Background
Methods
Data source
Scenarios
Literature review
Results
Aged 65 and above | Entire SHI population | Ratio aged ≥65 and entire SHI | |||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|
No. | ATC-Code | Agent | DDD (in Mio.) ≥65 years | Prescriptions ≥65 (in Mio.) | Sales ≥65 (in Mio. €) | Costs per DDD ≥65 | Total DDD (in Mio) | Total prescriptions (in Mio) | Total sales (in Mio. €) | Costs per DDD | DDD | Prescriptions | Sales |
1 | C02CA04 | Doxazosin | 51.4 | 0.56 | 19.5 | 0.38 € | 60.2 | 0.81 | 28.1 | 0.38 € | 85.38 % | 69.47 % | 69.37 % |
2 | N06AA09 | Amitriptyline | 45.7 | 1.13 | 19.8 | 0.43 € | 94.5 | 2.28 | 40.5 | 0.43 € | 48.36 % | 49.66 % | 48.88 % |
3 | C07AA07 | Sotalol | 34.0 | 0.53 | 10.2 | 0.30 € | 36.6 | 0.68 | 13.0 | 0.30 € | 92.90 % | 78.39 % | 78.56 % |
4 | C01AA02 | Acetyldigoxin | 32.5 | 0.93 | 11.7 | 0.36 € | 36.4 | 1.05 | 13.3 | 0.36 € | 89.29 % | 88.62 % | 88.06 % |
5 | N05CF01 | Zopiclona | 28.0 | 1.44 | 21.5 | 0.77 € | 47.3 | 2.62 | 38.7 | 0.79 € | 59.20 % | 54.87 % | 55.56 % |
6 | M01AH05 | Etoricoxib | 25.2 | 0.50 | 30.6 | 1.21 € | 51.7 | 1.07 | 62.4 | 1.21 € | 48.74 % | 46.61 % | 49.04 % |
7 | N06AA12 | Doxepin | 24.2 | 0.77 | 13.1 | 0.54 € | 54.2 | 1.68 | 29.1 | 0.52 € | 44.65 % | 45.71 % | 45.07 % |
8 | G04BD08 | Solifenacin | 22.6 | 0.24 | 32.5 | 1.44 € | 31.3 | 0.33 | 44.8 | 1.43 € | 72.20 % | 72.84 % | 72.54 % |
9 | N05CF02 | Zolpidema | 21.3 | 1.09 | 16.3 | 0.77 € | 32.5 | 1.81 | 26.7 | 0.78 € | 65.54 % | 60.36 % | 61.14 % |
10 | N06BX03 | Piracetam | 18.3 | 0.41 | 8.2 | 0.45 € | 20.6 | 0.48 | 9.7 | 0.45 € | 88.83 % | 85.85 % | 84.86 % |
11 | C04AD03 | Pentoxifylline | 15.0 | 0.35 | 7.2 | 0.48 € | 17.7 | 0.57 | 11.0 | 0.54 € | 84.75 % | 61.29 % | 65.61 % |
12 | N05BA08 | Bromazepam | 14.9 | 0.66 | 8.6 | 0.58 € | 21.2 | 1.04 | 13.5 | 0.60 € | 70.28 % | 63.40 % | 63.65 % |
13 | N06AA06 | Trimipramine | 14.6 | 0.49 | 10.8 | 0.74 € | 31.6 | 1.12 | 24.5 | 0.73 € | 46.20 % | 43.66 % | 44.17 % |
14 | N05BA01 | Diazepam | 13.1 | 0.53 | 6.0 | 0.46 € | 31.0 | 1.30 | 15.3 | 0.47 € | 42.26 % | 40.71 % | 39.16 % |
15 | N05CD06 | Lormetazepama | 12.5 | 0.38 | 5.2 | 0.42 € | 15.3 | 0.51 | 7.0 | 0.42 € | 81.70 % | 74.50 % | 74.20 % |
16 | C02CA08 | Terazosin | 12.3 | 0.19 | 6.6 | 0.54 € | 8.0 | 0.24 | 8.2 | 0.56 € | -b | - | - |
17 | C02AC01 | Clonidine | 11.7 | 0.33 | 5.9 | 0.50 € | 17.7 | 0.71 | 13.5 | 0.34 € | 66.10 % | 46.72 % | 43.86 % |
18 | C02LA01 | Reserpine and Diuretics | 11.3 | 0.12 | 4.7 | 0.42 € | 13.1 | 0.14 | 5.5 | 0.42 € | 86.26 % | 88.82 % | 85.45 % |
19 | C01BC04 | Flecainide | 9.7 | 0.22 | 11.4 | 1.18 € | 14.1 | 0.34 | 17.5 | 1.17 € | 68.79 % | 64.05 % | 65.30 % |
