(48) Effect of the COVID-19 Pandemic on Medicines Prescription for Children in Portugal

Friday, August 26, 2022

8:00 AM – 6:00 PM CEST

Location: Hall C

Publication Number: 379

Presenting Author(s)

Ana Silva
– INFARMED - National Authority of Medicines and Health Products, I.P., Lisboa, Lisboa, Portugal

Co-Author(s)

Claudia Furtado, PhD
– Head of Department, INFARMED - National Authority of Medicines and Health Products, I.P., United States
Célia Silva
– INFARMED - National Authority of Medicines and Health Products, I.P., Portugal

Background: During the coronavirus disease 2019 (COVID-19), clinical assistance and access to medicines may have been disrupted due to health systems workload and patient’s perception on safety.

Objectives: To characterise the prescription level and pattern of medicines in pediatric population (0 to 19 years) in Portugal from 2016 to 2021 and characterise the COVID-19 pandemic impact on medicines access.

Methods: Medicines dispensed in pharmacies were retrieved from national databases from year 2016 to 2021. The main outcome measure was number of packages per child inhabitant per month (packages/child/month) and was further stratified by age groups, medicines therapeutic groups, prescription setting and prescriber specialty.

Results: Between January 2016 and January 2020, the average monthly number of prescriptions to children was 990 530. Prescribed packages declined from 1 109 049 in February to 827 496 in March and to 471 305 in April 2020.
Prescribed packages during March to December 2020 were 35.6% lower compared with March to December 2019.
Percentage of children that had at least one prescription per year during 2020 (64% of total children population) was 14,9% lower compared with 2019.
Among the 3 medicines classes accounting for the most prescriptions in 2019, the corresponding percentage changes were -42.0% for antibiotics (ATC J01), -16.5% for respiratory diseases (ATC R03), and -29.1% for antihistaminics (ATC R06).
Among the 3 medicines accounting for the most prescriptions in 2019, the corresponding percentage changes were -43.0% for paracetamol, -44.3% for ibuprofen, and -6,3% for montelukast. However, considering prescription only medicines, besides montelukast, the corresponding percentage changes were -40,5% for amoxicillin and beta-lactamase inhibitor, -39,4% for desloratadine and -51,1% for amoxicillin .
In 2020, prescriber specialty ranking remained the same with exception of psychiatrics that changed position with otolaryngologist. All the medicines specialties decreased the number of prescriptions between 2020 with exception for dentists (+ 10,8%).
It was found that the proportion between public and private sector in 2020 had no significant variation, in line with the previous years trend (39,7% of prescriptions were originated in the private sector and 60,3% in the public sector (25,6% in Primary Care and 34,4% in Hospitals).

Conclusions: Declines in medicines utilization were greater for infection-related medicines than for chronic disease medicines.
This comprehensive analysis of the medicine’s utilization pattern generated evidence to national reflection and allowed authorities to identify the most detailed and in-depth analysis priorities to be undertaken.