抗精神病药在美国和法国市场的扩散，1998-2008 年。
Diffusion of antipsychotics in the US And French markets, 1998-2008.
机构信息
Department of Epidemiology, University of Toulouse, 37 allées Jules Guesde, Toulouse 31000, France.
出版信息
Psychiatr Serv. 2013 Jul 1;64(7):680-7. doi: 10.1176/appi.ps.004662012.
OBJECTIVE
Second-generation antipsychotics captured most of the U.S. antipsychotic market shortly after their introduction. Little is known about how second-generation antipsychotics have diffused in other countries with different health systems. The study objective was to describe trends in antipsychotic use in the United States and France from 1998 to 2008.
METHODS
Pharmaceutical policies in France and the United States are briefly described, followed by descriptive data on quarterly prescriptions for oral antipsychotics dispensed between January 1998 and September 2008. Data are from Xponent for the United States and the GERS database for France. Trends in the use of first- versus second-generation antipsychotics and in ingredient formulations of second-generation antipsychotics used are reported.
RESULTS
Between 1998 and 2008, total antipsychotic use in the United States increased by 78%. Total use in France was consistently higher despite a 9% decrease during the period. By 2008, second-generation antipsychotics represented 86% of the antipsychotics sold in the U.S. market, versus only 40% of the French market. However, average annual growth rates in use of second-generation antipsychotics were similar in the two countries. In France, use of all but one second-generation antipsychotic steadily increased, whereas in the United States trends in the use of newer drugs varied substantially by drug. For example, use of olanzapine decreased after 2003, but use of quetiapine increased.
CONCLUSIONS
These results highlight markedly divergent trends in the diffusion of new antipsychotics in France and the United States. Some differences may be explained by differences in health systems; others may reflect physicians' preferences and norms of practice.
目的
第二代抗精神病药物在推出后不久便占据了美国大部分抗精神病药物市场。对于第二代抗精神病药物在其他具有不同医疗体系的国家的扩散情况，人们知之甚少。本研究旨在描述 1998 年至 2008 年期间美国和法国抗精神病药物的使用趋势。
方法
简要介绍了法国和美国的药物政策，然后描述了 1998 年 1 月至 2008 年 9 月期间每季度开具的口服抗精神病药物处方的数据。数据来自美国的 Xponent 和法国的 GERS 数据库。报告了第一代和第二代抗精神病药物的使用趋势，以及第二代抗精神病药物成分配方的使用趋势。
结果
1998 年至 2008 年间，美国的总抗精神病药物使用量增加了 78%。尽管在此期间下降了 9%，法国的总使用量一直较高。到 2008 年，第二代抗精神病药物占美国市场销售的抗精神病药物的 86%，而法国市场仅占 40%。然而，两国第二代抗精神病药物的年平均增长率相似。在法国，除一种以外的所有第二代抗精神病药物的使用量都在稳步增加，而在美国，新药的使用趋势因药物而异。例如，奥氮平的使用量在 2003 年后下降，但喹硫平的使用量增加。
结论
这些结果突出了法国和美国新抗精神病药物扩散趋势的明显差异。一些差异可能是由医疗体系的差异解释的；其他差异可能反映了医生的偏好和实践规范。
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