20 | G04BD04 | Oxybutynin | 9.3 | 0.30 | 8.8 | 0.95 € | 11.3 | 0.45 | 15.1 | 0.95 € | 82.30 % | 66.64 % | 58.14 % |
21 | M01AC06 | Meloxicam | 9.3 | 0.21 | 3.3 | 0.35 € | 14.8 | 0.41 | 6.3 | 0.38 € | 62.84 % | 50.66 % | 52.12 % |
22 | N06AB03 | Fluoxetine | 8.8 | 0.10 | 2.9 | 0.33 € | 43.3 | 0.58 | 17.3 | 0.32 € | 20.32 % | 17.32 % | 16.79 % |
23 | M01AB01 | Indometacin | 8.7 | 0.25 | 4.0 | 0.46 € | 14.2 | 0.53 | 8.6 | 0.48 € | 61.27 % | 47.36 % | 46.63 % |
24 | C01AA08 | Metildigoxin | 8.4 | 0.17 | 2.7 | 0.32 € | 9.5 | 0.20 | 3.0 | 0.32 € | 88.42 % | 86.65 % | 90.00 % |
25 | M03BX07 | Tetrazepam | 8.3 | 0.57 | 8.0 | 0.96 € | 22.0 | 2.08 | 26.8 | 1.19 € | 37.73 % | 27.46 % | 29.90 % |
26 | C04AX21 | Naftidrofuryl | 7.5 | 0.34 | 8.2 | 1.09 € | 9.0 | 0.43 | 10.2 | 1.11 € | 83.33 % | 78.49 % | 80.17 % |
27 | C08CA05 | Nifedipinea | 6.5 | 0.26 | 3.8 | 0.58 € | 69.7 | 1.32 | 22.2 | 0.29 € | 9.33 % | 19.70 % | 17.11 % |
28 | M01AB11 | Acemetacin | 6.4 | 0.16 | 4.9 | 0.77 € | 9.8 | 0.28 | 8.3 | 0.80 € | 65.31 % | 56.34 % | 58.76 % |
29 | M03BX01 | Baclofen | 6.0 | 0.26 | 5.2 | 0.87 € | 17.1 | 0.66 | 16.1 | 0.93 € | 35.09 % | 39.12 % | 32.31 % |
30 | J01XE01 | Nitrofurantoin | 5.4 | 0.26 | 4.1 | 0.76 € | 8.7 | 0.43 | 6.7 | 0.85 € | 62.07 % | 59.99 % | 61.45 % |
Sum Top30 | 502.9 | 13.75 | 305.7 | 864.40 | 26.15 | 562.71 | 58.18 % | 52.59 % | 54.33 % | ||||
Sum all 83 agents | 598.7 | 16.93 | 387.8 | 1,124.00 | 37.71 | 1,037.37 | 53.27 % | 44.89 % | 37.38 % |
ATC-Code | Agent | Costs per DDD in € | DDD (in Mio.) | Surrogates according to PRISCUS list | Costs per DDD of surrogates in € | Total costs of surrogates in Mio. € | ||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|
Min | Max | Mean | Min | Max | Mean | |||||||
C02CA04 | Doxazosin | 0.38 | 51.4 | Other antihypertensives: ACE inhibitors, angiotensin receptor blockers, diuretics, beta blocker, calcium channel blocker | ACE inhibitors | 0.13 | Angiotensin receptor blockers | 1.08 | 0.23 | 6.64 | 55.51 | 23.73 |
N06AA09 | Amitriptyline | 0.43 | 45.7 | SSRIs, mirtazapine | SSRIs | 0.49 | Mirtazapine | 0.69 | 0.53 | 22.39 | 31.53 | 23.32 |
C07AA07 | Sotalol | 0.30 | 34.0 | Beta blocker, amiodarone, propafenone | beta blocker | 0.30 | Amiodarone | 0.72 | 0.77 | 10.09 | 24.48 | 21.69 |
C01AA02 | Acetyldigoxin | 0.36 | 32.5 | Beta blocker, diuretics, ACE inhibitors | ACE inhibitors | 0.13 | Beta blocker | 0.30 | 0.18 | 4.20 | 9.65 | 24.43 |
N05CF01 | Zopiclona | 0.77 | 28.0 | Valerian, sedative anti-depressants (trazodone, mianserin, mirtazapine), opipramol, low-potency neuroleptics (melperone & pipamperone) | Valerian | 0.00 | Low-potency neuroleptics | 2.32 | 0.77 | 0.00 | 64.86 | 11.80 |
