STATE AGENCY OF MEDICINES

STATISTICS ON MEDICINES CONSUMPTION

2009

Riga, 2010 Author: State Agency of Medicines Prepared by: E. Gailite, A. Zake, A. Seilis Publisher – State Agency of Medicines © 2010

When using or quoting the data included in this issue, please indicate the source Co n t e n t s

Introduction 4 Calculations 6 Results 7 Medicines consumption share according to consumer groups (% of total turnover - LVL) 9 Medicines consumption share according to consumer groups (% of number of packagings sold) 10 Market share according to sales to pharmacies (% of sales – LVL) 11 Market share according to sales to hospitals (% of sales – LVL) 12 Market share according to sales to other medical establishments (% of sales – LVL) 13 Market share according to sales to other wholesalers (% of sales – LVL) 14 Medicines consumption share according to dispensing status – prescription or non-prescription medicines (% of total turnover – LVL) 15 Medicines consumption share according to dispensing status – prescription or non-prescription medicines (% of total turnover – LVL) through years 16 Medicines consumption share according to dispensing status – prescription or non-prescription medicines (% of number of packagings sold) 17 Medicines consumption share according to dispensing status – prescription or non-prescription medicines (DDD/1000 Latvian inhabitants/day) through years 18 Medicines consumption (DDD/1000 inhabitants/ day) 19 Most marketable medicines (total consumption DDD/ 1000 inhabitants/ day) 42 The composition of the sales amount for medicines in 2009 according to the number of packagings sold by general type pharmacies 43 Manufacturers’ sale volumes according to medicines sold to pharmacies, hospitals, veterinary medicine establishments and other health care centres (% of sale (LVL)) in 2009 48 Medicines consumption by manufacturers (% of sale (LVL)) through years 49 Medicines consumption by manufacturers (turnover in LVL) through years 50 Medicines consumption according to Marketing Authorisation Holders (turnover in LVL) in 2009 51 Most marketed prescription medicines by DDD/1000 inhabitants/ day 52 Most marketed prescription medicines by turnover in LVL (international trade name) 53 Most marketed prescription medicines by turnover in LVL (original trade name) 54 Most marketed non-prescription medicines by DDD/1000 inhabitants/ day 55 St a ti s tic on M e dicin es C u mp tion 2009 Most marketed non-prescription medicines by turnover in LVL (international trade name) 56 Most marketed non-prescription medicines by turnover in LVL (original trade name) 57 Medicines consumption by ATC groups (DDD/1000 inhabitants/ day in %) in 2009 58 Medicines consumption by ATC groups (DDD/1000 inhabitants/ day) through years 59 Medicines consumption by ATC groups (consumption (LVL)) in 2009* 60 Medicines consumption by ATC groups (consumption in LVL) through years * 61 Most marketed medicines of ATC 2nd level(DDD/1000 inhabitants/ day) 62 Most marketed medicines of ATC 3rd level (DDD/1000 inhabitants/ day) 63 2009 sales figures for the market of veterinary medicines 64 The most demanded veterinary medicines in 2009 after ATCvet level 5 (according to the number of packagings sold) 65 The most demanded antiinfectives for systemic use (according to the number of packagings sold) 66 Composition of the sales amount of ATCvet group QJ51RV01 (antibiotics and corticosteroids) veterinary medicines 67 Quarterly division of the sales amount of the most demanded antiinfectives for systemic use in 2009 (according to the number of packagings sold) 68 The most demanded veterinary medicines in 2009 according to the number of packagings sold (by original brand name) 69

STATE AGENCY OF MEDICINES 3 In t r o d u c t i o n

Statistics on medicines consumption is an integral part of the pharmacy industry compiling information on the medicines utilisation. Data on consumption are investigated by dividing medicines into groups according to their application basing of the ATC/DDD classification system. Anatomical Therapeutic Chemical (ATC) and Defined Daily Dose (DDD) system is an international standard for drug utilization studies recommended by the World Health Organisation (WHO). The purpose of the ATC/DDD system is to serve as a tool for medicines utilization research in order to compare medicines consumption between countries, regions as well as to see tendencies in medicines utilisation in different times and levels. Interest in medicines consumption since 1960-ies (time when they started to investigate medicines consumption by dividing medicines into groups of their application) has increased significantly. The main objective of the ATC/DDD system it to use this as a tool for compiling statistical data with an aim to enhance a rational use of medicines. This systems has been used since 1970 when it was recognised as an appropriate tool for comparing data at national and international levels. Within the ATC classification system, the medicines are divided into different groups according to the organ or system on which they act and their chemical, pharmacological and therapeutic properties. Medicines are classified in groups at five different levels. The classification of a substance in the ATC/DDD system is not a recommendation for use, nor does it imply any judgements about efficacy or relative efficacy of drugs and groups of drugs. (Reference: „Guidelines for ATC and DDD classification assignment” WHO Collaboratoring Centre for Drug Statistics Methodology, Oslo 2006) St a ti s tic on M e dicin es C u mp tion 2009

STATE AGENCY OF MEDICINES 4 Me t h o d

Medicines consumption statistics of the Republic of Latvia compiles data on human medicines used in 2005 to 2009. Data have been collected by compiling and analysing sales figures submitted by the wholesalers (in 2009 - 40 wholesalers) to the State Agency of Medicines (SAM). For a research and comparison purposes of a specific medicinal product the SAM uses DDD figure allocated by the World Health Organisation Collaborating Centre for Drug Statistics Methodology (hereinafter - WHO-Centre). The DDD is an assumed average maintenance dose per day for a drug used for its main indication in adults. It should be emphasised that the defined daily dose is a unit of measurement and does not necessarily reflect the recommended or prescribed daily dose. The SAM uses „ATC Index with DDDs”, published by the WHO – Centre as a reference. WHO-Centre publishes changes within the ATC/DDD system once a year. The SAM uses the most recent version and on separate occasions it causes discrepancies for some medicinal products when comparing statistical data over years (for example, the DDD value for Simvastatin (C10AA01) was changed in 2009 from 15 mg (oral dose form) to 30 mg (oral dose form)) or discrepancies in the data of an ATC subgroup (e.g., in 2009 the ATC code for Bupropion was changed from N07BA02 to N06AX12). St a ti s tic on M e dicin es C u mp tion 2009

STATE AGENCY OF MEDICINES 5 Ca l c u l a t i o n s

The medicines consumptions statistics is measured using Defined Daily Dose (DDD).

DDD is an average adult dose used for the main indication. For the statistical calculations at country level the SAM uses ATC codes allocated by the WHO-Centre and assigned DDDs, but for comparisons with statistical data of other countries the SAM uses a figure recommended by the WHO-Centre – number of DDD units used in one day per 1000 inhabitants, as follows:

Number of DDDs x 1000 365 x Number of inhabitants in Latvia

For example, Gliclazidum consumption in 2009 is as follows: DDD Gliclazidum: 0,16 g Total consumption: 245 733,24 g per year Number of inhabitants: 2 261 300 1. Total Gliclazidum consumption is expressed in DDDs applying the following formula: 245 733,24 g/ 0,16 g = 1 535 832,75 DDD 2. In order to calculate DDDs used in one day per 1000 inhabitants we place numbers in the above formula:

1 535 832,75 x 1000 inhabitants/day

= 1,86 DDD /1000 St a ti s tic on M e dicin es C u mp tion 2009 365 x 2 261 300

The figure 1,86 DDD /1000 inhabitants/day shows that 2 inhabitants out of each1000 Latvian inhabitants uses 1 therapeutical dose of Gliclazidum every day. However is should be noticed that DDD is a technical tool and it does not reflect a real daily dose. It is hard to assign DDD for medicines as the doses depend on indications, individuals and therapeutical practices. We should also take into consideration a fact that sales figures provided by the wholesalers do not reflect the real numbers of medicines used as medicines may be still in pharmacies or at homes. DDD is calculated per total number of inhabitants although medicines are used by patients of a specific age or sex. However even taking into consideration the above facts the DDD system is still a very appropriate tool for statistical researches.

STATE AGENCY OF MEDICINES 6 Re s u l t s

2009 sales figures of medicines for human use* Thanks to wholesalers’ responsiveness the SAM and wholesalers have a successful cooperation resulting in providing data on medicines sales figures in Latvia. Data have been collected and compiled since 2001 on regular basis. Since 2005 information relating to sales figures has been compiled quarterly. In order to evaluate the amount of medicines reaching a consumer all data analysis are based on medicines consumption data reflecting the real situation – medicines reaching the next level within the sales chain. Medicines consumption data do not take into account information if one wholesaler sells medicines to an another wholesaler, as in this case medicines are not provided to a consumer but stays where they are – within the wholesaler. Also information on consumer groups is analysed – we collect data from hospitals, clinics, pharmacies, rehabilitation establishments, specialised centres, emergency medicines centres, outpatient clinics and departments, doctor’s practices and different diagnostic laboratories and veterinary health care establishments (veterinary clinics). In 2009 the total medicines turnover was 256.85 million lats – increasing by 0.3 % in comparison to 2008 (256.14 million lats). In 2008 the turnover for medicines reaching a consumer (general pharmacies, hospitals, veterinary medicine centres and other medical establishments) was 195.69 million lats. All data are VAT (10%) inclusive.

*The results with sales figures for market of veterinary medicines are available in the last 4 pages St a ti s tic on M e dicin es C u mp tion 2009

STATE AGENCY OF MEDICINES 7 Tendencies in Latvia over the previous 5 years

Total turnover Average Increase in price Number of Year of medicines price for one in comparison to a packagings (LVL) packaging previous year (%)

2005 60 678 250 125 877 705 2,07 40 2006 57 781 961 148 359 323 2,57 24 2007 59 913 556 180 464 676 3.01 17 2008 58 794 094 204 738 308 3.48 16 2009 47 523 265 195 689 300 4.14 19

An average price for one packaging was LVL 4,14 (in 2008 – LVL 3.48). This figure has increased by 19 %. To evaluate for which price group the increase has been the greatest, we have distinguished several price ranges.

Increase in price Price range of a single in comparison to a packaging (LVL) previous year (%) < 5 13 5-50 06 50-100 -1 100-500 -2 500-1000 2

> 1000 -3 St a ti s tic on M e dicin es C u mp tion 2009

In 2009 the greatest rise in the price for one packaging has been for medicines in the price range below 5 LVL (including Value Added Tax (VAT)) with an increase of 13%. But for medicines in the price ranges above 50 LVL a decrease in price was observed.

STATE AGENCY OF MEDICINES 8 Medicines consumption share according to consumer groups (% of total turnover - LVL)

Hospitals – medicines consumption in hospitals (pharmacies within the hospitals). Pharmacies – medicines consumption in general pharmacies. Other – medicines consumption in other medical establishments, for example, in rehabilitation centres, specialised centres, emergency medicine centres, outpatient departments and clinics, doctor’s practices and diagnostic laboratories.

Other wholesaler – medicines consumption if one wholesaler sells medicines to another wholesaler. St a ti s tic on M e dicin es C u mp tion 2009 Veterinary medicine establishments – medicines consumption in veterinary medicine clinics and practices.

STATE AGENCY OF MEDICINES 9 Medicines consumption share according to consumer groups (% of number of packagings sold) St a ti s tic on M e dicin es C u mp tion 2009

STATE AGENCY OF MEDICINES 10 Market share according to sales to pharmacies (% of sales – LVL)

*Other – total sales of other wholesalers St a ti s tic on M e dicin es C u mp tion 2009

STATE AGENCY OF MEDICINES 11 Market share according to sales to hospitals (% of sales – LVL)

*Other – total sales of other wholesalers St a ti s tic on M e dicin es C u mp tion 2009

STATE AGENCY OF MEDICINES 12 Market share according to sales to other medical establishments (% of sales – LVL)

*Other – total sales of other wholesalers St a ti s tic on M e dicin es C u mp tion 2009

STATE AGENCY OF MEDICINES 13 Market share according to sales to other wholesalers (% of sales – LVL)

*Other – total sales of other wholesalers St a ti s tic on M e dicin es C u mp tion 2009

STATE AGENCY OF MEDICINES 14 Medicines consumption share according to dispensing status – prescription or non-prescription medicines (% of total turnover – LVL)

Non-prescription medicinal products - medicinal products the pharmacological properties, strength, amount in packaging, type of use and the possible side effects caused by use of which shall not cause a direct or indirect threat to the health of the patient if they are used in accordance with instructions. In a

pharmacy outpatient medical treatment medicinal products shall be issued without a prescription. St a ti s tic on M e dicin es C u mp tion 2009

Prescription medicinal products - medicinal products the pharmacological properties, strength, amount in packaging, type of use and the possible side effects caused by use without medical supervision of which may cause a direct or indirect threat to the health of the patient. In a pharmacy outpatient medical treatment medicinal products shall be issued only on the basis of a prescription.

