P158 Increase of medication usage for asthma, COPD and rhinitis during three decades in finland

BackgroundThe Finnish National Asthma Programme (1994–2004), COPD Programme (1998–2007), and Allergy Programme (2008–2018) improved diagnostics and care, and saved costs.1 Yet, the long-term medication trends are undetermined.MethodsWe used national registry data from the Finnish Statistics on Medicines from 1990 to 2018. The data include all medications purchased in pharmacies in Finland with a population of 5.5 million. We analyzed the drugs for asthma and COPD, systemic antihistamines, nasal drugs and cough/cold preparations by employing Anatomical Therapeutic Chemical classification (ATC) (figure 1). Medication consumption was expressed as the number Defined Daily Doses (DDDs) per 1000 inhabitants per day.ResultsIn early 1990s, use of asthma drugs decreased, probably because overuse of inhaled beeta-2-agonists diminished as inhaled corticosteroids became first-line treatment (figure 1). In 1993, the use of asthma drugs started a steady increase because of improved awareness and diagnostics fueled by the Asthma Programme. Increase in prevalence contributed to this development. After 2008, the Allergy Programme has boosted the increase. The COPD Programme enhanced management, and many asthma drugs were also employed for COPD treatment. Use of antihistamines, nasal corticosteroids and specific immunotherapy increased along with the Allergy Programme. Antihistamines became also available over the count (OTC). Interestingly, sales of cough and cold preparations have been in steady decline.ConclusionsThere have been several, even opposite trends in medicating chronic respiratory diseases in Finland during the last 28 years. The net result, nevertheless, has been a general increase in drug use. As asthma and allergic rhinitis are effectively treated by modern medication, the increase mainly reflects better awareness and improved diagnostics of these conditions. In COPD, drugs are less effective and multipharmacy and overuse may become a problem. The reduction in the use of cough medicines is a result of long-term educational efforts. Time series data from nationwide statistics play an essential role when monitoring outcomes of public health programmes.ReferenceErhola M, et al. 25 years of respiratory health in Finland. Lancet Respir Med 2019;7(5):e16.Abstract P158 Figure 1Nationwide consumption of medications for treating asthma, chronic obstructive airway disease (COPD) and gallery in 1990–2018 in Finland