Historique
Article de Périodique
Pregabalin and gabapentin use in France from 2012 to 2023, impact of prescription restrictions, a time series analysis (2025)
Auteur(s) :
MICHEL, A. ;
PRADE, M. ;
DE BANDT, D.
Année
2025
Page(s) :
art. 104929
Langue(s) :
Anglais
Domaine :
Autres substances / Other substances
Discipline :
EPI (Epidémiologie / Epidemiology)
Thésaurus géographique
FRANCE
Thésaurus mots-clés
PREGABALINE
;
EVOLUTION
;
PRESCRIPTION MEDICALE
;
MESUSAGE
;
PHARMACIE
;
VENTE
;
BASE DE DONNEES
;
DEPENSES DE SANTE
;
POLITIQUE
Autres mots-clés
Note générale :
Utilise Medic’AM
Résumé :
Introduction: Gabapentinoids use is accompanied by increased misuse, particularly for pregabalin. In May 2021, France introduced secure prescription requirements for pregabalin. This paper aims to analyse variations in gabapentinoid dispensing, with a focus on changes in prescription rules.
Materiel and method: We performed an ecological study using the French national health insurance database from January 2012 to December 2023. We analysed pregabalin and gabapentin doses sold by city pharmacies expressed in monthly defined daily dose per thousand inhabitant a day (DDD/TID) between January 2012 and December 2023. Dose sales trends before and after May 2021 were compared using segmented analysis of Autoregressive Integrated Moving Average models. Descriptive analysis was performed to analyse associated expenses expressed in euros.
Results: Between 2012 and 2020, pregabalin doses sold rose from 3.228 DDD/TID to 4.908 DDD/TID. After the reform, they declined to 3.923 DDD/TID in 2023. Gabapentin doses sold increased from 1.042 DDD/TID to 1.257 DDD/TID between 2012 and 2020, then rose further post-reform, reaching 1.705 DDD/TID. Costs related to the pregabalin doses sold decreased from €132.47 to €51.36 million from 2012 to 2023. Costs related to gabapentin decrease from €32.31 to €26.84 million between 2012 and 2021, then increase to €37.70 million in 2023.
Discussion: These data suggest that the May 2021 reform has reduced pregabalin consumption and induced an increase of gabapentin use. Cost implications remain of difficult interpretation due to multiple confounding factors. Further research could clarify these trends and be used to optimize prescription practices. [Author's abstract]
Highlights:
May 2021 prescribing rules cut pregabalin sales but lead to gabapentin's increase.
In December 2023, pregabalin use fell by 20%, while gabapentin increased by 35%.
New prescription rules appear to have shifted prescribing toward gabapentin.
Overall gabapentinoid use fell, but costs for gabapentin rose markedly.
Prescription restriction rules highlight the need to anticipate drug-switch behaviours.
Materiel and method: We performed an ecological study using the French national health insurance database from January 2012 to December 2023. We analysed pregabalin and gabapentin doses sold by city pharmacies expressed in monthly defined daily dose per thousand inhabitant a day (DDD/TID) between January 2012 and December 2023. Dose sales trends before and after May 2021 were compared using segmented analysis of Autoregressive Integrated Moving Average models. Descriptive analysis was performed to analyse associated expenses expressed in euros.
Results: Between 2012 and 2020, pregabalin doses sold rose from 3.228 DDD/TID to 4.908 DDD/TID. After the reform, they declined to 3.923 DDD/TID in 2023. Gabapentin doses sold increased from 1.042 DDD/TID to 1.257 DDD/TID between 2012 and 2020, then rose further post-reform, reaching 1.705 DDD/TID. Costs related to the pregabalin doses sold decreased from €132.47 to €51.36 million from 2012 to 2023. Costs related to gabapentin decrease from €32.31 to €26.84 million between 2012 and 2021, then increase to €37.70 million in 2023.
Discussion: These data suggest that the May 2021 reform has reduced pregabalin consumption and induced an increase of gabapentin use. Cost implications remain of difficult interpretation due to multiple confounding factors. Further research could clarify these trends and be used to optimize prescription practices. [Author's abstract]
Highlights:
May 2021 prescribing rules cut pregabalin sales but lead to gabapentin's increase.
In December 2023, pregabalin use fell by 20%, while gabapentin increased by 35%.
New prescription rules appear to have shifted prescribing toward gabapentin.
Overall gabapentinoid use fell, but costs for gabapentin rose markedly.
Prescription restriction rules highlight the need to anticipate drug-switch behaviours.
Affiliation :
General Practice Department, University of Versailles - Saint Quentin en Yvelines, Montigny le Bretonneux, France
Center for Research in Epidemiology and Population Health, The French National Institute of Health and Medical Research, INSERM U1018 Equipe 11, Villejuif, Île-de-France, France
Center for Research in Epidemiology and Population Health, The French National Institute of Health and Medical Research, INSERM U1018 Equipe 11, Villejuif, Île-de-France, France