Prescription of antidepressants and anxiolytics in France 2012-2022 and changes with covid19.
Depression and anxiety have their prevalence increased during the COVID-19 pandemic. We aimed to describe the consumption of antidepressants and anxiolytics since 2012 in France and evaluate the potential effect of the COVID-19 pandemic until the end of 2022.
We conducted an interrupted time series analysis of routine drug sales data (Medic'AM) from French outpatient pharmacies from 2012-2022 covering the full population by health insurance. We investigated defined daily doses of antidepressants and anxiolytics sold per 1,000 inhabitants (DDD/TID) and health system expenditures in amounts reimbursed by health insurances, before and after COVID-19 pandemic onset and in relation with stringency of pandemic mitigation measures. Analyses were performed descriptively and based on segmented linear regression models and Auto-Regressive Integrated Moving Average (ARIMA) models.
From 2012 to 2019, overall antidepressants sales increased (+0.02 DDD/TID each month) and overall anxiolytics sales decreased (-0.07 DDD/TID each month, 95% CI -0.09 to -0.06) in France. Expenditures for both drug classes relevantly decreased in 2012-2016, as generics increasingly became available. With pandemic onset, there was a relevant and persisting trend increase (+0.20 DDD/TID per month) of antidepressants sales overall, with an estimated excess of 120 DDD/TID (95% prediction interval [PI] 93.9 to 146.4) sold from May 2020 until December 2022. Patterns similar to the overall trend were observed for recommended first-line antidepressants. Anxiolytics sales were elevated from February 2020 throughout the pandemic and returned to expected levels by December 2022, with an estimated excess of 32 DDD/TID (95% PI 8.7 to 55.7). There was no evident association between stringency and antidepressants or anxiolytics sales.
This study showed a protracted increase in the trend in antidepressants consumption since onset of the COVID-19 pandemic. Pandemic’s impact on anxiolytics consumption was temporary, while it may have had long-lasting consequences for the management of depression.
We conducted an interrupted time series analysis of routine drug sales data (Medic'AM) from French outpatient pharmacies from 2012-2022 covering the full population by health insurance. We investigated defined daily doses of antidepressants and anxiolytics sold per 1,000 inhabitants (DDD/TID) and health system expenditures in amounts reimbursed by health insurances, before and after COVID-19 pandemic onset and in relation with stringency of pandemic mitigation measures. Analyses were performed descriptively and based on segmented linear regression models and Auto-Regressive Integrated Moving Average (ARIMA) models.
From 2012 to 2019, overall antidepressants sales increased (+0.02 DDD/TID each month) and overall anxiolytics sales decreased (-0.07 DDD/TID each month, 95% CI -0.09 to -0.06) in France. Expenditures for both drug classes relevantly decreased in 2012-2016, as generics increasingly became available. With pandemic onset, there was a relevant and persisting trend increase (+0.20 DDD/TID per month) of antidepressants sales overall, with an estimated excess of 120 DDD/TID (95% prediction interval [PI] 93.9 to 146.4) sold from May 2020 until December 2022. Patterns similar to the overall trend were observed for recommended first-line antidepressants. Anxiolytics sales were elevated from February 2020 throughout the pandemic and returned to expected levels by December 2022, with an estimated excess of 32 DDD/TID (95% PI 8.7 to 55.7). There was no evident association between stringency and antidepressants or anxiolytics sales.
This study showed a protracted increase in the trend in antidepressants consumption since onset of the COVID-19 pandemic. Pandemic’s impact on anxiolytics consumption was temporary, while it may have had long-lasting consequences for the management of depression.