School of Population and Global Health, University of Western Australia, Nedlands 6009, Western Australia, Australia.
Respiratory Environmental Health, Wal-Yan Respiratory Research Centre, The Kids Research Institute Australia, Nedlands 6009, Western Australia, Australia.
Alcohol Alcohol. 2024 Jul 21;59(5). doi: 10.1093/alcalc/agae063.
This study aimed to investigate acamprosate and naltrexone dispensing patterns in Australia.
A 10% representative sample of medications subsidized by the Australian Pharmaceutical Benefits Scheme (PBS) was used to identify individuals who were dispensed naltrexone or acamprosate between January 2006 and December 2023. Data were used to examine concurrent dispensing, medication switching and treatment episode length, as well as changes in prevalence and incidence over time.
During the study, we identified 22 745 individuals with a total of 117 548 dispensed prescriptions (45.3% naltrexone, 43.0% acamprosate, and 11.7% concurrent dispensing). Alcohol pharmacotherapy dispensing occurred in 1354 per 100 000 individuals. It is estimated that 2.9% of individuals with an alcohol use disorder in Australia are receiving a PBS-listed pharmacological treatment. For both pharmacotherapies, individuals were most likely to be male (60.0%) and 35-54 years of age (56.0%). Individuals were more likely to switch from acamprosate to naltrexone rather than the reverse. From 2006 and 2023, the number of prevalent individuals treated with an alcohol pharmacotherapy significantly increased, driven mainly the use of naltrexone, which more than doubled over the study period. Incident naltrexone-treated individuals were more likely to remain on treatment for the recommended minimum 3-month period compared to acamprosate treated individuals, although overall dispensing for at least 3 months was low (5.1%).
In Australia between 2006 and 2023, rates of naltrexone dispensing have substantially increased, while acamprosate dispensing showed minimal changes. However, the use of alcohol pharmacotherapies remains low compared with the likely prevalence of alcohol use disorders.
本研究旨在调查澳大利亚氨丁三醇和纳曲酮的配药模式。
采用澳大利亚药品福利计划（PBS）补贴药物的 10%代表性样本，确定 2006 年 1 月至 2023 年 12 月期间配给纳曲酮或氨丁三醇的个体。使用数据来检查同时配药、药物转换和治疗疗程，以及随时间推移的患病率和发病率变化。
在研究期间，我们确定了 22745 名患者，共开出 117548 张处方（45.3%为纳曲酮，43.0%为氨丁三醇，11.7%为同时配药）。酒精药物治疗的配药率为每 10 万人中有 1354 人。据估计，澳大利亚有 2.9%的酒精使用障碍患者正在接受 PBS 上市的药物治疗。对于两种药物治疗，患者主要为男性（60.0%）和 35-54 岁（56.0%）。患者更有可能从氨丁三醇转为纳曲酮治疗，而不是相反。从 2006 年到 2023 年，接受酒精药物治疗的患者人数显著增加，主要是由于纳曲酮的使用增加，在研究期间增加了一倍多。与接受氨丁三醇治疗的患者相比，新接受纳曲酮治疗的患者更有可能在推荐的至少 3 个月的治疗期内继续治疗，尽管总体上至少治疗 3 个月的比例较低（5.1%）。
在澳大利亚，2006 年至 2023 年间，纳曲酮的配药率大幅上升，而氨丁三醇的配药率则基本不变。然而，与可能的酒精使用障碍患病率相比，酒精药物治疗的使用仍然较低。
