Increasing sales of selective serotonin reuptake inhibitors are closely related to
increasing number of products on the market Margrethe Nielsen
PhD student
The Nordic Cochrane CentreConflicts of interests: None
Sales of all psychoactive drugs in DenmarkDDD: defined daily doses per 1,000 inhabitants
0
20
40
60
80
100
120
140
160
year
DD
D
antipsychotics, anxiolytics andhypnotics
antidepressants, psychostimulants,antidementia
total
Influence of benzos and neurotransmitter reuptake inhibitors on total usage
0
20
40
60
80
100
120
140
160
year
DD
D all psychoactive drugs - total
benzos and neurotransmitter reuptake inhibitors
The total sales of benzodiazepines and benzodiazepine-like drugs and neurotransmitter
reuptake inhibitors
0
20
40
60
80
100
120
year
DD
D
Total benzodiazepines
Total neurotransmitter reuptakeinhibitors
Possible explanations
Sales of all psychoactive drugs in Denmark – changes in disease classification systems
0
20
40
60
80
100
120
140
160
year
DD
D
antipsychotics, anxiolytics andhypnotics
antidepressants, psychostimulants,antidementia
total
Symptoms
and increasing
number of diagnoses
Increasing number of symptoms for the diagnosis of depression
implementing and harmonising
SSRI DDD, number of products and indications
0
10
20
30
40
50
60
1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005/ 06
2007 2008
year
nu
mb
er o
f D
DD
an
d n
um
ber
of
pro
du
cts
number of indications
Number of SSRI products
SSRI DDD
Benzo DDD, number of indications and products
0
20
40
60
80
100
120
year
indications
number of benzodiazepine product
benzo DDD
Recommendation of screening from referenceprogram from the National Board of Health
• ”In the literature there is conflicting information about the efficacy of systematic screening for depression, in order to ensure that more people are treated. A newer Cochrane review is thus showing minimal influence of systematic screening on the degree of diagnostics, treatment and outcome. There is on the other hand a generel agreement that screening for depression in risk groups can improve outcome, for example for patients with stroke or heart disease.”(my translation)(IIb)
The Commission’s proposal on information to patients (1)
• Enable citizens to get high-quality informa-tion about prescription only-medicines
• Pharmaceutical companies should disseminate informa-tion about drugs
• Certain information in a new presentation
The Commission’s proposal on information to patients (2)
• Allowing the pharma-ceutical industry to promote their products to the public
• No clear distinction between advertising and information
• Comparisons between medicinal products are not allowed