title: Trends in antiarrhythmic drug use after marketing authorization of dronedarone: comparison between Emilia Romagna (Italy) and Sweden.
abstract: OBJECTIVE
  Our aim was to evaluate whether dronedarone authorization impacts antiarrhythmic drug prescribing in Sweden and Emilia Romagna (Italy).
  
  
  METHODS
  Prescriptions of classes I and III antiarrhythmics, expressed as defined daily doses per thousand inhabitants per day (DDD/TID) were monthly using information collected from pharmacy-reimbursed databases. Interrupted time series analysis was applied to compare prescription data over the 2009-2011 period.
  
  
  RESULTS
  In Emilia Romagna, the overall consumption of antiarrhythmics was six times as high as in Sweden (7.6 vs. 1.2 DDD/TID). In the first year on the market, dronedarone represented 1.0 % in Italy and 10.7 % in Sweden of the overall antiarrhythmic prescriptions. In Sweden, dronedarone authorization generated an increase in the prescription trend of antiarrhythmics (trend change +0.02; p < 0.001) without variation in amiodarone use In Emilia Romagna, dronedarone marketing did not influence the prescription pattern of either overall antiarrhythmics or amiodarone.
  
  
  CONCLUSIONS
  Emilia Romagna and Sweden substantially differ in terms of overall antiarrhythmic use. Although clinical guidelines place dronedarone among first-choice treatments for atrial fibrillation, amiodarone prescribing was not affected in either country by the entry of dronedarone, probably due to a cautious approach by clinicians in line with regulatory recommendations and safety warnings.
authors.affiliation: Department of Medical and Surgical Sciences, University of Bologna, Via Irnerio, 48, I-40126 Bologna, BO, Italy.
authors.forename: Carlo
authors.initials: C
authors.lastname: Piccinni
authors.forename: Emanuel
authors.initials: E
authors.lastname: Raschi
authors.forename: Elisabetta
authors.initials: E
authors.lastname: Poluzzi
authors.forename: Aurora
authors.initials: A
authors.lastname: Puccini
authors.forename: Thomas
authors.initials: T
authors.lastname: Cars
authors.forename: Björn
authors.initials: B
authors.lastname: Wettermark
authors.forename: Igor
authors.initials: I
authors.lastname: Diemberger
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Boriani
authors.forename: Fabrizio
authors.initials: F
authors.lastname: De Ponti
mesh_terms: D000638:Amiodarone / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use; D000889:Anti-Arrhythmia Agents / Q000009:adverse effects / Q000627:therapeutic use*; D000077764:Dronedarone; D011307:Drug Prescriptions; D004363:Drug Utilization / Q000639:trends; D017723:Drug Utilization Review; D019983:Guideline Adherence / Q000639:trends; D019538:Health Care Surveys; D054625:Healthcare Disparities / Q000639:trends; D006801:Humans; D007558:Italy; D008389:Marketing of Health Services / Q000639:trends*; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians' / Q000639:trends*; D013548:Sweden; D013997:Time Factors
chemical_list: D000889:Anti-Arrhythmia Agents; D000077764:Dronedarone; D000638:Amiodarone