M01AH05 | Etoricoxib | 1.21 | 25.2 | Paracetamol, weak opioids (codeine, tramadol), Metamizole, weak NSAID, antidepressants (long-acting tranquilizers, tricyclic antidepressants, other non-serotomergic monoamine oxidase inhibitors, SSRIs, other Selective reuptake inhibitors, other antidepressants), anticonvulsants (older anti-epileptics, newer anti-epileptics, neuromuscular blocking agents) | Paracetamol | 0.49 | Newer anti-epileptics | 4.03 | 3.90 | 12.35 | 101.56 | 16.50 |
N06AA12 | Doxepin | 0.54 | 24.2 | SSRIs, mirtazapine | SSRIs | 0.49 | Mirtazapine | 0.69 | 0.53 | 11.86 | 16.70 | 12.94 |
G04BD08 | Solifenacin | 1.44 | 22.6 | Trospium | Trospium | 1.05 | Trospium | 1.05 | 1.05 | 23.73 | 23.73 | 5.89 |
N05CF02 | Zolpidema | 0.77 | 21.3 | Valerian, sedative anti-depressants (trazodone, mianserin, mirtazapine), opipramol, low-potency neuroleptics (melperone & pipamperone) | Valerian | 0.00 | Low-potency neuroleptics | 2.32 | 0.77 | 0.00 | 49.34 | 2.95 |
N06BX03 | Piracetam | 0.45 | 18.3 | ACE inhibitors (donepezil, galantamine, rivastigmine), Memantine | Memantine | 3.86 | Acetylcholinesterase inhibitors | 4.25 | 4.11 | 70.64 | 77.78 | 7.80 |
C04AD03 | Pentoxifylline | 0.48 | 15.0 | ACE inhibitors (donepezil, galantamine, rivastigmine), Memantine | Memantine | 3.86 | Acetylcholinesterase inhibitors | 4.25 | 4.11 | 57.90 | 63.75 | 10.36 |
N05BA08 | Bromazepam | 0.58 | 14.9 | Lorazepam, lormetazepam, short-acting benzodiazepine & benzodiazepine receptor agonists (zolpidem, zopiclone, brotizolam, triazolam, zaleplon), opipramol, mirtazapine, low-potency neuroleptics (melperone & pipamperone) | Lormetazepam | 0.42 | Low-potency neuroleptics | 2.32 | 0.75 | 6.26 | 34.52 | 9.77 |
N06AA06 | Trimipramine | 0.74 | 14.6 | SSRIs, mirtazapine | SSRI | 0.49 | Mirtazapine | 0.69 | 00.53 | 7.15 | 10.07 | 11.23 |
N05BA01 | Diazepam | 0.46 | 13.1 | Lorazepam, lormetazepam, short-acting benzodiazepine & benzodiazepine receptor agonists (zolpidem, zopiclone, brotizolam, triazolam, zaleplon), opipramol, mirtazapine, low-potency neuroleptics (melperone & pipamperone) | Lormetazepam | 0.42 | Low-potency neuroleptics | 2.32 | 0.75 | 5.50 | 30.35 | 75.19 |
N05CD06 | Lormetazepama | 0.42 | 12.5 | Valerian, sedative anti-depressants (trazodone, mianserin, mirtazapine), opipramol, zolpidem, low-potency neuroleptics (melperone & pipamperone) | Valerian | 0.00 | Low-potency neuroleptics | 2.32 | 0.78 | 0.00 | 28.96 | 30.82 |
C02CA08 | Terazosin | 0.54 | 12.3 | Other antihypertensives: ACE inhibitors angiotensin receptor blockers, diuretics, beta blocker , calcium channel blocker (except nifedipine) | ACE inhibitors | 0.13 | Beta blocker | 0.30 | 0.18 | 1.59 | 3.65 | 6.79 |
