[At what care level are cyclo-oxygenase-2 inhibitors prescribed?].
OBJECTIVE
To find the evolution in the billing of prescriptions for selective cyclooxygenase-2 (COX-2) inhibitors since they came on the market and to compare this evolution in primary care (PC) and specialist care (SC).Design. Cross-sectional, descriptive study.


METHODS
Toledo Health Area. Main measurements. Data were obtained from the System of Drug Information (SIFAR) to analyse the monthly turnover of NSAID prescriptions (M01A group in the official classification of medicines, including rofecoxib and celecoxib) issued by doctors in PC and SC between January 2000 and June 2001.


RESULTS
In our area during the study period, 583,558 NSAID packages were prescribed; 6.61% were COX-2 inhibitors, which represented 29.08% of NSAID expenditure. 98.23% of NSAID packages and 94.61% of COX-2 inhibitors were prescribed in PC. The use of COX-2 inhibitors in SC rose from 10.03% of the total NSAIDs in February 2000 to 29.79% in June 2001; whilst in PC it rose from 1.52% to 10.78%. Rofecoxib and celecoxib were third and fifth in the lists of most prescribed NSAIDs (number of packages) in SC, and ninth and twelfth in PC. In terms of cost of prescription, they were first and second in SC, and first and fourth in PC.


CONCLUSIONS
COX-2 inhibitors have become the main NSAIDs prescribed. The appearance of these drugs had a different impact on SC and PC doctors, with greater use of them and a more rapid introduction in SC.
Montero Fernández
M J
MJ
Farmacéutico. Gerencia de Atención Primaria de Toledo. España. mjmontero@sescam.org
Rodríguez Alcalá
F J
FJ
Valles Fernández
N
N
López de Castro
F
F
Esteban Tudela
M
M
Cordero García
B
B
D003430:Cross-Sectional Studies; D051546:Cyclooxygenase 2; D052246:Cyclooxygenase 2 Inhibitors; D016861:Cyclooxygenase Inhibitors / Q000627:therapeutic use*; D011307:Drug Prescriptions / Q000706:statistics & numerical data; D006801:Humans; D007527:Isoenzymes / Q000037:antagonists & inhibitors*; D008565:Membrane Proteins; D010818:Practice Patterns, Physicians'; D011320:Primary Health Care; D011451:Prostaglandin-Endoperoxide Synthases; D013030:Spain
D052246:Cyclooxygenase 2 Inhibitors; D016861:Cyclooxygenase Inhibitors; D007527:Isoenzymes; D008565:Membrane Proteins; D051546:Cyclooxygenase 2; C496540:PTGS2 protein, human; D011451:Prostaglandin-Endoperoxide Synthases