Department of Community Medicine, Health Information and Decision, Faculty of Medicine, University of Porto, Porto, Portugal.
Faculty of Pharmaceutical Sciences, State University of Campinas, Campinas, Sao Paulo, Brazil.
J Affect Disord. 2023 Feb 15;323:213-218. doi: 10.1016/j.jad.2022.11.069. Epub 2022 Nov 25.
This study aimed to investigate the trends in antidepressants sales in Brazil.
We performed a joinpoint analysis of antidepressants sales in Brazil from 2014 to 2020, recorded in the Brazilian National Controlled Products Management System. The primary outcomes were the defined daily dose per 1000 inhabitants per day (DID) and the market shares for each antidepressant per year. We used joinpoint regression to assess the changes in antidepressant consumption in DID to obtain the average annual percent change (AAPC) and 95 % confidence intervals (95 % CI). Changes in market shares were tested by chi-square trend test (p < 0.05 as significant).
From 2014 to 2020, 42,252,989 antidepressant sales were recorded in the system. Antidepressant sales increased from 13.7 to 33.6 DID in the period (AAPC: 15.7; 95 % CI: 13.0-18.4; p < 0.001); the largest increases were observed for serotonin reuptake inhibitors and 'other' antidepressants (including serotonin-norepinephrine reuptake inhibitors), whereas tricyclics remained steady. Escitalopram and sertraline were the most sold drugs. Market share of serotonin reuptake inhibitors decreased, particularly for paroxetine (13.1 % to 6.5 %; p = 0.016), while 'other' antidepressants' market share expanded from 21.9 % to 33.3 % (p = 0.027), especially for desvenlafaxine (2.9 % to 14.3 %; p < 0.001).
The dataset does not include antidepressants dispensed in hospitals, public services, and compounding pharmacies, neither their therapeutic indications.
Sales of antidepressants significantly increased in Brazil from 2014 to 2020, which were mainly driven by higher prescriptions of serotonin reuptake inhibitors and 'other' antidepressants classes. Market share changes seem to be driven by novelty of products.
本研究旨在调查巴西抗抑郁药销售趋势。
我们对 2014 年至 2020 年巴西国家控制药品管理系统记录的抗抑郁药销售情况进行了 joinpoint 分析。主要结局指标为每 1000 名居民每日定义日剂量（DID）和每年每种抗抑郁药的市场份额。我们使用 joinpoint 回归评估 DID 中抗抑郁药消费的变化，以获得平均年百分比变化（AAPC）和 95%置信区间（95%CI）。通过卡方趋势检验（p<0.05 为显著）测试市场份额的变化。
2014 年至 2020 年期间，系统共记录了 42252989 份抗抑郁药销售记录。抗抑郁药销售从 13.7 增至 33.6 DID（AAPC：15.7%；95%CI：13.0-18.4%；p<0.001）；最大的增长发生在选择性 5-羟色胺再摄取抑制剂和“其他”抗抑郁药（包括 5-羟色胺-去甲肾上腺素再摄取抑制剂），而三环类抗抑郁药保持稳定。艾司西酞普兰和舍曲林是销量最大的药物。选择性 5-羟色胺再摄取抑制剂的市场份额下降，特别是帕罗西汀（13.1%降至 6.5%；p=0.016），而“其他”抗抑郁药的市场份额从 21.9%扩大到 33.3%（p=0.027），特别是文拉法辛（2.9%增至 14.3%；p<0.001）。
该数据集不包括医院、公共服务和复方药房分发的抗抑郁药及其治疗适应症。
2014 年至 2020 年，巴西抗抑郁药销售显著增加，主要原因是选择性 5-羟色胺再摄取抑制剂和“其他”抗抑郁药类别的处方量增加。市场份额的变化似乎是由产品的新颖性驱动的。
