Stephen Ilyas1, Joanna Moncrieff. 1. General Adult Psychiatry, Tower Hamlets Centre for Mental Health, East London NHS Foundation Trust, London.
Abstract
BACKGROUND: Increasing rates of prescriptions for antidepressants, antipsychotics and stimulants have been reported from various countries. AIMS: To examine trends in prescriptions and the costs of all classes of psychiatric medication in England. METHOD: Data from the Prescription Cost Analysis 1998-2010 was examined, using linear regression analysis to examine trends. RESULTS: Prescriptions of drugs used for mental disorders increased by 6.8% (95% CI 6.3-7.4) per year on average, in line with other drugs, but made up an increasing proportion of all prescription drug costs (P = 0.001). There were rising trends in prescriptions of all classes of psychiatric drugs, except anxiolytics and hypnotics (which did not change). Antidepressant prescriptions increased by 10% (95% CI 9.0-11) per year on average, and antipsychotics by 5.1% (95% CI 4.3-5.9). Antipsychotics overtook antidepressants as the most costly class of psychiatric medication, with costs rising 22% (95% CI 17-27) per year. CONCLUSIONS: Rising prescriptions may be partly explained by longer-term treatment and increasing population. Nevertheless, it appears that psychiatric drugs make an increasing contribution to total prescription drug costs, with antipsychotics becoming the most costly. Low-dose prescribing of some antipsychotics is consistent with other evidence that their use may not be restricted to those with severe mental illness.
BACKGROUND: Increasing rates of prescriptions for antidepressants, antipsychotics and stimulants have been reported from various countries. AIMS: To examine trends in prescriptions and the costs of all classes of psychiatric medication in England. METHOD: Data from the Prescription Cost Analysis 1998-2010 was examined, using linear regression analysis to examine trends. RESULTS: Prescriptions of drugs used for mental disorders increased by 6.8% (95% CI 6.3-7.4) per year on average, in line with other drugs, but made up an increasing proportion of all prescription drug costs (P = 0.001). There were rising trends in prescriptions of all classes of psychiatric drugs, except anxiolytics and hypnotics (which did not change). Antidepressant prescriptions increased by 10% (95% CI 9.0-11) per year on average, and antipsychotics by 5.1% (95% CI 4.3-5.9). Antipsychotics overtook antidepressants as the most costly class of psychiatric medication, with costs rising 22% (95% CI 17-27) per year. CONCLUSIONS: Rising prescriptions may be partly explained by longer-term treatment and increasing population. Nevertheless, it appears that psychiatric drugs make an increasing contribution to total prescription drug costs, with antipsychotics becoming the most costly. Low-dose prescribing of some antipsychotics is consistent with other evidence that their use may not be restricted to those with severe mental illness.
Authors: Silvia Alessi-Severini; James M Bolton; Murray W Enns; Matthew Dahl; David M Collins; Dan Chateau; Jitender Sareen Journal: CMAJ Open Date: 2014-10-01