Asthma, antibiotic prescriptions dropped from 2019 to 2020, Finnish study finds

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A national study in Finland showed that the number of antibiotics and asthma medications dropped by 59.6% and 19.8%, respectively, from 2019 to 2020, generating millions in savings.

It is already known that the 2020 lockdown in many countries due to the global pandemic has led to a drop in childhood infections. Finnish researchers, in a recently published study, said that prescriptions for antibiotics and asthma also fell there, reducing reimbursement costs.

Researchers looked at the amount of systemic antibiotics and asthma medications distributed to children aged 0-12 before and during the pandemic and analyzed the effect on reimbursement costs.

In Finland, all citizens receive free public health care and medicines are covered by partial or full reimbursement, depending on the medicine.

Data for 2019 and 2020 are from the Finnish national register of reimbursable prescriptions. Prescription rates per 1,000 children were calculated for each quarter and compared using rate ratios and 95% confidence intervals.

For antibiotics, 331,857 prescriptions were dispensed, 69.1% in 2019 and 30.9% in 2020. The most common antibiotic dispensed in 2019-2020 was amoxicillin (55.4%), and most antibiotics were dispensed in 2019. Prescriptions for all antibiotics fell by 55.3% in 2020, with the largest drop in macrolides (59.2%). The smallest concerned cephalosporins.

The greatest reduction in macrolides was observed in children aged 0 to 5 years (59.6%, 95% CI, 60.9% to 58.2%).

Total reimbursable expenditure for antibiotics was €1.95 million (US$2.21 million) in 2020 and €4.3 million (US$4.88 million) in 2019, for a saving of €2.3 million (US$2.6 million) (54.5%).

For asthma, 337,911 asthma medications were dispensed in 2019 and 2020, including 55.5% in 2019 and 44.5% in 2020.

Asthma medications decreased by 19.8%, mostly in the short-acting beta-agonist category for children aged 0-5 years (35.2%, 95% CI 36.1 % to 34.2%). This suggests there were lower rates of asthma exacerbations and wheezing episodes in early 2020, the researchers said.

Total reimbursable expenses in 2020 were €2.94 million ($3.33 million) and €3.83 million ($4.34 million) in 2019, down 23% from 0.88 million euros ($998,337).

Taken together, the lower number of drugs dispensed in both categories reduced reimbursement costs by €3.4 million (US$3.85 million) from 2019 to 2020.

The researchers also looked at primary care visits for children. While falling from March to June 2020, they rebounded in August and were overall higher in 2020 than in 2019.

Even as primary care visits increased, the number of drugs dispensed decreased, suggesting that the drop in the number of antibiotics was due to a drop in infections, not a barrier to care.

Reference

Haapanen M, Renko M, Artama M, Kuitunen I. Systemic antibiotics and asthma medications dispensed to children 0-12 years old decreased significantly during the COVID-19 pandemic in 2020. Acta Pediatrician. 2022;111:376-382. doi:10.1111/apa.16144


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