Care of the elderly varies widely within the EU

Drug access by older citizens varies widely across 25 EU member countries, according to a new study by IMS Health. Per capita usage of drugs to treat Alzheimer's disease in the five EU countries where utilization was highest was 20 times greater than in the five lowest-use countries.

Access and use of pharmaceutical products by older citizens varies widely...
Access and use of pharmaceutical products by older citizens varies widely across 25 EU member countries.

IMS Health is the world’s leading provider of market intelligence to the pharmaceutical and healthcare industries. In a recent study called "Ageing Well: A Healthy Deal for Older Citizens of the European Union?" the institution examines pharmaceutical consumption in office-based settings for treatments primarily focused on patients 61 years and over. They major result: Both, the access and the use of pharmaceutical products by older citizens varies widely across the EU member countries.

While the differences reflect varying approaches by health systems to managing treatment demand, effective healthcare delivery requires an understanding of the underlying sources of these differences – especially as the rapid increase of Europeans age 61 and older strains social resources throughout the EU.

IMS found high levels of variation in the consumption of medications for treating major disease areas afflicting older citizens, such as neurodegenerative diseases, respiratory disease, osteoporosis and dyslipidaemia. While attributable in part to epidemiology and other factors, the variance also suggests inefficiencies in pharmaceutical utilization – either from over or under-use. For example, per capita usage of drugs to treat Alzheimer’s disease in the five EU countries where utilization was highest was 20 times greater than in the five lowest-use countries.

“Innovations have transformed physicians’ ability to diagnose and treat diseases that primarily afflict older citizens,” said Murray Aitken, senior vice president, Healthcare Insight, IMS. “The magnitude of the differences in usage across the EU member states reflects variations in both medical practice and actions by healthcare stakeholders to manage supply and demand of drugs. These variations in healthcare delivery will be accentuated over the next 20 years as the population ages and health resources are affected across the EU.”

Further findings are:

  • The variation in use of pharmacotherapies is significantly greater than demographic or epidemiological grounds alone would indicate. Comparing countries with the highest and lowest usage rates, the study found a ten-fold difference in drugs used to treat chronic obstructive pulmonary disease; a six-fold difference in drugs for treating osteoporosis and dyslipidaemia; and a 20-fold difference in anti-Alzheimer’s therapies. Anti-hypertensive treatments were the most consistent among high-use and low-use countries, with only a two-fold difference in usage rates.
  • The majority of therapy areas focused on older citizens heavily relies on drugs that have been available in the marketplace for more than two decades. The leading five drugs in seven of the eleven therapy areas studied have been on the market for more than 20 years; one drug used for cardiovascular treatments – digoxin (brand name Lanoxin) – has been available for 69 years. Only anti-Alzheimer’s, osteoporosis, dyslipidaemia and genito-urinary therapies had their leading five products introduced since 1988.
  • On average, less than half of the New Chemical Entities introduced globally over the past ten years are accessible to citizens across the EU countries. Older citizens of more recent EU-member countries generally have fewer new drugs available to them. For example, Germany’s citizens have access to 60 percent of available new chemical entities, while only 34 percent are available in Estonia.
  • Countries joining the EU more recently have generally adopted newer pharmaceutical products more rapidly over the past five years than they did previously. This is particularly the case in Estonia, Lithuania, Latvia, Hungary, Romania and Slovenia.
  • IMS expects that demographic shifts and the increased use of pharmaceuticals by today’s lower-use countries will drive significantly higher consumption rates through 2030. To match the current average level of utilization by the top five countries and to reflect aging populations, usage in Hungary and Bulgaria would increase 50 percent and rise more than 175 percent in the case of Romania, Latvia, Lithuania and Italy. New therapies and shifts in epidemiology could result in even greater increases.

“As EU nations plan for the inevitable rise in consumption demand among therapy classes that address diseases of older citizens, harnessing available healthcare information and actively leveraging the experience of their fellow member states will be key to driving rational investments and best-practice standards of care,” commented Aitken. “A consistent picture of disease prevalence, incidence, treatment options, use of medicines and health outcomes across Europe will ensure that priorities are aligned to their future needs. How governments and healthcare providers manage this – and the societal pressures that will influence them – will determine how Europe enables its people to age in good health.”

About the Study
The IMS study -- Ageing Well: A Healthy Deal for Older Citizens of the European Union? -- examines which medications are most used in the elderly population, how consistently they are consumed across the EU, whether all countries have similar access to new medications, and how the ageing of Europe’s population will impact consumption. The study measures pharmaceutical consumption by patients age 61 year and over in 25 of the 27 member countries within the EU (excluding Cyprus and Malta). For a therapeutic class to be included, it had to be majority prescribed in the office based sector, and have at least 70 percent of its office-based prescription volume had to be derived from the 61+ age group. These consist of therapies treating cardiovascular risk as well as actual cardiovascular disorders, treatments and preventatives for osteoporosis, treatments for Parkinson’s and Alzheimer’s, respiratory treatments for chronic obstructive pulmonary disease, oral treatments for Type II diabetes, and treatments for benign prostatic hyperplasia and incontinence. One other therapy area was included because its use is strong in the elderly (although it did not meet the 70 percent threshold): Non-Steroidal Anti-Inflammatory Drugs (NSAIDS).

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