STATE AGENCY OF MEDICINES 15 Medicines consumption share according to dispensing status – prescription or non-prescription medicines (% of total turnover – LVL) through years St a ti s tic on M e dicin es C u mp tion 2009

STATE AGENCY OF MEDICINES 16 Medicines consumption share according to dispensing status – prescription or non-prescription medicines (% of number of packagings sold) St a ti s tic on M e dicin es C u mp tion 2009

STATE AGENCY OF MEDICINES 17 Medicines consumption share according to dispensing status – prescription or non-prescription medicines (DDD/1000 Latvian inhabitants/day) through years DDD/1000 inhabitants/day St a ti s tic on M e dicin es C u mp tion 2009

STATE AGENCY OF MEDICINES 18 Medicines consumption (DDD/1000 inhabitants/ day)

International name for an active DDD/1000 inhabitants/day ATCcode substance 2005 2006 2007 2008 2009 A Alimentary tract and metabolism 113,79 108,85 112,24 112,88 105,40 A01 Stomatological preparations 7,30 10,27 11,04 10,14 7,11 A01AA01 Natrii fluoridum 7,10 9,96 10,66 9,72 6,85 A01AB Antiinfectives and antiseptics for 0,20 0,31 0,38 0,42 0,26 local oral treatment A01AB03 Chlorhexidinum 0,20 0,31 0,38 0,42 0,26 A02 Drugs for acid related disorders 16,76 19,23 23,62 25,89 23,24 A02B Drugs for peptic ulcer and gastro- 16,76 19,23 23,62 25,89 23,24 oesophageal reflux disease (gord) A02BA H2-receptor antagonists 4,40 5,24 5,98 5,60 4,92 A02BA01 Cimetidinum 0,33 0,20 0,02 - - A02BA02 Ranitidinum 3,89 4,89 5,82 5,46 4,82 A02BA03 Famotidinum 0,18 0,15 0,14 0,14 0,11 A02BC Proton pump inhibitors 12,14 13,77 17,42 20,06 18,13 A02BC01 Omeprazolum 11,93 13,41 16,64 18,74 16,66 A02BC02 Pantoprazolum 0,03 0,05 0,04 0,04 0,61 A02BC03 Lansoprazolum 0,00 0,11 0,49 0,97 0,62 A02BC05 Esomeprazolum 0,18 0,20 0,25 0,31 0,24 A02BX Other drugs for peptic ulcer and 0,22 0,22 0,22 0,23 0,19 gastro-oesophageal reflux disease (gord) A02BX02 Sucralfatum 0,21 0,21 0,20 0,21 0,17 A02BX05 Bismuthi subcitras 0,01 0,01 0,02 0,02 0,02 A03 Drugs for functional 13,12 13,25 12,78 12,02 10,30 gastrointestinal disorders St a ti s tic on M e dicin es C u mp tion 2009 A03A Drugs for functional bowel 5,93 5,89 6,10 5,99 4,80 disorders A03AA Synthetic anticholinergics, esters 0,13 0,15 0,17 0,16 0,13 with tertiary amino group A03AA04 Mebeverini hydrochloridum 0,13 0,15 0,17 0,16 0,13 A03AD Papaverine and derivatives 5,35 5,20 5,31 5,16 4,07 A03AD01 Papaverini hydrochloridum 0,08 0,01 0,01 0,01 0,00 A03AD02 Drotaverinum 5,27 5,19 5,30 5,15 4,07 A03AX Other drugs for functional bowel 0,45 0,54 0,62 0,67 0,60 disorders A03AX13 Simeticonum 0,45 0,54 0,62 0,67 0,60 A03B Belladonna and derivatives, plain 4,93 5,17 4,52 3,98 3,90 A03BA Belladonna alkaloids, tertiary 4,91 5,15 4,50 3,96 3,88 amines A03BA01 Atropini sulfas 0,04 0,07 0,23 0,20 0,15 A03BA04 Vilkogas alkaloīdu kopsumma 4,87 5,08 4,27 3,76 3,74

STATE AGENCY OF MEDICINES 19 A03BB Belladonna alkaloids, 0,02 0,02 0,02 0,02 0,01 semisynthetic, quaternary ammonium compounds A03BB01 Hyoscini butylbromidum 0,02 0,02 0,02 0,02 0,01 A03F Propulsives 2,26 2,20 2,16 2,05 1,60 A03FA01 Metoclopramidum 1,87 1,82 1,75 1,64 1,33 A03FA03 Domperidonum 0,39 0,37 0,41 0,41 0,28 A04 Antiemetics and antinauseants 0,02 0,02 0,03 0,03 0,04 A04AA Serotonin (5TH3) antagonists 0,02 0,02 0,03 0,03 0,04 A04AA01 Ondansetronum 0,00 0,01 0,01 0,01 0,02 A04AA02 Granisetronum 0,00 0,01 0,01 0,01 0,01 A04AA03 Tropisetronum 0,01 0,01 0,01 0,01 0,00 A04AA05 Palonosetron * * 0,00 0,00 0,00 A05 Bile and liver therapy 0,10 0,11 0,15 0,18 0,16 A05AA Bile acid preparations 0,10 0,11 0,15 0,18 0,16 A05AA02 Acidum ursodeoxycholicum 0,10 0,11 0,15 0,18 0,16 A06 Laxatives 5,78 6,67 6,79 6,81 5,90 A06AB Contact laxatives 4,51 5,17 5,10 4,80 4,43 A06AB02 Bisacodylum 2,82 3,17 3,11 2,98 2,82 A06AB08 Natrii picosulfas 1,69 2,00 1,99 1,82 1,61 A06AD Osmotically acting laxatives 1,27 1,50 1,69 2,01 1,47 A06AD11 Lactulosum 1,21 1,43 1,62 1,92 1,39 A06AD15 Macrogolum 0,06 0,07 0,07 0,09 0,07 A07 Antidiarrheals, intestinal 2,53 2,35 2,38 2,58 2,09 antiinflammatory/antiinfective agents A07A Intestinal antiinfectives 0,07 0,00 0,00 0,00 0,00 A07AA02 Nystatinum 0,07 0,00 - - - A07AX03 Nifuroxazide - - - - 0,00

A07B Intestinal adsorbents 1,00 0,79 0,89 1,04 0,70 St a ti s tic on M e dicin es C u mp tion 2009 A07BA Charcoal preparations 0,56 0,32 0,29 0,30 0,10 A07BA01 Carbo activatus 0,56 0,32 0,29 0,30 0,10 A07BC Other intestinal adsorbents 0,44 0,47 0,60 0,74 0,60 A07BC05 Diosmectitum 0,44 0,47 0,60 0,74 0,60 A07D Antipropulsives 0,87 1,01 1,00 0,97 0,78 A07DA03 Loperamidum 0,87 1,01 1,00 0,97 0,78 A07E Intestinal antiinflammatory aģents 0,47 0,41 0,33 0,41 0,46 A07EA Corticosteroids acting locally 0,00 0,00 0,00 0,00 0,00 A07EA06 Budesonidum 0,00 0,00 0,00 0,00 0,00 A07EC Aminosalicylic acid and similar 0,47 0,41 0,33 0,41 0,45 agents A07EC01 Sulfasalazinum 0,18 0,23 0,22 0,26 0,30 A07EC02 Mesalazinum 0,29 0,18 0,11 0,15 0,15 A07F Antidiarrheal microorganisms 0,12 0,14 0,16 0,16 0,15 A07FA02 Saccharomyces boulardii 0,12 0,14 0,16 0,16 0,15

STATE AGENCY OF MEDICINES 20 A08 Antiobesity preparations, excl, diet 0,10 0,19 0,39 0,59 0,57 products A08AA Centrally acting antiobesity 0,04 0,10 0,30 0,51 0,50 products A08AA10 Sibutraminum 0,04 0,10 0,30 0,51 0,50 A08AB Peripherally acting antiobesity 0,06 0,09 0,09 0,08 0,07 products A08AB01 Orlistatum 0,06 0,09 0,09 0,08 0,07 A08AX Other antiobesity drugs 0,00 0,00 0,00 0,00 0,00 A08AX01 Rimonabant * * * 0,00 - A10 Drugs used in diabetes 18,29 20,44 22,10 26,76 28,25 A10A Insulins and analogues 5,06 5,87 6,95 8,60 9,48 A10AB Insulins and analogues for 1,98 2,09 2,02 2,55 2,90 injection, fast-acting A10AB01 Insulinum humanum 0,86 0,65 0,59 0,24 0,16 A10AB04 Insulinum lisprum 0,61 0,44 - - - A10AB05 Insulinum aspart 0,51 0,85 1,14 1,56 1,84 A10AB06 Insulin glulisine * 0,14 0,29 0,75 0,90 A10AC Insulins and analogues for 1,97 1,79 1,62 1,48 1,50 injection, intermediate-acting A10AC01 Insulinum humanum 1,97 1,79 1,62 1,48 1,50 A10AD Insulins and analogues for 0,90 1,47 2,27 2,86 3,00 injection, intermediate-acting combined with fast-acting A10AD01 Insulinum humanum 0,49 0,37 0,23 0,05 - A10AD04 Insulin lispro - 0,22 0,87 1,48 1,57 A10AD30 Kombinācijas 0,41 0,88 1,17 1,33 1,43 A10AE Insulins and analogues for 0,21 0,52 1,04 1,71 2,08 injection, long-acting A10AE04 Insulinum glarginum 0,21 0,39 0,73 1,03 1,21 St a ti s tic on M e dicin es C u mp tion 2009 A10AE05 Insulin detemir - 0,13 0,31 0,68 0,87 A10B Blood glucose lowering drugs, 13,23 14,57 15,15 18,16 18,77 excl, insulīns A10BA Biguanides 6,04 6,48 7,60 9,12 9,72 A10BA02 Metformini hydrochloridum 6,04 6,48 7,60 9,12 9,72 A10BB Sulfonamides, urea derivatives 6,90 6,78 7,07 8,35 8,27 A10BB01 Glibenclamidum 0,66 0,38 0,04 - - A10BB07 Glipizidum 1,08 0,94 0,80 0,80 0,80 A10BB08 Gliquidonum 0,20 0,16 0,13 0,15 0,18 A10BB09 Gliclazidum 2,27 1,74 1,62 2,02 1,86 A10BB12 Glimepiridum 2,69 3,56 4,48 5,38 5,43 A10BD Combinations of oral blood glucose 0,17 1,06 0,00 0,00 0,00 lowering drugs A10BD02 Metforminum un sulfonamīdi 0,00 0,00 ** ** ** A10BD03 Metforminum un rosiglitazonum 0,17 1,06 ** ** ** A10BG Thiazolidinediones 0,01 0,12 0,37 0,56 0,59 A10BG02 Rosiglitazoni maleas 0,01 0,02 0,07 0,07 0,07

STATE AGENCY OF MEDICINES 21 A10BG03 Pioglitazonum 0,00 0,10 0,30 0,49 0,52 A10BX Other blood glucose lowering 0,11 0,13 0,11 0,13 0,19 drugs, excl, insulīns

A10BX02 Repaglinidum 0,11 0,13 0,11 0,13 0,19 A10BX04 Exenatide * * * - 0,00 A11 Vitamins 48,20 34,29 30,38 25,19 25,07 A11C Vitamin A and D, incl, combinations 0,06 0,21 0,37 0,57 0,48 of the two A11CA Vitamin A, plain 0,00 0,07 0,02 0,04 0,01 A11CA01 Retinolum 0,00 0,07 0,02 0,04 0,01 A11CC Vitamin D and analogues 0,06 0,14 0,35 0,53 0,47 A11CC02 Dihydrotachysterolum 0,00 0,02 0,00 0,00 - A11CC03 Alfacalcidolum 0,02 0,06 0,27 0,42 0,36 A11CC04 Calcitriolum 0,04 0,07 0,08 0,11 0,10 A11D Vitamin B1, plain and in 0,02 0,23 0,36 0,27 0,17 combination with vitamin B6 and B12 A11DA Vitamin B1, plain 0,02 0,23 0,36 0,27 0,17 A11DA01 Thiamini hydrochloridum 0,02 0,23 0,36 0,27 0,17 A11G Ascorbic acid (vitamin C), incl, 46,93 32,62 28,99 24,21 24,32 combinations A11GA Ascorbic acid (vitamin C), plain 46,93 32,62 28,99 24,21 24,32 A11GA01 Ascorbic acid (vit C) 46,93 32,62 28,99 24,21 24,32 A11H Other plain vitamin preparations 1,19 1,21 0,66 0,14 0,10 A11HA02 Pyridoxini hydrochloridum 0,03 0,08 0,12 0,13 0,10 A11HA03 Kombinētie preparāti, kuru sastāvā 1,16 1,13 0,54 0,01 0,00 divas aktīvās vielas/ Tocopheroli acetas/ Alfa-Tocopheroli acetas A12 Mineral supplements 0,82 0,66 0,54 0,65 0,55 St a ti s tic on M e dicin es C u mp tion 2009 A12AA03 Calcii gluconas 0,57 0,41 0,21 0,16 0,09 A12AA04 Calcii carbonas 0,16 0,13 0,15 0,26 0,21 A12AA07 Calcii chloridum 0,01 0,00 - - - A12AA12 Calcii acetas 0,08 0,12 0,18 0,23 0,24 A14 Anabolic agents for systemic use 0,17 0,17 0,17 0,22 0,13 A14AB01 Nandroloni decanoas 0,17 0,17 0,17 0,22 0,13 A16 Other alimentary tract and 0,61 1,18 1,87 1,81 1,99 metabolism products A16AA01 Levocarnitine * * * 0,00 0,00

