Evaluation of drug deliveries and refunds for obstructive airway diseases in France between 2012 and 2017.
BACKGROUND
The aim of this survey was to investigate variations of drugs for obstructive airway diseases delivery rates and refunds at a national level which are rarely reported.


METHODS
The French national health data system (56 million, 87% of the population) was used to identify insurance beneficiaries with at least one drug delivery (Anatomical Therapeutic Classification R03) per year between 2012 and 2017.


RESULTS
At least one drug delivery in 2017 was identified for 7.5 million people (12.9%). High proportions of people with at least one, two or three drug deliveries were observed between the ages of 0 to 2 years (22%, 10%, 5.5%), then decreased between the ages of 18 and 40 years (9.3%, 3.8%, 2.3%) and increased again in people 75 years and older (17.8%, 11.9% 9.9%), with strong variations between years. In 2017, the proportions of people with at least one delivery, either alone or in combination with other drugs, were 68% for inhaled corticosteroids (ICS) (median 1; IQR 1-4), 59% for short-acting beta2-agonists (SABA) (1; 1-3), 42% for long-acting beta2-agonists (LABA) (2; 1-6), 11% for leukotriene receptor antagonists (3; 1-9), and 12% for inhaled anti-cholinergics (4; 1-10). Younger patients more often received SABAs (0-2 years: 84%) and leukotriene receptor antagonists (3-6 years: 14%) and people 75 years and older more often received LABAs (59%) and ICS, either alone or in combination with other drugs (28%).The mean annual refund reimbursed per person decreased from €136 in 2012 to €118 in 2017.


CONCLUSION
This study suggests a low level of use for drug classes associated with low delivery rates, suggesting inappropriate prescriptions and poor follow-up. These results highlight the difficulty of identifying these problems if delivery rates variations over several years are not taken into account.
['Tuppin|Philippe|P|', 'Aguadé|Anne-Sophie|AS|', 'Guillo|Sylvie|S|', 'Gastaldi|Christelle|C|', 'Taillé|Camille|C|']
Drugs Asthma COPD Epidemiology Observational study