(P-139) Consumption Patterns of Chronic Medication During the COVID-19 Pandemic in Portugal

Background: Drugs used in diabetes (DB), hypertension (HT) and hypercholesterolemia (HC) have the highest consumption rate in Portugal and account for 30% of total pharmaceutical expenditure in 2020. The COVID-19 pandemic outbreak led to many constraints that could have negative impact in the access of the population to regular use of drugs or even adherence to the treatment of this diseases.

Objectives: To explore changes in drug utilization patterns in the treatment of diabetes, hypertension and hypercholesterolemia in Portugal during the COVID-19 pandemic.

Methods: Country and regional analysis of drug utilization – diabetes (ATC: A10), hypertension (ATC: C02, C03, C07, C08, C09) and hypercholesterolemia (ATC: C10) – for 2019 and 2020. Monthly data was retrieved from hmR Pharmacy Sales Information System, a nationwide database with representative ambulatory data. Consumption data was expressed in defined daily doses (DDD) per 1000 habitants per day (DHD) using the ATC/DDD system for each therapeutic subgroup. National and regional drug consumption was analyzed since the pandemic outbreak (march to December 2020) and compared with the same period in the previous year. Results were stratified by INN.

Results: In march 2020, a high DHD uptake was observed (DB: 138.7; HT: 520.0; HC: 197.5) compared to the previous year (DB: +52.7%, HT: +43.1%; HC: +48.7%), followed by a small downfall in the following 2 months (-4.6%, -7.6% and -1.7%, respectively). In DB, insulin consumption on the 2nd semester was 15.3 DHD, per month, lower than the previous year (average growth -5.9%), while other GLD had a mean consumption of 98.0 DHD per month (+2.5%). In HT, no significant changes were observed for the 2nd semester of 2020 (C02: 3.0 DHD, 0.9%; C03: 57.8 DHD, -2.1%; C07: 40.2 DHD, 1.1%; C08: 47.9 DHD, -1.6%; C09: 232.3 DHD, -0.2%). In HC, the average consumption for the 2nd semester of 2020 was 150.2 DHD per month, higher than the previous year (average growth 5.5%). Regional differences were found.

Conclusions: Consumption pattern of DB, HT and HC drugs had a significant increase in the first month of the COVID-19 pandemic outbreak in Portugal and a lower consumption level in the following 2 months, followed by a relatively stable trend in the next months. Long term problems related to patients’ access to their medication were not confirmed. Results suggest that patients may have anticipated the prescriptions' refill at the start of the outbreak due to the uncertainty of the pandemic impact but rapidly returned to normal drug refill.