EPI-PHARE publishes an update of its study on the dispensation of reimbursed prescription drugs in pharmacies since the start of the pandemic in France.

The results after 5 weeks of confinement in France show a return to a standardized consumption of treatments for chronic pathologies since mid-April, after an initial phenomenon of “storage” during the first 2 weeks of confinement.

What did we already know about the subject after the first two weeks of confinement in France ?

• The Covid-19 pandemic temporarily destabilized the healthcare system for the management of other pathologies, despite the use of teleconsultations which were able to partially mitigate and absorb difficulties for many situations, and the regulatory possibility since 20 March in France to use “expired” prescriptions to renew chronic disease treatments.

• At the start of confinement, patients stored drugs prescribed for chronic pathologies, in particular treatments for cardiovascular pathologies (antihypertensives, statins, etc.) and diabetes (insulin and oral antidiabetics), mental disorders ( antidepressants, anxiolytics …), neurological (epilepsy, Parkinson’s disease, multiple sclerosis …), endocrine (dysthyroidism) or respiratory (asthma, chronic obstructive pulmonary disease) diseases.

What does the study bring after 5 weeks of confinement in France ?

• After an initial storage of drugs for chronic pathologies, week 15 (from April 6 to 12) was marked by under-consumption before a return to normalized consumption in week 16 (from April 13 to 19).

• For the treatments whose administration imperatively requires the physical recourse to a health professional there was a collapse of consumption over the entire period of 5 weeks of confinement, which persisted in week 16: -35% to -71% for vaccines; -40% for ophthalmological treatment of age-related macular degeneration (AMD), -68% for intrauterine contraceptive devices (IUDs) with progestogen. Products intended for medical diagnostic procedures: preparations for colonoscopy (-82%), iodized products for scanner (-66%), contrast agents for MRI (-67%) also fell sharply. Unperformed examinations, essential to diagnose certain cancers or serious illnesses, could lead to delays in treatment.

• There was also a sharp drop in consumption during confinement for other drug treatments that could be prescribed for acute or chronic, which persisted in week 16: oral corticosteroid therapy (-64%), non-steroidal anti-inflammatory drugs or NSAIDs (-70%), systemic antibiotic therapy (-37%), antiulcer drugs such as proton pump inhibitors or PPIs (-13%).

• For the treatment of Covid-19, purchases on medical prescriptions of chloroquine and hydroxychloroquine were limited in time, in connection with the media coverage of this potential treatment (peaks respectively on February 27 and March 8); the combination of hydroxychloroquine and azithromycin, which was used only exceptionally before the Covid-19 epidemic, jumped 7,000% in week 13 to reach approximately 10,000 patients. Dispensing of ibuprofen was almost stopped following messages from health officials, while dispensing of prescribed paracetamol reached up to 1 million patients per day on March 16.

There were particularities for certain populations: for people living in socially advantaged areas, there was a trend towards greater use of hydroxychloroquine (alone or combined with azithromycin) for Covid-19, and a rate of slightly higher storage of drugs for chronic conditions. Children were given little medical attention during confinement, a finding that can be explained by a possible effect of stopping the circulation of all viruses (except SARS-CoV-2) and other infectious agents with the closure of nurseries and schools, but also less vaccination and a significant drop in certain treatments. For emergency contraception and medically assisted procreation, there has been less management that has persisted since the start of the Covid-19 epidemic.

This follow-up is essential and will be continued until the end of the pandemic.