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Legemiddel- Statistikk 2009:2 legemiddel- statistikk 2009:2 Reseptregisteret 2004–2008 The Norwegian Prescription Database 2004–2008 rapport 2009:2 Reseptregisteret 2004–2008 The Norwegian Prescription Database 2004–2008 Marit Rønning Christian Berg Kari Furu Irene Litleskare Milada Mahic Solveig Sakshaug Randi Selmer Hanne Strøm Rapport 2009:2 Nasjonalt folkehelseinstitutt / The Norwegian Institute of Public Health Tittel/Title: Reseptregisteret 2004–2008 The Norwegian Prescription Database 2004–2008 Redaktør/Editor: Marit Rønning Forfattere/Authors: Christian Berg Kari Furu Irene Litleskare Milada Mahic Marit Rønning Solveig Sakshaug Randi Selmer Hanne Strøm Publisert av / Published by: Nasjonalt folkehelseinstitutt Postboks 4404 Nydalen NO-0403 Norway Tel: + 47 21 07 70 00 E-mail: [email protected] www.fhi.no Design/Layout Grafia kommunikasjon AS Acknowledgement: Julie D.W. Johansen (English version) Forsideillustrasjon / Front page illustration: Crestock.com Trykk/Print: Grafia kommunikasjon AS. 09-50659/800 Opplag / Number printed: 800 Bestilling/Order: [email protected] Fax: +47-21 07 81 05 Tel: +47-21 07 82 00 ISSN: 1890-9647 ISBN: 978-82-8082-317-5 trykt utgave/printed version ISBN: 978-82-8082-318-2 elektronisk utgave/electronic version Tidligere utgave / Previous edition: 2008: Reseptregisteret 2004–2007 / The Norwegian Prescription Database 2004–2007. Forord Bruken av legemidler i befolkningen er økende. En viktig målsetting for norsk legemiddelpolitikk er rasjonell legemiddelbruk. En forutsetning for arbeidet med å optimalisere legemiddelbruken i befolkningen er kunnskap om hvilke legemidler som brukes, hvem som bruker legemidlene og hvordan de brukes. For å få bedre kunnskap på dette området, vedtok Stortinget i desember 2002 å etablere et nasjonalt reseptbasert legemiddelregister (Reseptregisteret). Oppgaven med å etablere registeret ble gitt til Folkehelseinstituttet som fra 1. januar 2004 har mottatt månedlige opplysninger fra alle apotek om utlevering av legemidler til pasienter, leger og institusjoner. Denne rapporten er andre utgave i den årlige statistikken fra Reseptregisteret. Målet med rapporten er å presentere Reseptregisteret og utvalgte data. Rapporten har tre deler. Del 1 inneholder generell informasjon om Reseptregisteret, legemiddelforskrivning, statistikk og målemetoder. I del 2 presenteres en del nøkkeltall og kommentarer til utvalgte tema og legemid- delgrupper. Del 3 inneholder tabeller med opplysninger om antall individer som har fått utlevert legemidler etter resept fra apotekene i Norge i siste femårsperiode (2004–2008). Opplysningene er fordelt på enkeltlegemidler og legemiddelgrupper. ATC (Anatomisk Terapeutisk Kjemisk)- klassifikasjon er benyttet i tabellene. For 2008 er informasjon om alders- og kjønnsfordeling og kostnader inkludert i tabellene. ATC/DDD-versjon gjeldende fra januar 2009 er benyttet i rapporten, se også www.whocc.no Reseptregisteret har også en nettside der man kan finne informasjon om antall individer som har fått utlevert legemidler etter resept (prevalens), fordelt på kjønn, 10 års aldersgrupper og geografi (fylke eller helseregion). Nettstedet er: www.norpd.no (engelsk versjon) eller www.reseptregis- teret.no (norsk versjon). Data er tilgjengelige fra 2004 og nettsiden blir årlig oppdatert i mars/april for foregående år. Det er også mulig å søke om utlevering av data fra Reseptregisteret til forskning eller til andre formål som er i henhold til formålet for Reseptregisteret. Mer informasjon om dette finnes i innledningen til bokens del 3 og på nettsiden til Folkehelseinstituttet (www.fhi.no). Avdeling for legemiddelepidemiologi Folkehelseinstituttet April 2009 4 Rapport 2009:2 • Folkehelseinstituttet Preface The use of drugs in the population is increasing. An important goal of the health policies regarding pharmaceuticals in Norway is rational drug use. In order to improve drug use, knowl- edge about which drugs are used, how they are used and who uses them is vital. In December 2002, the Parliament decided to establish a national prescription database in Norway (NorPD). The task of building up the register was given to the Norwegian Institute of Public Health (NIPH). Since 1st January 2004, the institute has received monthly data on prescriptions from all Norwe- gian pharmacies. This report is the second edition in the annual statistical report from NorPD. The purpose of the report is to present NorPD and selected data. The report has three parts. Part 1 contains general information about NorPD, prescribing of medicines and drug statistics. The second part includes some key figures and comments about selected topics and drug groups. Part 3 contains tables with information about the number of individuals who had prescriptions dispensed from pharmacies in Norway