Prevalence and direct costs of potentially inappropriate prescriptions in France: a population-based study.

Older adults drug utilization insurance health reimbursement medication cost pharmacoepidemiology potentially inappropriate prescriptions

Journal

Expert review of pharmacoeconomics & outcomes research
ISSN: 1744-8379
Titre abrégé: Expert Rev Pharmacoecon Outcomes Res
Pays: England
ID NLM: 101132257

Informations de publication

Date de publication:
Jun 2022
Historique:
pubmed: 17 9 2021
medline: 18 6 2022
entrez: 16 9 2021
Statut: ppublish

Résumé

Potentially inappropriate prescriptions (PIPs) in the older population remain a growing public health concern due to the many associated adverse events increasing healthcare service use and health costs. This study aimed to assess the prevalence and direct costs of PIPs in older adults aged ≥65 years in France. A population-based cross-sectional study was conducted in 2017 using a representative sample of the French national healthcare reimbursement system database. PIPs were defined using the French REMEDI[e]S tool. Overall reimbursed direct costs and by PIP category were extrapolated to the French older population. The overall PIP prevalence was estimated at 56.7% (95% CI: 56.4-57.0). Medications with an unfavorable benefit/risk ratio had the highest prevalence (34.0%, 95% CI: 33.7-34.3). Direct costs associated with PIPs represented 6.3% of the total reimbursed medication costs in 2017 (€507 million). Drug duplications were the main contributors to these costs (39.2% of the total reimbursed PIP costs, €199 million) and among all PIPs, proton pump inhibitors (>8 weeks) were the most expensive PIPs (€152 million). PIP prevalence is still high among French older adults, with substantial direct costs. Large-scale interventions targeting the most prevalent and/or costly PIPs are needed to reduce their clinical and economic impacts.

Sections du résumé

BACKGROUND UNASSIGNED
Potentially inappropriate prescriptions (PIPs) in the older population remain a growing public health concern due to the many associated adverse events increasing healthcare service use and health costs. This study aimed to assess the prevalence and direct costs of PIPs in older adults aged ≥65 years in France.
METHODS UNASSIGNED
A population-based cross-sectional study was conducted in 2017 using a representative sample of the French national healthcare reimbursement system database. PIPs were defined using the French REMEDI[e]S tool. Overall reimbursed direct costs and by PIP category were extrapolated to the French older population.
RESULTS UNASSIGNED
The overall PIP prevalence was estimated at 56.7% (95% CI: 56.4-57.0). Medications with an unfavorable benefit/risk ratio had the highest prevalence (34.0%, 95% CI: 33.7-34.3). Direct costs associated with PIPs represented 6.3% of the total reimbursed medication costs in 2017 (€507 million). Drug duplications were the main contributors to these costs (39.2% of the total reimbursed PIP costs, €199 million) and among all PIPs, proton pump inhibitors (>8 weeks) were the most expensive PIPs (€152 million).
CONCLUSIONS UNASSIGNED
PIP prevalence is still high among French older adults, with substantial direct costs. Large-scale interventions targeting the most prevalent and/or costly PIPs are needed to reduce their clinical and economic impacts.

Identifiants

pubmed: 34525899
doi: 10.1080/14737167.2021.1981863
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

627-636

Auteurs

Barbara Roux (B)

Centre of Pharmacovigilance and Pharmacoepidemiology, Department of Pharmacology Toxicology and Centre of Pharmacovigilance, University Hospital of Limoges, Limoges, France.
INSERM UMR 1248, Faculty of Medicine, University of Limoges, Limoges, France.

Julien Bezin (J)

Department of Clinical Pharmacology, University Hospital of Bordeaux, Bordeaux, France.
Univ. Bordeaux, INSERM UMR 1219, Bordeaux Population Health Research Center, Team Pharmacoepidemiology, Bordeaux, France.

Camille Morival (C)

Department of Clinical Pharmacology, University Hospital of Bordeaux, Bordeaux, France.
Univ. Bordeaux, INSERM UMR 1219, Bordeaux Population Health Research Center, Team Pharmacoepidemiology, Bordeaux, France.

Pernelle Noize (P)

Department of Clinical Pharmacology, University Hospital of Bordeaux, Bordeaux, France.
Univ. Bordeaux, INSERM UMR 1219, Bordeaux Population Health Research Center, Team Pharmacoepidemiology, Bordeaux, France.

Marie-Laure Laroche (ML)

Centre of Pharmacovigilance and Pharmacoepidemiology, Department of Pharmacology Toxicology and Centre of Pharmacovigilance, University Hospital of Limoges, Limoges, France.
INSERM UMR 1248, Faculty of Medicine, University of Limoges, Limoges, France.
Laboratoire Vie-Santé (Vieillissement Fragilité Prévention, e-Santé), IFR GEIST, Université de Limoges, Limoges, France.

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Classifications MeSH