A16AB02 Imiglucerase * * * 0,00 0,00

A16AX01 Acidum thiocticum 0,61 1,18 1,87 1,81 1,99

A16AX03 Sodium phenylbutyrate * * * 0,00 -

A16AX05 Zinc acetate * * * 0,00 0,00

STATE AGENCY OF MEDICINES 22 B Blood and blood forming orgāns 36,22 50,88 50,25 55,76 53,95 B01 Antithrombotic aģents 32,82 43,34 45,71 52,33 50,70 B01A Antithrombotic aģents 32,82 43,34 45,71 52,33 50,70 B01AA Vitamin K antagonists 1,49 1,67 1,99 2,48 2,81 B01AA03 Warfarinum natricum/ Warfarinum 1,49 1,67 1,99 2,48 2,81 B01AB Heparin group 0,01 1,96 2,21 2,26 2,55 B01AB01 Heparinum 0,01 1,96 1,35 1,32 1,72 B01AB04 Dalteparin * * 0,07 0,11 0,13 B01AB05 Enoxaparin * * 0,42 0,56 0,44 B01AB06 Nadroparin * * 0,37 0,25 0,23 B01AB12 Bemiparin * * * 0,02 0,03 B01AC Platelet aggregation inhibitors excl, 31,32 39,71 41,51 47,59 45,33 heparin B01AC04 Clopidogrelum 0,60 1,16 1,72 2,30 1,77 B01AC05 Ticlopidini hydrochloridum 0,01 0,00 - - - B01AC06 Acidum acetylsalicylicum 30,71 38,55 39,79 45,29 43,56 B01AC11 Iloprost * * 0,00 0,00 - B01AC16 Eptifibatide * * 0,00 0,00 0,00 B01AC17 Tirofiban * 0,00 0,00 0,00 0,00 B01AD Enzymes 0,00 0,00 0,00 0,00 0,00 B01AD01 Streptokinase * * * 0,00 0,00 B01AD02 Alteplase * * * 0,00 0,00 B01AD07 Reteplase * * * 0,00 0,00 B01AD11 Tenecteplase 0,00 - - - 0,00 B01AE Direct thrombin inhibitors 0,00 0,00 0,00 0,00 0,00 B01AE06 Bivalirudin * 0,00 0,00 0,00 - B01AX Other antithrombotic agents 0,00 0,00 0,00 0,00 0,01 B01AX05 Fondaparinux * * * 0,00 0,01 B02 Antihemorrhagics 0,38 0,02 0,03 0,02 0,02 St a ti s tic on M e dicin es C u mp tion 2009 B02AA Amino acids 0,00 0,00 0,01 0,01 0,01 B02AA02 Tranexamic acid * * 0,01 0,01 0,01 B02AB Proteinase inhibitors 0,00 0,00 0,01 0,00 0,00 B02AB01 Aprotinin 0,00 0,00 0,01 - - B02BA Vitamin K 0,37 0,00 0,00 0,00 0,00 B02BA01 Phytomenadione * * * 0,00 0,00 B02BA02 Menadionum 0,37 0,00 - - - B02BD Blood coagulation factors 0,01 0,02 0,01 0,00 0,01 B02BD01 Coagulation factor IX, II, VII and X in - - - - 0,00 combination B02BD02 Factor VIII coagulationis plasmatis 0,01 0,00 0,00 0,00 0,00 B02BD03 Factor VIII inhibitor bypassing activity * * 0,00 0,00 0,00 B02BD04 Factor IX coagulationis plasmatis 0,00 0,00 0,00 0,00 0,00 B02BD05 Coagulation factor VII * 0,02 0,01 - - B02BD06 Von willebrand factor and coagulation * * * 0,00 0,00 factor VIII in combination B02BD08 Eptacog alfa (activated) * * * 0,00 0,00

STATE AGENCY OF MEDICINES 23 B03 Antianemic preparations 3,02 7,51 4,51 3,41 3,23 B03A Iron preparations 1,48 1,36 0,45 0,18 0,71 B03AA Iron bivalent, oral preparations 1,43 1,31 0,40 0,12 0,27 B03AA05 Ferri chloridum 0,00 0,00 0,00 0,00 - B03AA07 Ferri sulfas/Kombinētie preparāti, kuru 0,30 0,34 0,40 0,12 0,27 sastāvā divas aktīvās vielas B03AA09 Ferri aspartas 1,13 0,97 0,00 - - B03AB Iron trivalent, oral preparations 0,00 0,00 0,00 0,00 0,40 B03AB05 Dextriferron - - - - 0,40 B03AC Iron trivalent, parenteral 0,05 0,05 0,05 0,06 0,05 preparations B03AC01 Ferric (III)-hydroxyde polyisomaltose 0,03 0,03 0,04 - - B03AC02 Ferri oxydum saccharum complexum 0,02 0,01 0,01 0,02 0,02 B03AC06 Ferric oxide dextran complex * * * 0,04 0,03 B03B Vitamin B12 and folic acid 1,54 6,15 4,06 2,45 1,74 B03BA Vitamin B12 (cyanocobalamin and 1,48 6,15 4,06 2,45 1,74 analogues) B03BA01 Cyanocobalaminum 1,48 6,15 4,06 2,45 1,74 B03BB Folic acid and derivatives 0,06 0,01 0,00 0,00 0,00 B03BB01 Acidum folicum 0,06 0,01 - - - B03X Citi antianēmiski līdzekļi 0,00 0,00 0,00 0,78 0,77 B03XA Citi antianēmiski līdzekļi 0,00 0,00 0,00 0,78 0,77 B03XA01 Erythropoietin * * * 0,30 0,24 B03XA02 Darbepoetin alfa * * * 0,48 0,54 C Cardiovascular system 144,33 166,41 182,61 212,35 200,48 C01 Cardiac therapy 26,95 27,51 29,30 29,54 25,48 C01A Cardiac glycosides 5,92 5,41 5,35 5,10 4,65 C01AA05 Digoxinum 5,92 5,41 5,35 5,10 4,65 C01B Antiarrhythmics, class I and III 5,48 5,17 4,92 4,74 4,23

C01BB01 Lidocainum 0,00 0,00 - - - St a ti s tic on M e dicin es C u mp tion 2009 C01BC Antiarrhythmics, class IC 0,14 0,15 0,18 0,22 0,22 C01BC03 Propafenonum 0,14 0,15 0,18 0,22 0,22 C01BD Antiarrhythmics, class III 2,67 2,51 2,37 2,26 2,01 C01BD01 Amiodaronum/Amiodaroni 2,67 2,51 2,37 2,26 2,01 hydrochloridum C01C Cardiac stimulants excl, cardiac 0,04 0,38 0,33 0,42 0,26 glycosides C01CA Adrenergic and dopaminergic 0,04 0,38 0,33 0,42 0,26 agents C01CA04 Dopamini hydrochloridum 0,01 0,01 0,01 0,01 0,01 C01CA07 Dobutaminum 0,00 0,00 0,00 0,00 0,00 C01CA24 Epinephrinum/Epinephrini 0,03 0,36 0,32 0,41 0,25 hydrogenotartras C01D Vasodilators used in cardiac 11,89 11,92 12,73 12,05 10,31 diseases C01DA Organic nitrates 11,89 11,92 12,73 12,05 10,31 C01DA02 Glyceryli trinitras 0,98 0,79 1,53 1,01 0,78

STATE AGENCY OF MEDICINES 24 C01DA05 Pentaerithrityli tetranitras 0,13 0,00 - - - C01DA08 Isosorbidi dinitras 3,66 3,21 2,46 1,83 1,29 C01DA14 Isosorbidi mononitras 7,12 7,92 8,74 9,21 8,24 C01E Other cardiac preparations 3,62 4,64 5,97 7,23 6,02 C01EA01 Alprostadil * 0,00 0,00 0,00 0,00 C01EB15 Trimetazidinum 3,62 4,64 5,85 6,94 5,74 C01EB16 Ibuprofen - - - - 0,00 C01EB17 Ivabradine * * 0,12 0,29 0,27 C02 Antihypertensives 2,72 2,57 3,67 4,44 5,15 C02A Antiadrenergic agents, centrally 0,79 1,23 1,17 1,88 2,90 acting C02AB Methyldopa 0,07 0,07 0,07 0,07 0,06 C02AB01 Methyldopum 0,07 0,07 0,07 0,07 0,06 C02AC Imidazoline receptor agonists 0,72 1,16 1,10 1,81 2,84 C02AC01 Clonidini hydrochloridum/Clonidinum 0,05 0,30 - 0,22 0,91 C02AC05 Moxonidinum 0,67 0,86 1,10 1,59 1,94 C02C Antiadrenergic agents, peripherally 1,93 1,34 2,50 2,56 2,24 acting C02CA01 Prazosinum 0,09 0,08 0,04 - - C02CA04 Doxazosinum/Doxazosini mesilas 1,84 1,26 2,46 2,56 2,24 C02D Arteriolar smooth muscle, agents 0,00 0,00 0,00 0,00 0,00 acting on C02DD Nitroferricyanide derivatives 0,00 0,00 0,00 0,00 0,00 C02DD01 Nitroprussidum 0,00 0,00 0,00 0,00 0,00 C03 Diuretics 16,38 16,96 17,14 17,67 16,72 C03A Low-ceiling diuretics, thiazides 1,38 1,20 1,01 0,92 0,78 C03AA03 Hydrochlorothiazidum 1,38 1,20 1,01 0,92 0,78 C03B Low-ceiling diuretics, excl, 6,43 6,36 5,91 5,74 5,15 thiazides

C03BA11 Indapamidum 6,43 6,36 5,91 5,74 5,15 St a ti s tic on M e dicin es C u mp tion 2009 C03C High-ceiling diuretics 5,72 6,12 6,45 6,77 6,62 C03CA01 Furosemidum 4,19 4,17 4,07 3,89 3,56 C03CA04 Torasemidum/Torasemidum natricum 1,52 1,95 2,38 2,88 3,06 C03CC01 Acidum etacrynicum 0,01 0,00 0,00 - - C03D Potassium-sparing agents 2,85 3,28 3,77 4,24 4,17 C03DA01 Spironolactonum 2,85 3,28 3,77 4,24 4,17 C04 Peripheral vasodilators 1,57 1,60 2,68 2,80 2,57 C04AD02 Xantinoli nicotinas 0,32 0,30 0,18 - - C04AD03 Pentoxyphyllinum 1,25 1,30 1,40 1,52 1,32 C04AX21 Naftidrofuryl * * 1,10 1,28 1,25 C07 Beta blocking agents 16,55 23,43 24,33 28,26 28,19 C07A Beta blocking agents 16,55 23,43 24,33 28,26 28,19 C07AA Beta blocking agents, non-selective 0,73 0,75 0,64 0,59 0,50 C07AA05 Propranololum/Propranololi 0,63 0,63 0,50 0,48 0,40 hydrochloridum C07AA07 Sotaloli hydrochloridum 0,10 0,12 0,14 0,11 0,09

STATE AGENCY OF MEDICINES 25 C07AB Beta blocking agents, selective 15,21 22,06 23,01 26,97 27,05 C07AB02 Metoprololum 6,98 10,72 10,54 11,76 11,74 C07AB03 Atenololum 1,96 1,75 1,24 1,13 0,87 C07AB05 Betaxolol 0,09 0,34 0,79 0,90 1,05 C07AB07 Bisoprololi fumaras 5,77 8,67 9,55 11,60 11,87 C07AB12 Nebivololum 0,41 0,58 0,89 1,58 1,52 C07AG Alpha and beta blocking agents 0,61 0,62 0,68 0,70 0,64 C07AG02 Carvedilolum 0,61 0,62 0,68 0,70 0,64 C08 Calcium channel blockers 21,95 27,39 30,23 35,80 32,56 C08C Selective calcium channel blockers 20,95 26,36 29,20 34,61 31,43 with mainly vascular effects C08CA01 Amlodipinum 9,52 13,92 15,84 19,85 18,44 C08CA02 Felodipinum 2,33 2,39 2,67 2,36 2,01 C08CA05 Nifedipinum 3,18 2,61 2,07 1,98 1,74 C08CA06 Nimodipinum 0,00 0,00 0,00 0,00 0,00 C08CA08 Nitrendipinum 2,98 3,31 3,26 3,51 3,20 C08CA09 Lacidipinum 2,83 3,52 4,15 4,85 4,29 C08CA13 Lercanidipini hydrochloridum 0,11 0,61 1,21 2,06 1,76 C08D Selective calcium channel blockers 1,00 1,03 1,03 1,19 1,13 with direct cardiac effects C08DA01 Verapamilum/Verapamili 0,45 0,47 0,44 0,47 0,43 hydrochloridum C08DB01 Diltiazemum/Diltiazemi 0,55 0,56 0,59 0,72 0,70 hydrochloridum C09 Agents acting on the renin- 53,01 58,85 63,13 75,22 69,55 angiotensin system C09A ACE inhibitors, plain 52,66 56,73 59,12 68,75 62,78 C09AA01 Captoprilum 1,48 2,10 2,51 2,57 1,16 C09AA02 Enalaprilum/Enalaprili maleas 31,14 30,36 27,81 27,65 24,54 C09AA03 Lisinoprilum 1,39 1,14 1,07 1,07 1,09 St a ti s tic on M e dicin es C u mp tion 2009 C09AA04 Perindoprilum 5,48 9,29 13,24 20,11 19,03 C09AA05 Ramiprilum 5,30 6,86 8,39 11,19 11,70 C09AA06 Quinaprili hydrochloridum 1,73 1,96 1,88 1,83 1,64 C09AA08 Cilazaprilum 0,24 0,15 0,07 0,03 - C09AA09 Fosinoprilum 5,57 4,44 3,97 4,14 3,49 C09AA10 Trandolaprilum 0,07 0,07 0,06 0,08 0,07 C09AA11 Spiraprili hydrochloridum 0,04 0,03 0,02 0,01 0,01 C09AA15 Zofenoprilum 0,22 0,33 0,10 0,07 0,05 C09C Angiotensin II antagonists, plain 0,35 2,12 4,01 6,47 6,77 C09CA01 Losartanum kalicum 0,00 0,01 0,01 0,00 0,19 C09CA02 Eprosartanum 0,01 0,04 0,04 0,03 0,03 C09CA03 Valsartanum 0,03 0,07 0,11 0,15 0,19 C09CA04 Irbesartan - 0,11 0,34 0,61 0,51 C09CA06 Candesartanum 0,09 0,72 1,61 2,89 3,20 C09CA07 Telmisartanum 0,19 0,67 1,24 1,97 1,96 C09CA08 Olmesartanum 0,03 0,50 0,66 0,82 0,69

