Henry D A, Cully L R, Grigson T, Lee C
University of Newcastle, Royal Newcastle Hospital, NSW.
Med J Aust. 1991 Sep 2;155(5):332-6. doi: 10.5694/j.1326-5377.1991.tb142294.x.
To determine the recent pattern of use of hypolipidaemic drugs in the Australian community.
Drug utilisation study employing prescription data collected during the operation of the Australian Pharmaceutical Benefits Scheme (PBS).
Non-hospital drug use in Australia.
All patients, pensioners and non-pensioners, who received prescriptions for hypolipidaemic agents under the PBS between January 1987 and December 1989.
The total number of prescriptions, average quantity dispensed with each prescription, defined daily doses (DDD) and Australian population figures for pensioners and non-pensioners were used to express the consumption of hypolipidaemic agents as DDD/1000 individuals/day.
Between the March quarter 1987 and the December quarter 1989 prescribing of hypolipidaemics for the Australian community increased from 68,120 to 304,760 prescriptions per quarter, which translates to a rise in use from 1.2 to 5.2 DDD/1000 inhabitants/day. This included a rise in the use of clofibrate from 0.6 to 2.6 DDD/1000 inhabitants/day, and of cholestyramine from 0.6 to 1.9 DDD/1000 inhabitants/day. Prescribing of hypolipidaemics for pensioners increased from 29,569 to 123,440 prescriptions per quarter. This translated into a rise in use from 3.7 to 14.8 DDD/1000 pensioners/day. Notable rises were seen for clofibrate, 1.9 to 8.1 DDD/1000 pensioners/day, and cholestyramine, 1.6 to 4.7 DDD/1000 pensioners/day. In comparison published data from the Nordic countries and the United States showed a lower overall use of hypolipidaemics and declining consumption of clofibrate.
The trend in Australia was unusual in that the use of clofibrate increased to a greater extent than that of the resins, cholestyramine and colestipol which are generally preferred for treatment of hypercholesterolaemia. Possible reasons for this include: the better tolerability of clofibrate; its readier availability during the study period; the recommendation by the Pharmaceutical Benefits Advisory Committee that clofibrate was the preferred drug when triglyceride levels were also elevated and the limited availability of newer hypolipidaemic agents.
确定澳大利亚社区近期降血脂药物的使用模式。
利用澳大利亚药品福利计划（PBS）运作期间收集的处方数据进行药物利用研究。
澳大利亚的非医院药物使用情况。
1987年1月至1989年12月期间在PBS下接受降血脂药物处方的所有患者，包括领取养老金者和非领取养老金者。
处方总数、每张处方的平均配药量、限定日剂量（DDD）以及领取养老金者和非领取养老金者的澳大利亚人口数据，用于以DDD/1000人/天来表示降血脂药物的消费量。
在1987年第一季度至1989年第四季度期间，澳大利亚社区降血脂药物的处方量从每季度68120张增加到304760张，这意味着使用量从1.2 DDD/1000居民/天上升到5.2 DDD/1000居民/天。这包括安妥明的使用量从0.6 DDD/1000居民/天增加到2.6 DDD/1000居民/天，以及消胆胺的使用量从0.6 DDD/1000居民/天增加到1.9 DDD/1000居民/天。领取养老金者的降血脂药物处方量从每季度29569张增加到123440张。这转化为使用量从3.7 DDD/1000领取养老金者/天上升到14.8 DDD/1000领取养老金者/天。安妥明的使用量显著增加，从1.9 DDD/1000领取养老金者/天增加到8.1 DDD/1000领取养老金者/天，消胆胺的使用量从1.6 DDD/1000领取养老金者/天增加到4.7 DDD/1000领取养老金者/天。相比之下，北欧国家和美国公布的数据显示降血脂药物的总体使用量较低，且安妥明的消费量在下降。
澳大利亚的这一趋势不同寻常，因为安妥明的使用量增加幅度大于通常更受青睐用于治疗高胆固醇血症的树脂类药物消胆胺和考来替泊。可能的原因包括：安妥明的耐受性更好；在研究期间更容易获得；药品福利咨询委员会建议当甘油三酯水平也升高时安妥明是首选药物；以及新型降血脂药物的供应有限。
