title: Impact of regulatory measures on antipsychotics drug consumption in Castilla y León, Spain.
abstract: OBJECTIVE
  Antipsychotics are currently used to treat different diseases; even some off-labelled conditions are treated with this medication. Consumption and cost of antipsychotic drugs sharply increased in Spain after second-generation drugs were marketed; several regulatory measures were adopted to curb this trend. The aim of this study was to examine the impact of these measures upon the use and cost of antipsychotics.
  
  
  METHODS
  Study of drug use (SDU) from 1995 to 2012. Consumption and cost data were obtained from the CONCYLIA database; this database contains the retail community pharmacies sales of medicinal products reimbursed by the National Health System in Castilla y León (Spain).
  
  
  METHODS
  Data are presented as defined daily doses per 1000 inhabitants per day (DID) and day treatment cost (DTC).
  
  
  RESULTS
  First-generation antipsychotics prescriptions gradually decreased from 3.0 to 1.8 DID; meanwhile, prescriptions for second-generation antipsychotics considerably increased from 0.3 to 9.9 DID. The use of risperidone dropped after the marketing of its structural derivative paliperidone with a similar efficacy but with a substantially higher cost per day. In 2011 and thereafter, patients in Spain began to pay a part of the medications cost, but this did not decrease antipsychotics consumption. Global cost of antipsychotics only began to fall after measures were adopted to lower the price of medicines because of the economic collapse in Spain after May 2010.
  
  
  CONCLUSIONS
  Several health policy measures have tried to reduce antipsychotics consumption in Spain, special ways of dispensing, marketing of generic drugs and special economic measures for patients. These measures eventually failed to avoid the increase in antipsychotics use. The cost only dropped when lowering prescription drug prices took place.
authors.affiliation: Centro de Estudios sobre la Seguridad de los Medicamentos (CESME), Universidad de Valladolid, Spain. Electronic address: lmartin@ife.uva.es.
authors.forename: L H
authors.initials: LH
authors.lastname: Martín Arias
authors.affiliation: Centro de Estudios sobre la Seguridad de los Medicamentos (CESME), Universidad de Valladolid, Spain.
authors.forename: C
authors.initials: C
authors.lastname: Treceño Lobato
authors.affiliation: Centro de Estudios sobre la Seguridad de los Medicamentos (CESME), Universidad de Valladolid, Spain.
authors.forename: S
authors.initials: S
authors.lastname: Pérez García
authors.affiliation: Centro de Estudios sobre la Seguridad de los Medicamentos (CESME), Universidad de Valladolid, Spain.
authors.forename: P
authors.initials: P
authors.lastname: García Ortega
authors.affiliation: Centro de Estudios sobre la Seguridad de los Medicamentos (CESME), Universidad de Valladolid, Spain.
authors.forename: M
authors.initials: M
authors.lastname: Sáinz Gil
authors.affiliation: Centro de Estudios sobre la Seguridad de los Medicamentos (CESME), Universidad de Valladolid, Spain.
authors.forename: R
authors.initials: R
authors.lastname: Sanz Fadrique
authors.affiliation: Centro de Estudios sobre la Seguridad de los Medicamentos (CESME), Universidad de Valladolid, Spain.
authors.forename: A
authors.initials: A
authors.lastname: Carvajal García-Pando
mesh_terms: D014150:Antipsychotic Agents / Q000191:economics* / Q000627:therapeutic use*; D003132:Commerce / Q000706:statistics & numerical data; D016208:Databases, Factual; D011307:Drug Prescriptions / Q000706:statistics & numerical data*; D006801:Humans; D007880:Legislation, Drug; D010594:Pharmacies; D012189:Retrospective Studies; D013030:Spain
chemical_list: D014150:Antipsychotic Agents
keywords: Antipsychotics; Day treatment cost; Defined daily dose; Drug consumption; First-generation; Regulatory measures; Second-generation