STATE AGENCY OF MEDICINES 26 C10 Lipid modifying agents 5,19 8,10 12,13 18,62 20,28 C10A Lipid modifying agents, plain 5,19 8,10 12,13 18,62 20,28 C10AA HMG CoA reductase inhibitors 5,02 7,84 11,78 18,29 19,83 C10AA01 Simvastatinum 1,84 2,08 1,87 2,16 1,81 C10AA02 Lovastatinum 0,04 0,05 0,04 0,04 0,02 C10AA03 Pravastatinum natricum 0,02 0,04 0,00 0,00 0,00 C10AA04 Fluvastatinum/Fluvastatinum natricum 0,19 0,07 0,02 0,03 0,07 C10AA05 Atorvastatinum 2,90 5,31 8,95 14,46 16,26 C10AA07 Rosuvastatinum 0,03 0,29 0,90 1,60 1,66 C10AB Fibrates 0,16 0,19 0,24 0,14 0,29 C10AB05 Fenofibratum 0,13 0,17 0,22 0,13 0,28 C10AB08 Ciprofibratum 0,03 0,03 0,02 0,01 0,00 C10AX Other lipid modifying agents 0,01 0,06 0,11 0,19 0,17 C10AX09 Ezetimibum 0,01 0,06 0,11 0,19 0,17 D Dermatologicals 0,31 0,30 0,37 0,38 0,27 D01 Antifungals for dermatological use 0,26 0,27 0,30 0,32 0,23 D01BA02 Terbinafini hydrochloridum 0,26 0,27 0,30 0,32 0,23 D05 Antipsoriatics 0,01 0,00 0,01 0,01 0,00 D05BB02 Acitretinum 0,01 0,00 0,01 0,01 0,00 D10 Anti-acne preparations 0,04 0,02 0,06 0,05 0,04 D10BA01 Isotretinoinum 0,04 0,02 0,06 0,05 0,04 D11 Other dermatological preparations 0,00 0,00 0,00 0,00 0,00 D11AX10 Finasteridum 0,00 0,00 - - - G Genito urinary system and sex 9,20 10,13 9,46 11,09 10,20 hormones G01 Gynecological antiinfectives and 0,68 0,72 0,77 0,74 0,61 antiseptics G01A Antiinfectives and antiseptics, excl, 0,68 0,72 0,77 0,74 0,61 combinations with corticosteroids

G01AA Antibiotics 0,02 0,02 0,04 0,04 0,04 St a ti s tic on M e dicin es C u mp tion 2009 G01AA10 Clindamycinum 0,02 0,02 0,04 0,04 0,04 G01AF Imidazole derivatives 0,52 0,57 0,56 0,57 0,49 G01AF01 Metronidazolum 0,08 0,10 0,07 0,09 0,06 G01AF02 Clotrimazolum 0,28 0,29 0,27 0,27 0,24 G01AF05 Econazolum/Econazoli nitras 0,11 0,11 0,12 0,11 0,09 G01AF12 Fenticonazolum 0,04 0,06 0,08 0,09 0,09 G01AF15 Butoconazolum 0,01 0,01 0,02 0,01 0,01 G01AX Other antiinfectives and antiseptics 0,14 0,13 0,17 0,13 0,09 G01AX03 Policresulenum - 0,00 0,05 0,03 0,01 G01AX11 Povidonum iodinatum 0,14 0,12 0,12 0,10 0,08 G02 Other gynecologicals 0,01 0,01 0,02 0,02 0,01 G02AD02 Dinoprostone * 0,00 0,01 0,01 0,00 G02CB01 Bromocriptinum/ Bromocriptini mesilas 0,01 0,01 0,01 0,00 - G02CB03 Cabergolinum 0,00 0,00 0,00 0,01 0,01 G03 Sex hormones and modulators of 6,84 7,17 5,92 6,09 4,87 the genital system

STATE AGENCY OF MEDICINES 27 G03B Androgens 0,29 0,31 0,37 0,14 0,24 G03BA03 Testosteronum 0,29 0,31 0,37 0,14 0,24 G03C Estrogens 3,95 3,91 3,17 3,40 2,81 G03CA03 Estradiolum 3,20 3,61 2,95 3,15 2,61 G03CA04 Estriolum 0,17 0,17 0,22 0,19 0,15 G03CA57 Estrogena conjugata 0,58 0,13 - - - G03CX01 Tibolone *** *** *** 0,05 0,05 G03D Progestogens 2,01 2,29 1,72 1,94 1,41 G03DA Pregnen (4) derivatives 1,07 1,38 0,79 0,77 0,31 G03DA02 Medroxyprogesterone 1,07 1,38 0,79 0,77 0,31 G03DB Pregnadien derivatives 0,71 0,77 0,85 1,17 1,10 G03DB01 Dydrogesteronum 0,67 0,77 0,83 1,16 1,10 G03DB02 Megestroli acetas 0,04 0,00 0,02 0,01 - G03DC Estren derivatives 0,23 0,14 0,08 0,00 0,00 G03DC02 Norethisteronum 0,15 0,06 0,00 - - G03DC05 Tibolonum 0,08 0,08 0,08 *** *** G03G Gonadotropins and other ovulation 0,27 0,34 0,38 0,34 0,20 stimulants G03GA Gonadotropins 0,13 0,18 0,25 0,17 0,16 G03GA01 Gonadotropinum chorionicum 0,10 0,14 0,19 0,13 0,13 G03GA05 Follitropinum alfa 0,03 0,04 0,06 0,04 0,03 G03GA06 Follitropinum beta 0,00 0,00 0,00 0,00 0,00 G03GA07 Lutropinum alfa 0,00 0,00 0,00 0,00 0,00 G03GB Ovulation stimulants, synthetic 0,14 0,16 0,13 0,17 0,04 G03GB02 Clomifeni citras 0,14 0,16 0,13 0,17 0,04 G03H Antiandrogens 0,32 0,31 0,28 0,27 0,21 G03HA01 Cyproteronum/Cyproteroni acetas 0,32 0,31 0,28 0,27 0,21 G03X Other sex hormones and 0,00 0,00 0,00 0,00 0,00 modulators of the genital system G03XB01 Mifepristone * * 0,00 0,00 0,00 St a ti s tic on M e dicin es C u mp tion 2009 G04 Urologicals 1,67 2,23 2,75 4,24 4,70 G04B Other urologicals, incl, 0,95 1,05 0,58 0,61 0,57 antispasmodics G04BD04 Oxybutyninum 0,76 0,78 0,25 0,25 0,24 G04BD07 Tolterodinum 0,01 0,03 0,02 0,02 0,03 G04BD08 Solifenacin - 0,01 0,01 0,01 0,01 G04BE01 Alprostadil * * 0,00 0,00 0,00 G04BE03 Sildenafili citras 0,12 0,14 0,17 0,20 0,18 G04BE08 Tadalafil 0,02 0,04 0,06 0,06 0,04 G04BE09 Vardenafilum 0,04 0,05 0,07 0,07 0,06 G04C Drugs used in benign prostatic 0,72 1,18 2,17 3,63 4,13 hypertrophy G04CA01 Alfuzosini hydrochloridum 0,31 0,44 0,44 0,34 0,21 G04CA02 Tamsulosini hydrochloridum 0,02 0,03 0,60 1,70 2,26 G04CA03 Terazosin - 0,01 0,04 0,04 0,01 G04CB01 Finasteridum 0,17 0,35 0,52 0,78 0,82

STATE AGENCY OF MEDICINES 28 G04CB02 Dutasteridum 0,22 0,35 0,57 0,77 0,83 H Systemic hormonal preparations, 11,77 12,56 14,07 16,93 18,12 excl. sex hormones and insulīns H01 Pituitary and hypothalamic 0,29 0,31 0,35 0,35 0,33 hormones and analogues H01A Anterior pituitary lobe hormones 0,07 0,08 0,09 0,09 0,11 and analogues H01AC01 Somatropinum 0,07 0,08 0,09 0,09 0,11 H01AC03 Mecasermin - - - - 0,00 H01B Posterior pituitary lobe hormones 0,21 0,22 0,24 0,24 0,19 H01BA02 Desmopressinum 0,05 0,06 0,06 0,07 0,06 H01BA04 Terlipressin - - - - 0,00 H01BB01 Demoxytocinum 0,11 0,11 0,12 0,11 0,09 H01BB02 Oxytocinum 0,05 0,05 0,06 0,06 0,05 H01C Hypothalamic hormones 0,01 0,01 0,02 0,02 0,03 H01CB02 Octreotidum 0,01 0,01 0,01 0,01 0,01 H01CB03 Lanreotide * * 0,01 0,01 0,02 H01CC01 Ganirelix 0,00 0,00 0,00 0,00 0,00 H01CC02 Cetrorelix 0,00 0,00 0,00 0,00 0,00 H02 Corticosteroids for systemic use 6,06 6,18 6,85 7,29 7,99 H02A Corticosteroids for systemic use, 6,06 6,18 6,85 7,29 7,99 plain H02AA Mineralocorticoids 0,06 0,05 0,06 0,07 0,06 H02AA02 Fludrocortisoni acetas 0,06 0,05 0,06 0,07 0,06 H02AB Glucocorticoids 6,00 6,13 6,79 7,22 7,93 H02AB02 Dexamethasonum 2,13 2,54 3,01 3,05 3,26 H02AB04 Methylprednisolonum 1,20 1,16 1,37 1,78 2,50 H02AB06 Prednisolonum 1,91 1,73 1,75 1,73 1,58 H02AB07 Prednisone 0,00 0,00 - - -

H02AB08 Triamcinolonum 0,53 0,49 0,42 0,43 0,39 St a ti s tic on M e dicin es C u mp tion 2009 H02AB09 Hydrocortisonum 0,23 0,22 0,24 0,23 0,20 H03 Thyroid therapy 5,42 6,07 6,87 9,28 9,78 H03AA01 Levothyroxinum natricum 4,21 4,71 5,50 7,76 8,46 H03BB02 Thiamazolum 1,21 1,36 1,37 1,52 1,32 H04 Pancreatic hormones 0,00 0,00 0,00 0,00 0,00 H04AA01 Glucagon 0,00 0,00 0,00 0,00 0,00 H05 Calcium homeostasis 0,00 0,00 0,00 0,01 0,02 H05AA02 Teriparatide 0,00 0,00 0,00 - 0,00 H05BA01 Calcitonin (salmon synthetic) 0,00 0,00 0,00 0,00 0,00 H05BX01 Cinacalcet * * 0,00 0,01 0,02 J Antiinfectives for systemic use 19,76 20,24 21,05 17,05 14,92 J01 Antibacterials for systemic use 15,35 14,32 15,04 12,92 11,35 J01A Tetracyclines 2,83 3,06 2,89 2,45 2,24 J01AA02 Doxycyclinum 2,80 3,04 2,87 2,44 2,23 J01AA07 Tetracyclini hydrochloridum 0,03 0,02 0,02 0,01 0,01 J01AA12 Tigecycline * * * 0,00 0,00