C02AC01 | Clonidine | 0.50 | 11.7 | Other antihypertensives: ACE inhibitors, angiotensin receptor blockers, diuretics, beta blocker , calcium channel blocker | ACE inhibitors | 0.13 | Angiotensin receptor blockers | 1.08 | 0.23 | 1.51 | 12.64 | 61.64 |
C02LA01 | Reserpine and Diuretics | 0.42 | 11.3 | Other antihypertensives: ACE inhibitors, angiotensin receptor blockers, diuretics, beta blocker, calcium channel blocker (except nifedipine) | ACE inhibitors | 0.13 | Beta blocker | 0.30 | 0.18 | 1.46 | 3.35 | 2.24 |
C01BC04 | Flecainide | 1.18 | 9.7 | Beta blocker, amiodarone | Beta blocker | 0.30 | Amiodarone | 0.72 | 0.30 | 2.88 | 6.98 | 9.87 |
G04BD04 | Oxybutynin | 0.95 | 9.3 | Trospium | Trospium | 1.05 | Trospium | 1.05 | 1.05 | 9.77 | 9.77 | 2.69 |
M01AC06 | Meloxicam | 0.35 | 9.3 | Paracetamol, weak opioids (codeine, tramadol), metamizole, “weaker” NSAID | Paracetamol | 0.49 | Codeine | 2.65 | 0.72 | 4.56 | 24.65 | 9.69 |
N06AB03 | Fluoxetine | 0.33 | 8.8 | Other SSRIs (citalopram, paroxetine, escitalopram, sertraline, escitalopram), trazodone, mitrazapine | other SSRIs | 0.51 | Trazodone | 1.44 | 0.56 | 4.50 | 12.67 | 8.71 |
M01AB01 | Indometacin | 0.46 | 8.7 | Paracetamol, weak opioids (codeine, tramadol), metamizole, “weaker” NSAID | Paracetamol | 0.49 | Codeine | 2.65 | 0.72 | 4.26 | 23.06 | 4.60 |
C01AA08 | Metildigoxin | 0.32 | 8.4 | Beta blocker, diuretics | Diuretics | 0.21 | Beta blocker | 0.30 | 0.26 | 1.76 | 2.49 | 2.06 |
M03BX07 | Tetrazepam | 0.96 | 8.3 | Tolperisone, short-acting benzodiazepine & benzodiazepine receptor agonists (zolpidem, zopiclone, brotizolam, triazolam, zaleplon), intermediate-acting tranquilizers (bromazepan, oxazepam, lorazepam, alprazolam, buspirone) | intermediate-acting Tranquilizers | 0.71 | Tolperisone | 1.55 | 0.82 | 5.89 | 12.87 | 12.59 |
C04AX21 | Naftidrofuryl | 1.09 | 7.5 | ACE inhibitors (donepezil, galantamine, rivastigmine), memantine | Memantine | 3.86 | Acetylcholinesterase inhibitors | 4.25 | 4.11 | 28.95 | 31.88 | 6.25 |
C08CA05 | Nifedipinea | 0.58 | 6.5 | Other antihypertensives: ACE inhibitors, angiotensin receptor blockers, diuretics, beta blocker, calcium channel blocker (except nifedipine) | ACE inhibitors | 0.13 | Beta blocker | 0.30 | 0.18 | 0.84 | 1.93 | 1.19 |
M01AB11 | Acemetacin | 0.77 | 6.4 | Paracetamol, weak opioids (codeine, tramadol), metamizole, “weaker” NSAID | Paracetamol | 0.49 | Codeine | 2.65 | 0.72 | 3.14 | 16.96 | 6.68 |
M03BX01 | Baclofen | 0.87 | 6.0 | Tolperisone, tizanidine | Tizanidine | 1.09 | Tolperisone | 1.55 | 1.45 | 6.54 | 9.30 | 4.91 |
J01XE01 | Nitrofurantoin | 0.76 | 5.4 | Other antibiotics in accordance with antibiogramm: cephalosporins, cotrimoxazole, trimethoprim | Cotrimoxazole | 1.77 | Trimethoprim | 2.79 | 2.33 | 9.56 | 15.07 | 2.16 |
Sum Top 30 | 502.9 | 325.93 | 810.03 | 430.46 |