title: The increased utilisation of dopamine agonists and the introduction of COMT inhibitors have not reduced levodopa consumption--a nation-wide perspective in Sweden.
abstract: OBJECTIVE
  To study the impact of the new pharmacological treatment strategies in Parkinson's disease by analysis of the sales of dopaminergic drugs in Sweden 1990-2001.
  
  
  METHODS
  Invoice statistics and statistics on prescription sales of dopaminergic drugs 1990-2001 were obtained from the 906 public pharmacies and the 89 hospital pharmacies in Sweden. The Swedish Diagnosis and therapy survey was used to study the diagnosis the drugs were prescribed for.
  
  
  RESULTS
  During the period the sales expressed in DDD/1000 inhabitants and day increased from 1.75 to 1.86 (6%) for levodopa and from 0.04 to 0.27 (575%) for dopamine agonists. The increase in sales of dopamine agonists occurred after 1997 and consisted entirely of the sales of the new agonists, cabergoline, pramipexole and ropinirole. In Swedish crowns the total sales of dopaminergic drugs increased with 126% during the period. The cost for the dopamine agonists was 8% of the total cost for dopaminergic drugs in 1990 and 23% in 2001. The prescription sales figures of levodopa and dopamine agonists for the different Swedish counties in 2001 varied between 1.52 and 2.44 and 0.13 and 0.74 DDD/1000 inhabitants and day, respectively. There was no correlation, whether positive or negative, between the sales of dopamine agonists, levodopa and COMT inhibitors or between the sales and the densities of neurologists.
  
  
  CONCLUSIONS
  The consumption of levodopa in Sweden continues to increase in spite of a dramatic increase in the utilisation of dopamine agonists and the introduction of COMT-inhibitors.
authors.affiliation: Department of Neurology, University Hospital, S-75185 Uppsala, Sweden. hakan.askmark@neurologi.uu.se
authors.forename: Håkan
authors.initials: H
authors.lastname: Askmark
authors.forename: Karolina
authors.initials: K
authors.lastname: Antonov
authors.forename: Sten-Magnus
authors.initials: SM
authors.lastname: Aquilonius
mesh_terms: D065098:Catechol O-Methyltransferase Inhibitors; D015259:Dopamine Agents / Q000191:economics / Q000600:supply & distribution* / Q000627:therapeutic use; D004791:Enzyme Inhibitors / Q000191:economics / Q000600:supply & distribution* / Q000627:therapeutic use; D006801:Humans; D007980:Levodopa / Q000191:economics / Q000600:supply & distribution* / Q000627:therapeutic use; D010300:Parkinson Disease / Q000188:drug therapy* / Q000453:epidemiology; D017891:Pharmacoepidemiology; D010818:Practice Patterns, Physicians' / Q000191:economics / Q000706:statistics & numerical data; D013548:Sweden / Q000453:epidemiology
chemical_list: D065098:Catechol O-Methyltransferase Inhibitors; D015259:Dopamine Agents; D004791:Enzyme Inhibitors; D007980:Levodopa