STATE AGENCY OF MEDICINES 29 J01C Beta-lactam antibacterials, 7,64 6,61 6,63 5,82 5,31 penicillins J01CA Penicillins with extended spectrum 6,02 5,04 4,54 3,86 3,61 J01CA01 Ampicillinum/Ampicillinum natricum/ 2,09 1,13 0,67 0,41 0,29 Ampicillinum trihydricum J01CA04 Amoxicillinum/Amoxicillinum 3,93 3,91 3,87 3,45 3,31 trihydricum/Amoxicillinum natricum J01CE Beta-lactamase sensitive penicillins 0,21 0,18 0,18 0,15 0,17 J01CE01 Benzylpenicillinum 0,03 0,03 0,05 0,03 0,02 J01CE02 Phenoxymethylpenicillinum 0,12 0,11 0,13 0,12 0,15 J01CE08 Benzathini benzylpenicillinum 0,06 0,03 - - - J01CF Beta-lactamase resistant penicillins 0,02 0,02 0,04 0,02 0,02 J01CF04 Oxacillinum natricum 0,02 0,02 0,04 0,02 0,02 J01CR Combinations of penicillins, incl, 1,39 1,37 1,87 1,79 1,51 beta-lactamase inhibitors J01CR01 Ampicillinum un enzīma inhibitors 0,01 0,01 0,01 0,02 0,02 J01CR02 Amoxicillinum trihydricum, Kalii 1,36 1,35 1,85 1,76 1,48 clavulanas J01CR05 Piperacilini natricum, Tazobactami 0,02 0,00 0,01 0,01 0,01 natricum J01D Other beta-lactam antibacterials 1,21 1,23 1,49 1,24 0,99 J01DB First-generation cephalosporins 0,66 0,66 0,74 0,58 0,46 J01DB01 Cefalexinum 0,15 0,16 0,18 0,10 0,08 J01DB04 Cefazolinum 0,38 0,38 0,41 0,34 0,26 J01DB05 Cefadroxilum 0,13 0,12 0,15 0,14 0,12 J01DC Second-generation cephalosporins 0,24 0,31 0,41 0,35 0,26 J01DC02 Cefuroximum/ Cefuroximum natricum 0,21 0,29 0,40 0,34 0,25 J01DC03 Cefamandolum nafatum 0,02 0,01 0,00 0,00 0,00 J01DC10 Cefprozilum 0,01 0,01 0,01 0,01 0,01 J01DD Third-generation cephalosporins 0,31 0,25 0,33 0,27 0,26 St a ti s tic on M e dicin es C u mp tion 2009 J01DD01 Cefotaximum 0,15 0,13 0,07 0,02 0,01 J01DD02 Ceftazidime 0,00 0,01 0,01 0,01 0,01 J01DD04 Ceftriaxonum 0,15 0,09 0,23 0,23 0,24 J01DD12 Cefoperazonum 0,01 0,01 0,02 0,01 0,00 J01DE Fourth-generation cephalosporins 0,00 0,00 0,00 0,00 0,00 J01DE01 Cefepime 0,00 0,00 0,00 0,00 0,00 J01DH Carbapenems 0,00 0,01 0,01 0,03 0,01 J01DH02 Meropenemum 0,00 0,01 0,01 0,03 0,01 J01DH03 Ertapenem 0,00 0,00 0,00 0,00 0,00 J01DH51 Imipenemum, Cilastatinum 0,00 0,00 0,00 0,00 0,00 J01E Sulfonamides and trimethoprim 0,00 0,00 0,00 0,00 0,00 J01EA01 Trimethoprimum 0,00 0,00 0,00 0,00 0,00 J01F Macrolides, lincosamides and 1,33 1,27 1,67 1,39 1,11 streptogramins J01FA01 Erythromycinum 0,37 0,32 0,37 0,18 0,13 J01FA02 Spiramycin 0,22 0,17 0,20 0,15 0,10 J01FA09 Clarithromycinum 0,58 0,60 0,79 0,81 0,65

STATE AGENCY OF MEDICINES 30 J01FA10 Azithromycinum 0,06 0,08 0,19 0,13 0,14 J01FF01 Clindamycin 0,07 0,08 0,10 0,10 0,08 J01FF02 Lincomycini hydrochloridum 0,03 0,02 0,02 0,02 0,01 J01G Aminoglycoside antibacterials 0,24 0,27 0,24 0,22 0,16 J01GA01 Streptomycin - 0,01 - 0,01 0,01 J01GB03 Gentamicinum/Gentamicini sulfas 0,23 0,24 0,20 0,17 0,11 J01GB04 Kanamycini sulfas 0,00 0,01 0,02 0,02 0,02 J01GB06 Amikacini sulfas 0,01 0,01 0,02 0,02 0,01 J01M Quinolone antibacterials 1,61 1,38 1,59 1,34 1,17 J01MA01 Ofloxacinum 0,49 0,15 0,24 0,22 0,22 J01MA02 Ciprofloxacinum 0,78 0,91 1,04 0,81 0,69 J01MA03 Pefloxacinum 0,02 0,02 0,02 0,00 - J01MA06 Norfloxacinum 0,24 0,23 0,23 0,22 0,20 J01MA14 Moxifloxacinum 0,01 0,01 0,00 0,03 0,02 J01MB04 Acidum pipemidicum 0,07 0,06 0,06 0,06 0,04 J01X Other antibacterials 0,49 0,51 0,53 0,46 0,38 J01XA01 Vancomycinum/Vancomycini 0,01 0,02 0,02 0,01 0,01 hydrocloridum J01XD01 Metronidazolum 0,11 0,12 0,14 0,12 0,09 J01XD02 Tinidazolum - - - - - J01XD03 Ornidazolum - - - - - J01XE01 Nitrofurantoinum 0,29 0,29 0,29 0,26 0,22 J01XX04 Spectinomycin 0,00 0,00 0,00 0,00 0,00 J01XX07 Nitroxolinum 0,08 0,09 0,08 0,07 0,06 J01XX08 Linezolid 0,00 0,00 0,00 0,00 0,00 J02 Antimycotics for systemic use 0,38 0,34 0,35 0,33 0,28 J02A Antimycotics for systemic use 0,38 0,34 0,35 0,33 0,28 J02AA01 Amphotericin B 0,00 0,00 0,00 0,00 0,00 J02AB02 Ketoconazolum 0,22 0,19 0,15 0,13 0,10 St a ti s tic on M e dicin es C u mp tion 2009 J02AC01 Fluconazolum 0,09 0,11 0,12 0,12 0,11 J02AC02 Itraconazolum 0,07 0,05 0,08 0,08 0,07 J02AC03 Voriconazole 0,00 0,00 0,00 0,00 0,00 J02AX04 Caspofungin 0,00 0,00 0,00 0,00 0,00 J04 Antimycobacterials 0,48 2,02 0,61 0,00 0,54 J04A Drugs for treatment of tuberculosis 0,48 2,02 0,61 0,00 0,54 J04AA Aminosalicylic acid and derivatives 0,00 0,83 0,61 0,00 0,02 J04AA02 Sodium aminosalicylate 0,00 0,83 0,61 - 0,02 J04AB Antibiotics 0,09 0,26 0,00 0,00 0,00 J04AB02 Rifampicinum 0,06 0,24 0,00 0,00 0,00 J04AB30 Capreomycinum 0,03 0,02 - - - J04AD Thiocarbamide derivatives 0,03 0,12 0,00 0,00 0,03 J04AD01 Protionamidum 0,03 0,12 - 0,00 0,03 J04AK Other drugs for treatment of 0,36 0,80 0,00 0,00 0,48 tuberculosis J04AK01 Pyrazinamidum 0,36 0,40 0,00 - 0,15 J04AK02 Ethambutolum 0,00 0,40 - 0,00 0,33

STATE AGENCY OF MEDICINES 31 J05 Antivirals for systemic use 3,55 3,55 5,05 3,79 2,75 J05A Direct acting antivirals 3,55 3,55 5,05 3,79 2,75 J05AB Nucleosides and nucleotides excl, 0,09 0,07 0,22 0,12 0,12 reverse transcriptase inhibitors J05AB01 Acyclovirum 0,02 0,03 0,03 0,03 0,03 J05AB04 Ribavirinum 0,06 0,03 0,05 0,06 0,08 J05AB06 Ganciclovirum 0,00 0,00 0,00 0,00 0,00 J05AB11 Valaciclovir 0,00 0,01 0,01 0,01 0,01 J05AB14 Valaciclovirum 0,01 0,00 0,13 0,02 0,00 J05AB15 Brivudine 0,00 0,00 0,00 0,00 0,00 J05AE Protease inhibitors 0,03 0,06 3,57 2,01 1,99 J05AE01 Saquinavirum 0,02 0,02 0,00 0,02 0,01 J05AE02 Indinavirum 0,01 0,01 0,00 0,00 0,00 J05AE03 Ritonavirum 0,00 0,00 0,80 1,25 0,51 J05AE04 Nelfinavirum 0,00 0,02 2,43 - - J05AE06 Lopinavir 0,00 0,01 0,01 0,02 0,01 J05AE07 Fosamprenavir * * 0,33 0,20 0,23 J05AE08 Atazanavir * * * 0,51 1,22 J05AE09 Tipranavir * 0,00 * 0,00 0,00 J05AF Nucleoside and nucleotide reverse 3,36 3,39 1,00 1,59 0,24 transcriptase inhibitors J05AF01 Zidovudinum 0,01 0,03 0,03 0,12 0,00 J05AF02 Didanosinum - - 0,29 0,07 0,19 J05AF04 Stavudinum 0,54 0,01 0,01 0,01 0,01 J05AF05 Lamivudinum 0,93 0,73 0,54 0,79 0,03 J05AF06 Abacavirum 0,27 1,00 0,11 0,59 0,01 J05AF07 Tenofovir disoproxil * * 0,01 0,00 - J05AF08 Adefovir dipivoxil * 0,00 0,01 0,00 - J05AF09 Emtricitabine * * 0,00 0,01 0,00 J05AF30 kombinācijas 1,61 1,62 *** *** *** St a ti s tic on M e dicin es C u mp tion 2009 J05AG Non-nucleoside reverse 0,03 0,03 0,05 0,06 0,30 transcriptase inhibitors J05AG01 Nevirapine 0,00 0,00 0,00 0,00 0,00 J05AG03 Efavirenzum 0,03 0,03 0,05 0,06 0,30 J05AH Neuraminidase inhibitors 0,03 0,01 0,01 0,00 0,08 J05AH01 Zanamivir 0,00 0,00 0,00 0,00 0,00 J05AH02 Oseltamivirum 0,03 0,01 0,01 0,00 0,08 J05AX Other antivirals 0,01 0,00 0,20 0,01 0,00 J05AX07 Enfuvirtidum 0,01 0,00 0,20 0,01 0,00 L Antineoplastic and 1,62 2,02 2,35 2,92 3,31 immunomodulating agents L02 Endocrine therapy 1,21 1,56 1,91 2,24 2,51 L02A Hormones and related agents 0,28 0,37 0,58 1,04 1,21 L02AA Estrogens 0,01 0,02 0,02 0,02 0,00 L02AA02 Polyestradioli phosphas 0,01 0,02 0,02 0,02 0,00 L02AB Progestogens 0,03 0,02 0,03 0,04 0,05

STATE AGENCY OF MEDICINES 32 L02AB01 Megestrol 0,03 0,02 0,03 0,04 0,05 L02AE Gonadotropin releasing hormone 0,24 0,33 0,53 0,98 1,16 analogues L02AE02 Leuprorelin * * 0,04 0,33 0,50 L02AE03 Goserelinum 0,14 0,14 0,18 0,25 0,25 L02AE04 Triptorelinum 0,10 0,19 0,31 0,40 0,41 L02B Hormone antagonists and related 0,93 1,19 1,33 1,20 1,30 agents L02BA Anti-estrogens 0,69 0,85 0,89 0,73 0,72 L02BA01 Tamoxifenum/Tamoxifeni citras 0,69 0,85 0,89 0,73 0,72 L02BA02 Toremifenum 0,00 0,00 0,00 0,00 - L02BA03 Fulvestrant * 0,00 0,00 0,00 0,00 L02BB Anti-androgens 0,15 0,20 0,23 0,19 0,25 L02BB01 Flutamidum 0,13 0,16 0,17 0,11 0,11 L02BB03 Bicalutamidum 0,02 0,04 0,06 0,08 0,14 L02BG Enzyme inhibitors 0,09 0,14 0,21 0,28 0,33 L02BG03 Anastrozolum 0,05 0,08 0,13 0,17 0,20 L02BG04 Letrozolum 0,03 0,04 0,05 0,07 0,08 L02BG06 Exemestanum 0,01 0,01 0,03 0,04 0,05 L03 Immunostimulants 0,15 0,19 0,17 0,25 0,27 L03A Cytokines and immunomodulators 0,15 0,19 0,17 0,25 0,27 L03AA Colony stimulating factors 0,00 0,01 0,02 0,03 0,04 L03AA02 Filgrastimum 0,00 0,01 0,01 0,01 0,02 L03AA10 Lenograstim 0,00 0,00 0,00 0,00 0,00 L03AA13 Pegfilgrastim * 0,00 0,01 0,02 0,02 L03AB Interferons 0,14 0,17 0,13 0,18 0,18 L03AB01 Interferon alfa natural - - - - 0,00 L03AB04 Interferon alfa-2a 0,02 0,02 0,04 0,05 0,05 L03AB05 Interferon alfa-2b 0,06 0,03 0,03 0,03 0,02 L03AB07 Interferonum beta-1a 0,27 0,43 0,53 0,30 0,32 St a ti s tic on M e dicin es C u mp tion 2009 L03AB08 Interferon beta-1b - - - - 0,08 L03AB10 Peginterferonum alfa-2b 0,02 0,07 0,05 0,10 0,03 L03AB11 Peginterferonum alfa-2a 0,04 0,05 0,01 0,00 0,00 L03AX Other cytokines and 0,01 0,01 0,02 0,04 0,05 immunomodulators L03AX03 BCG vaccine 0,00 0,00 0,01 0,01 0,00 L03AX13 Glatirameri acetas 0,01 0,01 0,01 0,03 0,05 L04 Immunosuppressants 0,26 0,27 0,27 0,43 0,53 L04AA01 Cyclosporinum 0,15 0,17 0,14 *** *** L04AA02 Muromonab-CD3 - 0,00 0,00 0,00 - L04AA06 Mofetili mycophenolas 0,06 0,03 0,03 0,11 0,13 L04AA08 Daclizumab 0,00 - 0,00 *** *** L04AA10 Sirolimus 0,00 0,01 0,01 0,02 0,02 L04AA11 Etanercept 0,00 0,01 0,02 - - L04AA12 Infliximab - 0,00 0,00 - - L04AA13 Leflunomide - 0,00 0,02 0,07 0,13

