Effects of expiring reimbursability of pentaerythrityl tetranitrate (PETN, pentalong®) on anti-anginal therapy: an observational study

Purpose Pentaerythrityl tetranitrate (PETN) was the most commonly prescribed long‐acting nitrate in Germany. We aimed to assess whether the discontinuation of PETN reimbursability in 2011 resulted in alternative prescriptions of anti‐anginal medications or in a discontinuation of anti‐anginal therapy. Methods This is an observational study using health claims data from one German federal state analysing all patients discontinuing a PETN treatment. Patients starting a new alternative anti‐anginal treatment (long‐acting nitrates, molsidome, ivabradine and ranolazine) were compared with patients without a new anti‐anginal treatment with respect to use of short‐acting nitrates, beta blockers (BBs) and calcium channel blockers (CCBs). Results Out of 12 909 patients, 12 763 (99%) discontinued PETN until 12/2012. Of these, 52% started an alternative anti‐anginal treatment, 43% did not receive any alternative treatment and 5% were excluded from analysis. Before termination of PETN reimbursability, 65% of patients received BBs, 29% CCBs and 10% short‐acting nitrates. In patients started on alternative anti‐anginal treatment, prescription rates for short‐acting nitrates, BBs and CCBs remained constant after discontinuing PETN. In patients without any alternative anti‐anginal treatment, prescription rates for BBs and CCBs did not change meaningfully (