title: Prescribing patterns of antiparkinsonian agents in Europe.
abstract: In the 1990 s, previous knowledge and randomized controlled trials supported the establishment of today's therapeutic recommendations in Parkinson's disease (PD). Scientific evidence allows different options for the treatment of PD. Patterns of use of antiparkinsonian agents (APA) across European countries may thus reflect these options. We wanted to describe patterns of use of APA in Europe and characterize the changes in prescription habits between 2003 and 2007. We investigated APA outpatient sales in 26 European countries where all commercially available APA were studied. Data for molecules and brand names were collected through IMS Health. Treatment per 1000 inhabitants daily (DID) was obtained from the WHO defined daily dose. Prescription pattern changes were evaluated by market share. Prescription patterns varied widely. In most countries, levodopa/dopamine agonists accounted for half of the drug use; whereas in others, anticholinergics, MAO inhibitors and amantadine prevailed. The greatest increase occurred with monoamine oxidase inhibitors and levodopa. There was an increase in dopamine agonists and a decrease in anticholinergics. For a 6.8% dose consume increase, there was a 41.1% sales increase (in euro). We showed an increase in the consumption of APA over 5 years. There was significant heterogeneity in the use of APA in Europe, suggesting differences in drug treatment. Costs of medication increased more than did dose consume, implying an increase in the cost of individual patient treatment. Published evidence does not explain the observed differences in the prescribing of APA.
authors.affiliation: Laboratory of Clinical Pharmacology and Therapeutics, Institute of Molecular Medicine, Lisbon School of Medicine, Lisbon, Portugal. mario.miguel.rosa@gmail.com
authors.forename: Mário Miguel
authors.initials: MM
authors.lastname: Rosa
authors.forename: Joaquim J
authors.initials: JJ
authors.lastname: Ferreira
authors.forename: Miguel
authors.initials: M
authors.lastname: Coelho
authors.forename: Rita
authors.initials: R
authors.lastname: Freire
authors.forename: Cristina
authors.initials: C
authors.lastname: Sampaio
mesh_terms: D000978:Antiparkinson Agents / Q000191:economics / Q000600:supply & distribution* / Q000627:therapeutic use*; D005060:Europe / Q000453:epidemiology; D006801:Humans; D010300:Parkinson Disease / Q000188:drug therapy* / Q000453:epidemiology; D010818:Practice Patterns, Physicians' / Q000191:economics / Q000706:statistics & numerical data*
chemical_list: D000978:Antiparkinson Agents