during the latest five years period (2004–2008). The information includes particular drug substances as well as drug groups. ATC (Anatomical Therapeutic Chemical) classification is used in the tables. For 2008, information about age, gender and costs are included in the tables. The ATC/ DDD version of January 2009 has been used in the report, see also www.whocc.no NorPD also has a web page where one can find information about the number of individuals who had prescriptions dispensed (prevalence), split by gender, 10-year age groups and geography (county or health region). The website is: www.norpd.no (English version) or www.reseptregis- teret.no (Norwegian version). Data is available from 2004 and the website is annually updated in March/April for the previous year. It is also possible to apply for data from NorPD for research or for other purposes which are according to the objectives of NorPD. More information about this can be found in the introduction to the book’s section 3, and at the website of the Norwegian Institute of Public Health (www.fhi.no). Department of Pharmacoepidemiology Norwegian Institute of Public Health April 2009 Rapport 2009:2 • Folkehelseinstituttet 5 Innhold Forord ................................................................................................................................................................4 1. Generell innledning ......................................................................................................................................... 11 1.1 Etableringen av Reseptregisteret ................................................................................................... 11 1.2 Reseptregisteret (NorPD) ................................................................................................................ 12 1.3 Fastlegeordningen, apotek systemet og refusjonssystemet ..................................................... 15 1.4 Grossistbasert lege­­middel statistikk .............................................................................................. 16 1.5 Anatomisk Terapeutisk Kjemisk (ATC)-klassifikasjon ................................................................. 17 1.6 Definert Døgndose (DDD) .................................................................................................................. 18 1.7 WHO Collaborating Centre for Drug Statistics Methodology ..................................................... 19 2. Kommentarer til utvalgte tema og legemiddelgrupper ........................................................................... 21 2.1 Utvalgte nøkkeltall fra Reseptregisteret ...................................................................................... 21 2.2 Legemiddelbruk under graviditet ................................................................................................... 24 2.3 Legemiddelbruk hos barn ................................................................................................................. 27 2.4 Legemidler mot ADHD ....................................................................................................................... 30 2.5 Legemiddelbruk hos eldre ( 70 år) og bruk av demensmidler ................................................... 33 2.6 Bruk av vanedannende legemidler (reseptgruppe B) .................................................................. 38 2.7 Bruken av legemidler med effekt på immunsystemet med fokus på TNF- -hemmere ....... 43 2.8 Bruk av hjerte/kar-midler og statiner ............................................................................................ 46 2.9 Bruk av østrogener i overgangs alderen ........................................................................................ 50 2.10 Bruk av protonpumpehemmere ved spiserørsbetennelse etter innføringen av nye refusjonsregler ................................................................................................ 53 3. Reseptregisteret 2004–2008 – Hovedtabeller ....................................................................................... 57 3.1 Beskrivelse av tabellene .................................................................................................................. 57 3.2 Legemidler med flest brukere i Norge 2008 ................................................................................. 60 3.3 ATC main groups ................................................................................................................................. 61 3.4 ATC group A – Alimentary tract and metabolism ......................................................................... 62 3.5 ATC group B – Blood and bloodforming organs ............................................................................. 72 3.6 ATC group
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