While statin drugs take the lion’s share, antidepressants are prescribed more and antibiotics less.
Australian prescriber The NPS MedicineWise revealed the 10 most prescribed drugs of the year.
The list, based on the Pharmaceutical Benefits Scheme (PBS) and PBS Repatriation (RPBS) prescriptions from the date of issue, includes both subsidized and non-subsidized prescriptions.
Between July 2020 and June 2021, eight of Australia’s most widely used drugs were aimed at lowering cholesterol and blood pressure.
The most widely used drug was atorvastatin, used to prevent cardiovascular disease in people at high risk and to treat abnormal lipid levels. The defined daily dose (DDD) of the drug is 76.22 per 1000 inhabitants per day.
Next come rosuvastatin and perindopril, a blood pressure medication, coming in third.
Unsurprisingly, the use of drugs to treat depression and anxiety has increased in the wake of the COVID-19 pandemic, with an increase in mental health issues and resulting general medicine presentations.
Sertraline was new to the NPS MedicineWise Top 10 list last year, but it dropped to eighth this year. The drug’s DDD is 27.42 per 1,000 inhabitants per day, an increase from 25.67 in 2019-2020.
Escitalopram, another selective serotonin reuptake inhibitor (SSRI), was the sixth most prescribed drug in the same 12-month period, with sertraline again in eighth place by this measure.
Dr Kate Annear, GP and NPS MedicineWise Medical Advisor, is not surprised by the drugs on the list.
‘[The increase of sertraline use] is a reflection of the increasing volume of antidepressants prescribed in Australia, ”she said.
“We are seeing more and more people with depression and anxiety disorders, many of them for the first time. The COVID pandemic has likely had an impact on that.
‘[And] not surprisingly, most of the pills distributed were used to prevent and treat heart disease and stroke. Cardiovascular disease is the leading cause of death in Australia. ‘
After sertraline, metformin, a diabetes drug, is ninth on the list, with a DDD of 26.59 per 1,000 people per day.
When looking at the number of prescriptions dispensed, rosuvastatin led at 14,185,361, followed by atorvastatin at 11,673,109.
Another notable change is the reduced use of antibiotics included in last year’s list. Cephalexin dropped from sixth to ninth place for number of prescriptions, while amoxicillin dropped completely from the top 10.
The pandemic has again brought changes in drug use, with the decline in antibiotics prescribing a potential silver liner helping to fight antimicrobial resistance. The rise in antimicrobial resistance has been called “global warming in healthcare,” and Dr Annear said it was positive to see a drop in prescriptions.
“This is good news, because prescribing antibiotics when they are not needed leads to antibiotic resistance,” she said.
“This continues a downward trend in antibiotic use in recent years, but Australia still has high use – more than double that of some European countries.”
Although prescriptions for cancer drugs were ranked lower on the list, government spending was highest for this class of drugs.
Aflibercept, used to treat macular degeneration and metastatic colorectal cancer, cost the most at $ 443,729,600 – not including discounts.
Between July 2020 and June 2021, there were only 364,846 prescriptions for the drug.
Pembrolizumab, used to treat various types of cancer including lung cancer and melanoma, was the second most expensive at $ 431,701,955, with just 49,694 prescriptions.
Top 10 PBS / RPBS Drugs by DDD / 1000 pop / day
- Atorvastatin – 76.22
- Rosuvastatin – 66.54
- Perindopril – 54.35
- Amlodipine – 53.35
- Candesartan – 34.56
- Telmisartan – 34.55
- Irbesartan – 29.36
- Sertraline – 27.42
- Metformin – 26.59
- Ramipril – 26.52
Top 10 PBS / RPBS drugs by number of prescriptions
- Rosuvastatin – 14 185 361
- Atorvastatin – 11,673,109
- Pantoprazole – 9,299,295
- Esomeprazole – 8,396,611
- Perindopril – 6,890,787
- Escitalopram – 5,470,158
- Metformin – 5,406,768
- Sertraline – 5 106 720
- Cefalexin – 4,617,588
- Amlodipine – 4,475,471
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