 1-6), 11% for leukotriene receptor antagonists (3; 1-9), and 12% for inhaled anticholinergics (4; 1-10). Younger patients more often received SABAs (0-2 years: 84%) and leukotriene receptor antagonists (3-6 years: 14%) and people 75 years and older more often received LABAs (59%) and ICS, either alone or in combination with other drugs (28%).The mean annual refund reimbursed per person decreased from €136 in 2012 to €118 in 2017.

Conclusion

This study suggests a low level of use for drug classes associated with low delivery rates, suggesting inappropriate prescriptions and poor follow-up. These results highlight the difficulty of identifying these problems if delivery rates variations over several years are not taken into account.

El texto completo de este artículo está disponible en PDF.

Key Words : Asthma, COPD, Drugs, Epidemiology, Observational study

Abbreviations : ATC, COPD, GINA, ICS, LABA, SABA, SNDS


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© 2021  Publicado por Elsevier Masson SAS.
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