Bytzer P, Hansen J M, Schaffalitzky de Muckadell O B
Odense Sygehus, medicinsk gastroenterologisk afdeling S.
Ugeskr Laeger. 1991 May 13;153(20):1405-10.
In spring 1989, H2-receptor blockers and sucralfate were released for sale over-the-counter in Denmark and, simultaneously, the automatic National Health Insurance subsidy for all ulcer medicine was discontinued. The consequences of these alterations for the pressure on the diagnostic measures for upper dyspepsia are assessed by analysis of the number of referrals for gastroscopy, outpatient history-taking or radiographic examination of the stomach and oesophagus. The consequences for the consumer pattern were assessed in questionnaire investigations both to the practitioners who prescribed ulcer medicine before the alterations were introduced and also to patients who bought ulcer medicine after these alterations. Only approximately 3% of ulcer medicine is sold directly over-the-counter without medical assessment or control. No problems in safety were observed as regards incorrect treatment or delayed diagnosis. The relative proportion of patients with demonstrated indications for necessary ulcer medicine has increased after the alterations primarily on account of decrease in employment of medicine in therapeutic trials. This does not appear, however, to have resulted in any marked increased in the diagnostic possibilities. Potent ulcer medicine has not become generally accepted as over-the-counter medicine. The health and health-economic consequences should, therefore, be followed up for a more prolonged period.
1989年春，H2受体阻滞剂和硫糖铝在丹麦开始非处方销售，同时，国家医疗保险对所有溃疡药物的自动补贴也被取消。通过分析胃镜检查、门诊病史采集或胃和食管X线检查的转诊数量，评估这些变化对上消化道消化不良诊断措施压力的影响。通过对在这些变化引入之前开具溃疡药物的从业者以及在这些变化之后购买溃疡药物的患者进行问卷调查，评估对消费模式的影响。只有大约3%的溃疡药物是在没有医学评估或监管的情况下直接非处方销售的。在不正确治疗或延迟诊断方面未观察到安全问题。变化后，有明确必要使用溃疡药物指征的患者相对比例有所增加，主要是因为治疗试验中药物使用减少。然而，这似乎并未导致诊断可能性有任何显著增加。强效溃疡药物尚未被普遍接受为非处方药物。因此，应在更长时间内对健康和健康经济后果进行跟踪。