STATE AGENCY OF MEDICINES 33 L04AA14 Anakinra 0,00 0,00 0,00 - - L04AA17 Adalimumab 0,00 0,00 0,00 - - L04AA21 Efalizumab 0,00 0,00 0,00 - - L04AA23 Natalizumab - - - - 0,00 L04AB01 Etanercept *** *** *** 0,02 0,03 L04AB02 Infliximab *** *** *** 0,01 0,01 L04AB04 Adalimumab *** *** *** 0,00 0,00 L04AC01 Daclizumab *** *** *** 0,00 0,00 L04AC03 Anakinra *** *** *** 0,00 0,00 L04AD01 Ciclosporin *** *** *** 0,14 0,15 L04AX01 Azathioprinum 0,05 0,04 0,05 0,05 0,06 L04AX03 Methotrexate - - - - 0,00 M Musculo-skeletal system 48,14 49,61 54,88 60,83 56,98 M01 Antiinflammatory and antirheumatic 44,97 44,59 47,45 51,78 47,73 products M01A Antiinflammatory and antirheumatic 44,95 44,58 47,44 51,77 47,72 products, non-steroids M01AB Acetic acid derivatives and related 29,64 25,50 26,11 27,68 23,94 substances M01AB01 Indometacinum 0,74 0,63 0,56 0,49 0,40 M01AB05 Diclofenacum 25,09 21,31 21,49 22,52 19,74 M01AB15 Ketorolacum 1,56 1,15 1,42 1,63 1,26 M01AB16 Aceclofenacum 0,26 0,46 0,65 0,84 0,76 M01AB55 Diclofenacum, kombinācijas 1,99 1,95 1,99 2,20 1,78 M01AC Oxicams 1,07 1,41 1,84 2,30 2,68 M01AC01 Piroxicamum 0,12 0,05 0,10 0,13 0,11 M01AC05 Lornoxicamum 0,32 0,43 0,53 0,56 0,53 M01AC06 Meloxicamum 0,63 0,93 1,21 1,61 2,04 M01AE Propionic acid derivatives 8,65 10,45 11,77 14,35 14,58

M01AE01 Ibuprofenum 8,18 10,04 11,30 13,89 14,21 St a ti s tic on M e dicin es C u mp tion 2009 M01AE02 Naproxenum 0,04 0,00 - - - M01AE03 Ketoprofenum 0,27 0,24 0,30 0,27 0,21 M01AE09 Flurbiprofen - - 0,00 0,01 0,01 M01AE12 Oxaprozinum 0,00 0,00 0,00 0,00 - M01AE14 Dexibuprofenum 0,01 0,01 0,01 0,01 0,00 M01AE17 Dexketoprofenum 0,15 0,16 0,16 0,17 0,15 M01AH Coxibs 0,26 0,24 0,37 0,47 0,36 M01AH01 Celecoxibum 0,26 0,13 0,08 0,07 0,05 M01AH04 Parecoxibum 0,00 0,00 0,00 - - M01AH05 Etoricoxib 0,00 0,11 0,29 0,40 0,31 M01AX Other antiinflammatory and 5,33 6,98 7,35 6,97 6,16 antirheumatic agents, non-steroids M01AX01 Nabumetonum 0,06 0,07 0,11 0,09 0,03 M01AX05 Glucosamini sulfas 0,73 1,31 1,26 1,58 1,79 M01AX17 Nimesulidum 4,54 5,60 5,98 5,30 4,34 M01C Specific antirheumatic agents 0,02 0,01 0,01 0,01 0,01

STATE AGENCY OF MEDICINES 34 M01CC01 D-Penicillaminum 0,02 0,01 0,01 0,01 0,01 M03 Muscle relaxants 1,83 2,15 2,52 2,79 2,43 M03BX01 Baclofenum 0,10 0,11 0,11 0,12 0,13 M03BX02 Tizanidinum 0,10 0,09 0,11 0,11 0,10 M03BX04 Tolperisonum 1,63 1,95 2,30 2,56 2,20 M04 Antigout preparations 0,45 0,49 0,54 0,68 0,73 M04AA01 Allopurinolum 0,45 0,49 0,54 0,68 0,73 M05 Drugs for treatment of bone 0,89 2,38 4,37 5,57 6,09 diseases M05BA02 Clodronic acid * * 0,02 0,04 0,05 M05BA03 Pamidronic acid 0,00 * 0,00 0,00 0,00 M05BA04 Natrii alendronas 0,69 0,97 0,49 0,33 0,09 M05BA06 Ibandronic acid 0,02 0,14 0,91 1,18 1,11 M05BA07 Natrii risedronas 0,14 0,40 0,71 0,89 1,04 M05BA08 Zoledronic acid 0,00 0,00 0,00 0,00 0,00 M05BB03 Alendronic acid and colecalciferol * 0,51 1,61 2,30 3,22 M05BX03 Strontium ranelate 0,04 0,36 0,63 0,83 0,57 M09 Other drugs for disorders of the 0,00 0,00 0,00 0,00 0,00 musculo-skeletal system M09AX01 Hyaluronic acid 0,00 0,00 0,00 0,00 0,00 N Nervous system 51,03 50,62 59,94 63,70 60,22 N02 Analgesics 6,51 5,00 5,33 5,14 5,20 N02A Opioids 1,45 1,30 1,45 1,68 1,80 N02AA Natural opium alkaloids 0,13 0,12 0,18 0,20 0,18 N02AA01 Morphinum 0,07 0,06 0,10 0,10 0,09 N02AA03 Hydromorphone * - 0,00 - - N02AA05 Oxycodone 0,00 0,00 0,00 0,00 0,00 N02AA08 Dihydrocodeini tartars 0,04 0,06 0,08 0,09 0,09 N02AA59 Codeinum, kombinācijas 0,02 0,00 0,00 ** ** N02AB Phenylpiperidine derivatives 0,22 0,11 0,22 0,29 0,33 St a ti s tic on M e dicin es C u mp tion 2009 N02AB02 Pethidinum 0,01 0,01 0,01 0,02 0,03 N02AB03 Fentanylum 0,21 0,10 0,21 0,27 0,30 N02AX Other opioids 1,10 1,07 1,05 1,19 1,29 N02AX02 Tramadolum/Tramadoli 1,10 1,07 1,05 1,19 1,29 hydrochloridum N02B Other analgesics and antipyretics 5,03 3,66 3,84 3,38 3,30 N02BA01 Acidum acetylsalicylas 2,02 0,97 1,00 0,91 0,82 N02BB02 Metamizolum natricum 1,00 1,07 0,94 0,85 0,79 N02BE01 Paracetamolum 2,01 1,62 1,90 1,62 1,69 N02C Antimigraine preparations 0,03 0,04 0,04 0,08 0,10 N02CC01 Sumatriptani succinas 0,02 0,02 0,04 0,07 0,09 N02CC03 Zolmitriptanum 0,01 0,00 0,00 0,00 0,00 N02CC06 Eletriptan 0,00 0,01 0,00 0,01 0,01 N03 Antiepileptics 4,18 4,24 5,45 5,92 5,90 N03A Antiepileptics 4,18 4,24 5,45 5,92 5,90 N03AD01 Ethosuximidum 0,00 0,00 - - -

STATE AGENCY OF MEDICINES 35 N03AE01 Clonazepamum 1,01 0,86 1,65 1,73 1,72 N03AF01 Carbamazepinum 1,29 1,33 1,35 1,40 1,36 N03AF02 Oxcarbazepinum 0,24 0,27 0,28 0,30 0,31 N03AG01 Acidum valproicum/ Natrii valproas 0,94 1,04 1,22 1,36 1,29 N03AG03 Acidum aminobutyricum 0,12 0,00 - - - N03AG06 Tiagabine * * * 0,00 0,00 N03AX09 Lamotriginum 0,23 0,28 0,33 0,40 0,42 N03AX11 Topiramatum 0,17 0,18 0,19 0,20 0,20 N03AX12 Gabapentinum 0,15 0,19 0,34 0,43 0,42 N03AX14 Levetiracetam * 0,00 0,00 0,00 0,00 N03AX16 Pregabalin 0,03 0,09 0,09 0,10 0,18 N04 Anti-parkinson drugs 3,25 2,75 4,08 4,13 3,98 N04A Anticholinergic agents 1,37 0,86 1,97 1,91 1,82 N04AA01 Trihexyphenidylum 1,31 0,80 1,94 1,91 1,82 N04AA02 Biperidenum 0,06 0,06 0,03 0,00 - N04B Dopaminergic agents 1,88 1,90 2,11 2,22 2,16 N04BA02 Carbidopum/Levodopum/Kombinētie 0,61 0,61 0,59 0,60 0,56 preparāti, kuru sastāvā divas aktīvās vielas N04BA03 Levodopa, decarboxylase inhibitor * 0,00 0,02 0,06 0,09 and COMT inhibitor N04BB01 Amantadini sulfas 0,53 0,55 0,56 0,57 0,59 N04BC01 Bromocriptinum 0,01 0,02 0,02 0,01 0,01 N04BC04 Ropinirolum 0,01 0,03 0,19 0,24 0,23 N04BC05 Pramipexolum 0,01 0,01 0,03 0,05 0,06 N04BD01 Selegilini hydrochloridum 0,71 0,68 0,69 0,68 0,62 N04BD02 Rasagiline - - - - 0,00 N04BX01 Tolcapone * * * 0,00 0,00 N04BX02 Entacapone 0,00 0,00 0,01 0,01 0,00

N05 Psycholeptics 16,10 16,14 22,56 23,48 22,33 St a ti s tic on M e dicin es C u mp tion 2009 N05A Antipsychotics 6,15 7,07 7,30 7,88 7,25 N05AA Phenothiazines with aliphatic side- 0,14 0,13 0,30 0,15 0,14 chain N05AA01 Chlorpromazini hydrochloridum 0,00 0,01 0,02 0,00 - N05AA02 Levomepromazinum 0,14 0,12 0,28 0,15 0,14 N05AB Phenothiazines with piperazine 0,35 0,63 0,18 0,18 0,00 structure N05AB02 Fluophenazinum 0,35 0,63 0,18 0,18 - N05AC Phenothiazines with piperidine 0,05 0,02 0,00 0,00 0,00 structure N05AC02 Thioridazinum/Thioridazini 0,05 0,02 - - - hydrochloridum N05AD Butyrophenone derivatives 2,34 2,30 2,44 2,49 2,37 N05AD01 Haloperidolum 2,19 2,15 2,26 2,28 2,17 N05AD03 Melperoni hydrochloridum 0,15 0,15 0,18 0,21 0,20 N05AE Indole derivatives 0,05 0,10 0,18 0,29 0,27 N05AE03 Sertindole 0,00 - 0,00 0,04 0,06

STATE AGENCY OF MEDICINES 36 N05AE04 Ziprasidonum 0,05 0,10 0,18 0,25 0,21 N05AF Thioxanthene derivatives 1,19 1,41 1,51 1,68 1,58 N05AF01 Flupentixolum 0,27 0,30 0,32 0,33 0,32 N05AF03 Chlorprothixenum 0,49 0,61 0,63 0,74 0,67 N05AF05 Zuclopenthixolum 0,43 0,50 0,56 0,61 0,59 N05AH Diazepines, oxazepines, 1,11 1,31 1,46 1,68 1,62 thiazepines and oxepines N05AH02 Clozapinum 0,61 0,65 0,64 0,65 0,58 N05AH03 Olanzapinum 0,33 0,41 0,47 0,53 0,47 N05AH04 Quetiapinum 0,17 0,25 0,35 0,50 0,57 N05AL Benzamides 0,38 0,47 0,55 0,52 0,41 N05AL01 Sulpiridum 0,13 0,14 0,15 0,15 0,13 N05AL05 Amisulpridum 0,25 0,33 0,40 0,37 0,28 N05AX Other antipsychotics 0,54 0,70 0,68 0,89 0,86 N05AX08 Risperidonum 0,54 0,66 0,52 0,61 0,62 N05AX11 Zotepine 0,00 0,01 0,02 0,02 0,01 N05AX12 Aripiprazole - 0,03 0,14 0,26 0,23 N05B Anxiolytics 7,71 7,03 11,63 11,53 10,99 N05BA Benzodiazepine derivatives 7,50 6,80 11,39 11,28 10,79 N05BA01 Diazepamum 2,79 2,09 3,74 3,47 3,17 N05BA02 Chlordiazepoxidum 0,20 0,16 0,26 0,24 0,22 N05BA03 Medazepamum 0,08 0,05 0,09 0,03 0,06 N05BA04 Oxazepamum 0,76 0,62 1,01 0,97 0,87 N05BA06 Lorazepamum 0,16 0,14 0,34 0,39 0,39 N05BA08 Bromazepamum 1,14 1,14 1,98 2,12 2,08 N05BA12 Alprazolamum 2,37 2,59 3,97 4,07 3,99 N05BE Azaspirodecanedione derivatives 0,21 0,23 0,24 0,25 0,20 N05BE01 Buspironi hydrochloridum 0,21 0,23 0,24 0,25 0,20 N05C Hypnotics and sedatives 2,24 2,04 3,63 4,06 4,09 St a ti s tic on M e dicin es C u mp tion 2009 N05CD Benzodiazepine derivatives 0,98 0,74 1,10 1,12 1,07 N05CD02 Nitrazepamum 0,83 0,60 0,88 0,88 0,84 N05CD05 Triazolamum 0,07 0,07 0,07 0,08 0,09 N05CD08 Midazolamum 0,08 0,07 0,15 0,16 0,14 N05CF Benzodiazepine related drugs 1,26 1,29 2,53 2,94 3,02 N05CF01 Zopiclonum 0,75 0,80 1,63 1,97 2,06 N05CF02 Zolpidemum 0,51 0,49 0,90 0,97 0,96 N05CF03 Zaleplon * * 0,00 - - N06 Psychoanaleptics 13,50 14,47 13,46 14,23 13,01 N06A Antidepressants 4,27 4,60 4,94 6,32 6,50 N06AA Non-selective monoamine reuptake 1,50 1,54 1,54 1,59 1,48 inhibitors N06AA02 Imipraminum 0,03 0,02 0,01 0,01 0,01 N06AA04 Clomipraminum/Clomipramini 0,22 0,22 0,21 0,21 0,20 hydrochloridum N06AA09 Amitriptylinum/Amitriptylini 1,03 1,09 1,10 1,15 1,08 hydrochloridum

