(C) The Impact of COVID-19 on Population-Level Drug Utilisation of Alendronate in Five European Databases

Saturday, August 27, 2022

8:00 AM – 6:00 PM CEST

Location: Hall E South

Publication Number: 637

Presenting Author(s)

Eng Hooi (Cheryl) Tan, PhD
– Nuffield Department of Orthopaedics, Rheumatology, and Musculoskeletal Sciences,University of Oxford, Oxfordshire, United Kingdom

Co-Author(s)

Danielle E. Robinson
– Nuffield Department of Orthopaedics, Rheumatology, and Musculoskeletal Sciences, University of Oxford, United Kingdom
Annika Joedicke
– Nuffield Department of Orthopaedics, Rheumatology, and Musculoskeletal Sciences,University of Oxford, Oxfordshire, United Kingdom
Maria Sanchez-Santos
– Nuffield Department of Orthopaedics, Rheumatology, and Musculoskeletal Sciences, University of Oxford, United Kingdom
Mees Mosseveld
– Department of Medical Informatics, Erasmus University Medical Centre, Rotterdam, The Netherlands, Netherlands
Katrine Bødkergaard Nielsen
– Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark, Denmark
Carlen Reyes
– Institut Universitari d�Investigaci� en Atenci� Prim�ria Jordi Gol, IDIAP Jordi Gol, BARCELONA, Barcelona, Spain
Annemarie Voss
– Department of Clinical Epidemiology, Leibniz-Institut für Präventionsforschung und Epidemiologie - BIPS, Germany
Ettore Marconi
– Health Search, Italian College of General Practitioners and Primary Care, Florence, Italy, Italy
Francesco Lapi
– Health Search, Italian College of General Practitioners and Primary Care, Florence, Italy, Italy
Jonas Reinold
– Leibniz Institute for Prevention Research and Epidemiology - BIPS, Bremen, Germany
Katia M. Verhamme, MD, MSc
– Erasmus University Medical Center, Rotterdam, The Netherlands, Rotterdam, Zuid-Holland, Belgium
Lars Pedersen, MSc, PhD
– Professor, Department of Clinical Epidemiology, Aarhus University Hospital and Aarhus University, Aarhus, Denmark, Denmark
Marcel de Wilde
– Erasmus University Medical Center, Rotterdam, The Netherlands, Rotterdam, Zuid-Holland, Netherlands
Marc Far Ruiz
– Fundació Institut Universitari per a la recerca a l’Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain, Spain
María Aragón
– Fundació Institut Universitari per a la recerca a l’Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain, Spain
Pauline Bosco-Levy
– MD, PhD, Bordeaux PharmacoEpi , Bordeaux, Gironde, France
Régis Lassalle
– Bordeaux PharmacoEpi, INSERM CIC-P 1401, Univ. Bordeaux, Bordeaux, France, Bordeaux, Aquitaine, France
Daniel Prieto-Alhambra, MD, MSc, PhD, FISPE
– Professor of Pharmaco- and Device Epidemiology, CSM, NDORMS, University of Oxford, University of Oxford, Oxford, United Kingdom

Background: Alendronate [ALN] is the most common osteoporosis medication prescribed in Europe. During the COVID-19 pandemic, non-urgent visits to primary care were restricted, affecting the initiation of new treatments.

Objectives: We aimed to describe the effect of COVID-19 on the prescription of ALN to new users in five European databases.

Methods: We included patients aged ≥ 18 years and registered for ≥ 1 year in the following databases: Clinical Practice Research Datalink (CPRD, UK), Health Search Database (HSD, Italy), Integrated Primary Care Information Project (IPCI, Netherlands), Nationwide linked Danish Registries (NDR, Denmark), and Sistema d'Informació per al Desenvolupament de la Investigació en Atenció Primària (SIDIAP, Spain). The number of new users of ALN was obtained from prescription records between January 2018 and June 2021 (December 2020 [NDR]). New users were defined as patients without a prescription for ALN in the preceding year. Monthly incidence was calculated, where the numerator was all new users of ALN in a given calendar month, and the denominator was the number of people available in the dataset on that given calendar month, who were not users of ALN as of the last day of the prior calendar month. The incidence was compared before and after March 2020, when lockdown was imposed due to COVID-19.

Results: Prior to lockdown in March 2020, there was a general upwards trend of new use in CPRD, which was not observed in the other databases. Incidence (per 10,000 patients) in CPRD increased from 0.98 in January 2018 to 2.56 in March 2020. In January to April of the preceding years (2018 and 2019), incidence was mostly stable in CPRD (0.93 to 1.24), HSD (2.53 to 2.77), IPCI (1.86 to 2.41), NDR (3.07 to 3.97), and SIDIAP (1.89 to 2.11).
After March 2020, the start of lockdown, new use of ALN rapidly decreased in all countries, reaching lows in April-May 2020, from 2.56 to 1.07 for CPRD, 2.76 to 1.09 for HSD, 2.59 to 1.80 for IPCI, 3.58 to 1.86 for NDR, and 2.05 to 0.91 for SIDIAP.
Recovery after the initial lockdown was observed with incidence of new use reaching pre-pandemic levels in CPRD (as of September 2020), HSD (October 2020), IPCI (June 2020), NDR (June 2020) and SIDIAP (November 2020).

Conclusions: Following the COVID-19 pandemic lockdowns in March 2020, the initiation of ALN declined in the immediate months after lockdown in five European countries. However, recovery to pre-pandemic use was observed.