The increased utilisation of dopamine agonists and the introduction of COMT inhibitors have not reduced levodopa consumption--a nation-wide perspective in Sweden.
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.
Askmark
Håkan
H
Department of Neurology, University Hospital, S-75185 Uppsala, Sweden. hakan.askmark@neurologi.uu.se
Antonov
Karolina
K
Aquilonius
Sten-Magnus
SM
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
D065098:Catechol O-Methyltransferase Inhibitors; D015259:Dopamine Agents; D004791:Enzyme Inhibitors; D007980:Levodopa