STATE AGENCY OF MEDICINES 37 N06AA10 Nortriptylinum 0,22 0,21 0,22 0,21 0,19 N06AB Selective serotonin reuptake 2,31 2,42 2,65 3,73 3,98 inhibitors N06AB03 Fluoxetinum/Fluoxetini hydrochloridum 0,40 0,31 0,26 0,27 0,27 N06AB04 Citalopramum/Citaloprami 0,44 0,41 0,44 0,46 0,39 hydrobromidum N06AB05 Paroxetinum 0,82 1,00 1,19 1,40 1,36 N06AB06 Sertralinum 0,49 0,53 0,62 0,73 0,67 N06AB08 Fluvoxamini maleas 0,16 0,17 0,14 0,14 0,12 N06AB10 Escitalopram * * - 0,73 1,17 N06AG Monoamine oxidase a inhibitors 0,00 0,00 0,00 0,00 0,00 N06AG02 Moclobemidum 0,00 0,00 - - - N06AX Other antidepressants 0,46 0,65 0,75 1,00 1,04 N06AX11 Mirtazapinum 0,07 0,20 0,16 0,27 0,35 N06AX12 Bupropion - - - - 0,12 N06AX14 Tianeptine 0,19 0,21 0,23 0,29 0,22 N06AX16 Venlafaxinum 0,19 0,21 0,23 0,28 0,31 N06AX18 Reboxetinum 0,01 0,01 0,01 0,00 0,00 N06AX21 Duloxetine * 0,02 0,12 0,16 0,16 N06B Psychostimulants, agents used for 2,44 2,18 2,10 2,08 1,72 adhd and nootropics N06BA04 Methylphenidatum 0,01 0,00 0,00 0,00 0,00 N06BA09 Atomoxetine * * 0,00 0,00 0,00 N06BC01 Caffeine * 0,00 0,00 0,00 0,00 N06BX02 Pyritinol 0,03 0,03 0,04 0,03 0,03 N06BX03 Piracetamum 2,40 2,15 2,06 2,05 1,68 N06D Anti-dementia drugs 6,79 7,68 6,42 5,83 4,80 N06DA Anticholinesterases 0,02 0,00 0,00 0,00 0,00 N06DA02 Donepezilum 0,02 0,00 0,00 0,00 0,00

N06DA04 Galantamine * * * 0,00 - St a ti s tic on M e dicin es C u mp tion 2009 N06DX Other anti-dementia drugs 6,77 7,68 6,42 5,83 4,80 N06DX01 Memantinum 0,05 0,05 0,06 0,06 0,05 N06DX02 Extractum Ginkgo bilobae 6,72 7,63 6,36 5,77 4,75 N07 Other nervous system drugs 7,49 8,03 9,06 10,79 9,79 N07A Parasympathomimetics 0,11 0,06 0,07 0,08 0,07 N07AA01 Neostigmini methylsulfas 0,04 0,00 - - - N07AA02 Pyridostigmini bromidum 0,07 0,06 0,07 0,08 0,07 N07B Drugs used in addictive disorders 0,25 0,30 0,45 0,41 0,26 N07BA01 Nicotinum 0,13 0,19 0,35 0,31 0,22 N07BA02 Bupropion * * * 0,00 - N07BA03 Varenicline * * 0,01 0,04 0,01 N07BB04 Naltrexonum 0,02 0,03 0,03 0,03 0,00 N07BC01 Buprenorphini hydrochloridum 0,10 0,08 0,06 0,02 0,00 N07BC51 Buprenorphine, combinations * * * 0,01 0,02 N07C Antivertigo preparations 7,13 7,66 8,54 10,30 9,46 N07CA01 Betahistinum 1,55 2,47 3,98 5,65 5,60

STATE AGENCY OF MEDICINES 38 N07CA02 Cinnarizinum 5,58 5,19 4,56 4,65 3,86 N07X Other nervous system drugs 0,00 0,00 0,00 0,00 0,00 N07XX02 Riluzole 0,00 0,00 0,00 0,00 0,00 P Antiparasitic products, insecticides 0,54 0,56 0,65 0,76 0,65 and repellents P01 Antiprotozoals 0,21 0,23 0,30 0,40 0,35 P01AB01 Metronidazolum 0,14 0,15 0,17 0,27 0,21 P01AB02 Tinidazolum 0,00 0,00 - - - P01AB03 Ornidazole 0,02 0,02 0,02 0,02 0,02 P01BA02 Chloroquini sulfas 0,05 0,06 0,10 0,11 0,12 P01BC02 Mefloquine 0,00 0,00 0,01 0,00 0,00 P02 Anthelmintics 0,33 0,33 0,35 0,36 0,30 P02CA01 Mebendazolum 0,21 0,21 0,22 0,22 0,18 P02CC01 Pyrantelum/Pyranteli embonas 0,10 0,10 0,11 0,12 0,11 P02CE01 Levamisolum 0,02 0,02 0,02 0,02 0,01 R Respiratory system 47,99 45,93 53,15 51,94 42,84 R01 Nasal preparations 21,35 21,81 25,99 25,51 19,84 R01A Decongestants and other nasal 21,22 21,69 25,83 25,30 19,58 preparations for topical use R01AA Sympathomimetics, plain 19,20 19,39 22,81 22,30 17,00 R01AA05 Oxymetazolinum 0,85 0,11 0,25 0,38 0,48 R01AA07 Xylometazolinum 11,41 12,85 14,24 15,90 13,50 R01AA08 Naphazolini nitras 6,94 6,43 8,32 6,02 3,02 R01AC Antiallergic agents, excl, 0,05 0,05 0,07 0,05 0,04 corticosteroids R01AC01 Natrii cromoglicas 0,00 0,00 - - - R01AC03 Azelastinum 0,05 0,05 0,07 0,05 0,04 R01AD Corticosteroids 1,97 2,25 2,95 2,95 2,54 R01AD01 Beclametasonum 0,42 0,39 0,38 0,27 0,20

R01AD05 Budesonidum 0,90 1,07 1,33 1,37 1,28 St a ti s tic on M e dicin es C u mp tion 2009 R01AD08 Fluticasonum 0,44 0,56 0,67 0,74 0,60 R01AD09 Mometasonum 0,21 0,23 0,57 0,57 0,46 R01B Nasal decongestants for systemic 0,13 0,12 0,16 0,21 0,26 use R01BA Sympathomimetics 0,13 0,12 0,16 0,21 0,26 R01BA52 Pseudoephedrine, combinations 0,13 0,12 0,16 0,21 0,26 R02 Throat preparations 1,28 1,15 1,20 1,05 0,82 R02AA02 Dequalinium 0,73 0,74 0,78 0,65 0,52 R02AA05 Chlorhexidinum 0,55 0,41 0,42 0,40 0,30 R03 Drugs for obstructive airway 10,86 10,50 11,40 11,60 10,86 diseases R03A Adrenergics, inhalants 5,10 5,34 5,80 5,84 5,71 R03AC02 Salbutamolum 4,14 4,34 4,76 4,83 4,55 R03AC04 Fenoteroli hydrobromidum 0,70 0,75 0,70 0,68 0,62 R03AC12 Salmeterolum 0,15 0,12 0,12 0,11 0,08 R03AC13 Formoterolum 0,11 0,13 0,22 0,22 0,46

STATE AGENCY OF MEDICINES 39 R03B Other drugs for obstructive airway 1,86 1,84 1,99 2,22 1,99 diseases, inhalants R03BA01 Beclometasoni dipropionas 1,05 0,98 0,96 0,89 0,83 R03BA02 Budesonidum 0,41 0,38 0,40 0,43 0,37 R03BA05 Fluticasoni propionas 0,40 0,42 0,49 0,45 0,36 R03BB04 Tiotropium bromide 0,00 0,06 0,14 0,45 0,43 R03C Adrenergics for systemic use 0,17 0,15 0,22 0,20 0,19 R03CC02 Salbutamoli sulfas 0,17 0,15 0,22 0,20 0,19 R03D Other systemic drugs for 3,73 3,17 3,39 3,34 2,97 obstructive airway diseases R03DA04 Theophyllinum 2,76 2,15 2,17 2,12 1,96 R03DA05 Aminophyllinum 0,62 0,58 0,53 0,42 0,37 R03DC03 Montelukastum 0,35 0,44 0,69 0,80 0,64 R05 Cough and cold preparations 8,47 6,23 7,54 6,75 5,73 R05C Expectorants, excl, combinations 7,91 5,60 6,71 6,09 5,36 with cough suppressants R05CA03 Guaifenesinum 0,04 0,05 0,08 0,08 0,06 R05CA05 Kombinētie preparāti, kuru sastāvā 0,01 0,00 - - - trīs aktīvās vielas/ Althaea officinalis R05CB01 Acetylcysteinum 1,93 1,50 1,83 1,93 1,66 R05CB02 Bromhexinum 3,82 2,32 2,54 2,12 1,92 R05CB03 Carbocisteinum 0,07 0,07 0,09 0,13 0,12 R05CB06 Ambroxolum 2,04 1,66 2,17 1,83 1,60 R05CB13 Dornasum alfa 0,00 0,00 0,00 0,00 0,00 R05D Cough suppressants, excl, 0,56 0,63 0,83 0,66 0,37 combinations with expectorants R05DA09 Dextromethorphanum 0,34 0,42 0,56 0,45 0,25 R05DB05 Pentoxyverinum/Pentoxyverini citras/ 0,03 0,03 0,04 0,01 0,00 Pentoxyverini hydrochloridum R05DB09 Oxeladini citras 0,06 0,06 0,08 0,07 0,04 St a ti s tic on M e dicin es C u mp tion 2009 R05DB13 Butamiratum 0,13 0,12 0,15 0,13 0,08 R06 Antihistamines for systemic use 5,73 5,93 6,74 6,78 5,40 R06A Antihistamines for systemic use 5,73 5,93 6,74 6,78 5,40 R06AA02 Diphenhydraminum 0,13 0,00 - - - R06AA04 Clemastinum 1,64 1,86 2,30 2,25 1,67 R06AB03 Dimetindenum 0,03 0,03 0,04 0,04 0,00 R06AC03 Chloropyramine 0,53 0,54 0,51 0,50 0,43 R06AE07 Cetirizinum 0,97 1,17 1,29 1,34 1,30 R06AE09 Levocetirizinum 0,22 0,24 0,32 0,40 0,29 R06AX07 Triprolidinum 0,15 0,19 0,21 0,19 - R06AX11 Astemizolum 0,00 0,00 - - - R06AX13 Loratadinum 1,11 1,20 1,28 1,35 1,04 R06AX17 Ketotifenum 0,35 0,33 0,34 0,31 0,25 R06AX22 Ebastinum 0,13 0,13 0,16 0,15 0,13 R06AX26 Fexofenadinum 0,37 0,15 0,09 0,01 0,04 R06AX27 Desloratadinum 0,10 0,08 0,20 0,24 0,25 R07 Other respiratory system products 0,30 0,31 0,28 0,25 0,19

STATE AGENCY OF MEDICINES 40 R07AB02 Nicethamidum 0,30 0,31 0,28 0,25 0,19 S Sensory orgāns 5,92 6,78 7,30 8,58 9,60 S01 Ophthalmologicals 5,92 6,78 7,30 8,58 9,60 S01E Antiglaucoma preparations and 5,92 6,78 7,30 8,58 9,60 miotics S01EA Sympathomimetics in glaucoma 0,00 0,00 0,00 0,22 0,70 therapy S01EA05 Brimonidine * * * 0,22 0,70 S01EB Parasympathomimetics 0,08 0,06 0,06 0,05 0,04 S01EB01 Pilocarpinum 0,08 0,06 0,06 0,05 0,04 S01EC Carbonic anhydrase inhibitors 0,47 0,58 0,84 1,01 1,34 S01EC01 Acetazolamide * * 0,13 0,12 0,11 S01EC03 Dorzolamidum 0,19 0,25 0,31 0,37 0,43 S01EC04 Brinzolamidum 0,28 0,33 0,40 0,52 0,80 S01ED Beta blocking agents 3,90 4,18 3,84 3,98 3,85 S01ED01 Timololum 2,89 3,19 2,95 3,11 2,99 S01ED02 Betaxololum 1,01 0,99 0,89 0,87 0,86 S01EE Prostaglandin analogues 1,47 1,96 2,56 3,32 3,67 S01EE01 Latanoprostum 1,47 1,96 2,56 3,32 3,67

