Comparison of drug prescribing before and during the COVID-19 pandemic: A cross-national European study

Iva Selke Krulichová*, Gisbert W. Selke, Marion Bennie, Mohammadhossein Hajiebrahimi, Fredrik Nyberg, Jurij Fürst, Kristina Garuolienė, Elisabetta Poluzzi, Juraj Slabý, Corinne Zara Yahni, Mattia Altini, Maria Pia Fantini, Václav Kočí, Stuart McTaggart, Caridad Pontes, Chiara Reno, Simona Rosa, Marta Turu Pedrola, Mitja Udovič, Björn Wettermark

*Corresponding author for this work

Research output: Contribution to journalArticleResearchpeer-review

1 Citation (Scopus)


Purpose: The COVID-19 pandemic had an impact on health care, with disruption to routine clinical care. Our aim was to describe changes in prescription drugs dispensing in the primary and outpatient sectors during the first year of the pandemic across Europe. Methods: We used routine administrative data on dispensed medicines in eight European countries (five whole countries, three represented by one region each) from January 2017 to March 2021 to compare the first year of the COVID-19 pandemic with the preceding 3 years. Results: In the 10 therapeutic subgroups with the highest dispensed volumes across all countries/regions the relative changes between the COVID-19 period and the year before were mostly of a magnitude similar to changes between previous periods. However, for drugs for obstructive airway diseases the changes in the COVID-19 period were stronger in several countries/regions. In all countries/regions a decrease in dispensed DDDs of antibiotics for systemic use (from −39.4% in Romagna to −14.2% in Scotland) and nasal preparations (from −34.4% in Lithuania to −5.7% in Sweden) was observed. We observed a stockpiling effect in the total market in March 2020 in six countries/regions. In Czechia the observed increase was not significant and in Slovenia volumes increased only after the end of the first lockdown. We found an increase in average therapeutic quantity per pack dispensed, which, however, exceeded 5% only in Slovenia, Germany, and Czechia. Conclusions: The findings from this first European cross-national comparison show a substantial decrease in dispensed volumes of antibiotics for systemic use in all countries/regions. The results also indicate that the provision of medicines for common chronic conditions was mostly resilient to challenges faced during the pandemic. However, there were notable differences between the countries/regions for some therapeutic areas.

Original languageEnglish
Pages (from-to)1046-1055
Number of pages10
JournalPharmacoepidemiology and Drug Safety
Issue number10
Publication statusPublished - Oct 2022


  • COVID-19
  • cross-national comparison
  • DDD volume
  • drug utilization
  • pandemic
  • pharmacoepidemiology
  • stockpiling


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