Division for Heart Disease and Stroke Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA.
University of North Carolina, Gillings School of Global Public Health, Chapel Hill, NC, USA.
Am J Hypertens. 2023 Jul 14;36(8):439-445. doi: 10.1093/ajh/hpad036.
The COVID-19 pandemic disrupted healthcare in the United States and raised concerns about certain antihypertensives, and may have impacted both prescribing practices and access to blood pressure (BP) medications.
We assessed trends in BP prescription fills before and during the first year of the COVID-19 pandemic, using cross-sectional data for BP fills and tablets in the IQVIA (IMS Health) National Prescription Audit® database. Drugs filled via retail (92% coverage), mail-order (78% coverage), and long-term care (72% coverage) channels from January 2018 through December 2020 were included. Data were projected nationally and by state.
Between 2.9 and 3.4 billion BP tablets were dispensed monthly until February 2020, increasing sharply to 3.8 billion in March 2020 and declining to 3.5 billion in April, then increasing at 3-month intervals until December 2020. The number of tablets per fill increased slightly over time, with the largest increase (from 66.7 to 68.6) during February-March, 2020. Tablets were dispensed through retail channels (99.7 billion), mail-order (14.7 billion), and long-term care (5.3 billion). Rates of patients initiating new medications decreased during 2020 compared to prior years. Fills did not vary significantly by drug class.
A sharp increase in BP fills occurred with COVID-19 emergence, suggesting patients may have secured medications in preparation for potential access limitations. A decrease in new fills, indicating decreased initiation and/or modification of treatment regimens, suggests need for efforts to re-engage patients in the healthcare system and provide alternative ways to obtain medication refills and adjustments.
COVID-19 大流行扰乱了美国的医疗保健服务，并引发了人们对某些降压药物的担忧，这可能同时影响了降压药物的处方开具和可及性。
我们使用 IMS Health（艾美仕）全国处方审计数据库中的血压处方填写和片剂的横断面数据，评估了 COVID-19 大流行第一年前后的血压处方填写趋势。纳入了 2018 年 1 月至 2020 年 12 月期间通过零售（92%的覆盖率）、邮购（78%的覆盖率）和长期护理（72%的覆盖率）渠道开具的药物。数据在全国范围内和按州进行预测。
在 2020 年 2 月之前，每月分发的降压片剂数量为 29 亿至 34 亿片，2020 年 3 月急剧增加到 38 亿片，4 月降至 35 亿片，然后每隔 3 个月增加一次，直到 2020 年 12 月。每次配药的片剂数量随着时间的推移略有增加，最大的增加（从 66.7 片增加到 68.6 片）发生在 2020 年 2 月至 3 月期间。通过零售渠道（997 亿片）、邮购（147 亿片）和长期护理（53 亿片）分发了片剂。与前几年相比，2020 年开始新服用药物的患者比例有所下降。处方填写在药物类别上没有显著差异。
随着 COVID-19 的出现，降压药物的处方数量急剧增加，这表明患者可能已经为潜在的用药限制做好了准备。新处方数量的减少表明，开始和/或修改治疗方案的人数减少，这表明需要努力让患者重新参与医疗保健系统，并提供获取药物补充和调整的替代途径。