V Various 0,02 0,03 0,05 0,08 0,06 V03 All other therapeutic products 0,02 0,03 0,05 0,08 0,06 V03AE02 Sevelamer 0,00 0,00 0,00 0,00 0,00 V03AF03 Calcii folinas 0,02 0,03 0,05 0,08 0,06 V03AF07 Rasburicase 0,00 0,00 0,00 0,00 - V03AF08 Palifermin * 0,00 0,00 0,00 0,00 Total 490,65 524,91 568,37 615,25 576,99

Notes: St a ti s tic on M e dicin es C u mp tion 2009 „0.00” – DDD/ 1000 inhabitants/day is below 0.005 * - medicines consumption according to ATC/DDD system was not calculated in previous years ** - for those ATC code DDD value has been deleted during this period „-“ – for those ATC group products with an assigned DDD value no sales have been registered *** - this ATC code was not assigned in current year

STATE AGENCY OF MEDICINES 41 Most marketable medicines (total consumption DDD/ 1000 inhabitants/ day)

% increase/ International trade name 2005 2006 2007 2008 2009 decrease

Acidum acetylsalicylicum 32,73 39,52 40,79 46,20 44,38 -4 Atorvastatinum* 2,90 5,31 8,95 14,46 16,26 12 Enalaprilum 31,14 30,36 27,81 27,62 24,54 -11 Acidum ascorbicum 45,91 32,33 28,99 24,21 24,37 1 Diclofenacum 25,09 23,26 23,48 24,72 21,52 -13 Perindoprilum 5,48 9,29 13,24 20,11 19,03 -5 Amlodipinum 9,52 13,92 15,84 19,85 18,44 -7 Omeprazolum 11,93 13,41 16,64 18,74 16,66 -11 Ibuprofenum 8,18 10,04 11,30 13,89 14,21 2 Xylometazolinum 11,41 12,85 14,24 15,90 13,50 -15 Bisoprololum 5,77 8,67 9,55 11,60 11,87 2 Metoprololum 6,98 10,72 10,54 11,76 11,74 0 Ramiprilum 5,30 6,86 8,39 11,19 11,70 5 Metforminum 6,04 6,48 7,60 9,12 9,72 7 Levothyroxinum 4,21 4,71 5,50 7,76 8,46 9 Isosorbidi mononitras 7,12 7,92 8,74 9,21 8,24 -10 Trimetazidinum 3,62 4,64 5,85 6,94 5,74 -17 Betahistinum 1,55 2,47 3,98 5,65 5,60 -1 Glimepiridum 2,69 3,56 4,48 5,38 5,43 1 Indapamidum 6,43 6,36 5,91 5,74 5,15 -10

* - the DDD value has been changed since 2009: from 10 mg (oral dose form) to 20 mg (oral

dose form). For the calculations in the table above the new DDD value (20 mg) was used. St a ti s tic on M e dicin es C u mp tion 2009

STATE AGENCY OF MEDICINES 42 The composition of the sales amount for medicines in 2009 according to the number of packagings sold by general type pharmacies

ATC 1st level code Percentage, % 1. Cardiovascular system (C) 21 2. Nervous system (N) 19 3. Alimentary tract and metabolism (A) 17 4. Musculo-skeletal system (M) 11 5. Respiratory system (R) 11 6. Other * 9 7. Dermatologicals (D) 6 8. Anti-infectives for systemic use (J) 4 9. Various (V) 3

*Other ATC groups: • Sensosory organs (S) • Genito-urinary system and sex hormones (G) • Blood and blood forming organs (B) • Antiperasitic products, insecticides and repellents (P) • Systemic hormonal preparations (H) • Antineoplastic and immunomodulating agents (L) St a ti s tic on M e dicin es C u mp tion 2009

STATE AGENCY OF MEDICINES 43 The composition of the sales amount according to the number of packagings sold by general type pharmacies and the most marketed medicines

Trade names for 3 of the most popular medicines ATC 1st level included in the Drug Register code ATC 2nd level Original trade name International trade name code 1. Cardio­ 1.1. Agents acting Prestarium 5 mg film-coated perindoprili argininum vascular system on the renin- tablets angiotensin system Noliprel Forte Arginine perindoprili argininum, 5mg/1,25mg film-coated indapamidum tablets Berlipril 10 mg tablets enalaprili maleas 1.2. Cardiac therapy Heart function improving tinctura leonuri, valerianae drops Valentis, oral drops, tinctura, tinctura crataegi liquid Validolum 60 mg tablets mentholum, menthylii isovaleras Tinctura Crataegi fructus crataegi 1.3. Beta blocking Concor 5 mg film-coated bisoprololi hemifumaras agents tablets Betaloc ZOK 50 mg metoprololi succinas controlled-release tablets Betaloc ZOK 100 mg metoprololi succinas controlled-release tablets 2. Nervous 2.1. Analgesics Nealginum propyphenazonum, system coffeinum, paracetamolum Citramons forte tabletes coffeinum, paracetamolum, acidum acetylsalicylicum St a ti s tic on M e dicin es C u mp tion 2009 Acetilsalicilskābe 325 mg acidum acetylsalicylicum tabletes 2.2. Psycholeptics Corvalolum oral liquid aethylii alpha- bromisovaleras stabilisatus, phenobarbitalum, menthae piperitae aetheroleum Baldriāna tinktūra RFF pilieni valerianae tinctura iekšķīgai lietošanai, šķīdums Lexotanil 3 mg tablets bromazepamum

2.3. Psycho­ Cavinton Forte10 mg tablets vinpocetinum analeptics Cavinton 5 mg tablets vinpocetinum

Futura Ginkgo Biloba ginkgo bilobae extractum

STATE AGENCY OF MEDICINES 44 3. Alimentary 3.1. Drugs for acid Lomac 20 mg capsules omeprazolum tract and related disorders metabolism Raniberl 150 mg film-coated ranitidinum tablets Rennie 680 mg/80 mg calcii carbonas, magnesii chewable tablets carbonas 3.2. Vitamins Vitamin C 500 mg Orange acidum ascorbicum, natrii chewable tablets ascorbas Upsavit vitamin C 1 g acidum ascorbicum effervescent tablets Vigantol Oel 0,5 mg/ml oral cholecalciferolum drops, solution 3.3. Drugs used in Metforal 850 mg film-coated metformini hydrochloridum diabetes tablets Diaprel MR 30 mg modified gliclazidum release tablets Metforal 500 mg film-coated metformini hydrochloridum tablets 4. Musculo- 4.1. Antiinflam­ Ibumetin 400 mg film-coated ibuprofenum skeletal system matory and tablets antirheumatic products Ibumetin 200 mg film-coated ibuprofenum tablets Ibuprofenum 400 mg ibuprofenum 4.2. Topical Fastum 2,5 % gel ketoprofenum products for joint and muscular pain Menovazīns RFF uz ādas mentholum racemicum, lietojams šķīdums procaini hydrochloridum, benzocainum Diclac 1% gels diclofenacum natricum 4.3. Drugs for FOSAVANCE alendronatum natricum, tretament of bone cholecalciferolum

diseases Risendros 35 mg film-coated natrii risedronas St a ti s tic on M e dicin es C u mp tion 2009 tablets Protelos strontium ranelatum

STATE AGENCY OF MEDICINES 45 5. Respiratory 5.1. Cough and cold Bromhexin Actavis 8 mg bromhexini hydrochloridum system preparations tablets

Brontex 3 mg/ml syrup ambroxoli hydrochloridum Brontex 30 mg tablets ambroxoli hydrochloridum 5.2. Nasal Xymelin 1 mg/ ml nasal spray, xylometazolini preparations solution hydrochloridum Xylometazolin ICN Polfa 1mg/ xylometazolini ml nasal drops hydrochloridum Coldargan Solution argenti proteinas, ephedrini laevulinas, natrii laevulinas, calcii laevulinas 5.3. Throat Decatylen 0,25 mg/0,03 mg dequalinii chloridum, preparations sūkājamās tabletes dibucaini hydrochloridum

Neo-angin Halstabletten spiritus 2,4-dichlorobenzylicus, amylmetacresolum, levomentholum Hexoraletten N 5 mg/1,5 mg chlorhexidini lozenges dihydrochloridum, benzocainum 6. Other ATC 6.1. Ophthalmo­ Oftan Catachrom 0,675/2/20 cytochromum groups* logicals mg/ml eye drops, solution c, adenosinum, nicotinamidum Xalatan 0,005 % eye drops latanoprostum Oftan Timolol 5 mg/ml acu timololum pilieni 6.2. Antithrombotic Thrombo ASS 100 mg acidum acetylsalicylicum agents Hjertemagnyl 150 mg/21 mg acidum acetylsalicylicum, film-coated tablets magnesii oxidum Hjertemagnyl 75 mg film- acidum acetylsalicylicum,

coated tablets magnesii oxidum St a ti s tic on M e dicin es C u mp tion 2009 6.3. Sex hormones Yasminelle 0,02 mg/3 mg film- drospirenonum, and modulators of coated tablets ethinylestradiolum the genital system Yarina 3000/30 mikrogramu drospirenonum, apvalkotās tabletes ethinylestradiolum Postinor-Duo 750 micrograms levonorgestrelum tablets

STATE AGENCY OF MEDICINES 46 7. Dermato­­ 7.1. Antiseptics and Hydrogenii peroxidum 3 per hydrogenii peroxidum logicals disinfectants centum Joda spirta šķīdums RFF 5 % iodum uz ādas lietojams šķīdums Solutio Viridis nitentis viride nitens spirituosa 1 % 7.2. Preparations for Tinctura Calendulae flores calendulae treatment of wounds and ulcers Bepanthen 50 mg/g ointment dexpanthenolum Kalendula 100 mg/g ointment calendulae tinctura 7.3. Antibiotics and Streptocīds pulveris sulfanilamidum chemotherapeutics for dermatological Streptocīda 10 % ziede sulfanilamidum use Sintomicīna 100 mg/g chloramphenicolum liniments 8. Anti- 8.1.Antibacterials Hiconcil 500 mg capsules amoxicillinum infectives for for systemic use systemic use Doxy-M-ratiopharm 100 mg doxycyclinum tablets Biseptol 480 mg tablets sulfamethoxazolum, trimethoprimum 8.2. Antivirals for Remantadīns 50 mg tabletes rimantadini hydrochloridum systemic use Combivir lamivudinum, zidovudinum Norvir ritonavirum 8.3. Antimycotics for Fluconazol Nycomed 150 mg fluconazolum systemic use capsules, hard Forcan 150 mg capsules fluconazolum Mycosyst 150 mg hard fluconazolum capsules 9. Various 9.1. All other Oscillococcinum anas barbariae hepatis et therapeutic products cordis extractum 200 k Aflubin drops gentiana, aconitum, St a ti s tic on M e dicin es C u mp tion 2009 bryonia, ferrum phosphoricum, acidum sarcolacticum Futura Fish Oil 1000 mg piscis oleum omega-3 capsules acidis abundans 9.2. All other non- Water for injections Fresenius aqua ad iniectabilia therapeutic products solvent for parenteral use Ūdens injekcijām ampulās aqua ad iniectabilia 9.3. Contrast media Gadovist 1,0 mmol/ml solution gadobutrolum for injections Urografin 76 % solution for natrium amidotrizoicum, injection and infusion megluminum amidotrizoicum Visipaque 320 mg I/ml iodixanolum solution for injection

*Other ATC groups: Sensory organs (S); Genito-urinary system and sex hormones (G); Blood and blood forming organs (B); Antiperasitic products, insecticides and repellents (P); Systemic hormonal preparations (H); Antineoplastic and immunomodulating agents (L);

STATE AGENCY OF MEDICINES 47 Manufacturers’ sale volumes according to medicines sold to pharmacies, hospitals, veterinary medicine establishments and other health care centres (% of sale (LVL)) in 2009 St a ti s tic on M e dicin es C u mp tion 2009

STATE AGENCY OF MEDICINES 48 Medicines consumption by manufacturers (% of sale (LVL)) through years St a ti s tic on M e dicin es C u mp tion 2009

STATE AGENCY OF MEDICINES 49 Medicines consumption by manufacturers (turnover in LVL) through years St a ti s tic on M e dicin es C u mp tion 2009

STATE AGENCY OF MEDICINES 50 Medicines consumption according to Marketing Authorisation Holders (turnover in LVL) in 2009

Sales (LVL with VAT Marketing Authorisation Holder included) 1 GlaxoSmithKline 12 930 371 2 Pfizer 10 504 696 3 Roche 10 208 452 4 Les Laboratoires Servier 8 082 053 5 Sanofi-Aventis 7 906 800 6 Berlin-Chemie/Menarini Group 7 062 662 7 AstraZeneca 6 677 581 8 Bayer/Bayer Schering Pharma 5 639 842 9 Novartis 5 756 927 10 KRKA 5 126 216 11 Nycomed 4 560 888 12 Olainfarm 4 401 927 13 Novo Nordisk 4 084 854 14 Gedeon Richter 3 895 493 15 Merck KgaA 3 753 868 16 Merck Sharp & Dohme (Merck & Co) 3 684 598 17 Amgen Europe BV 3 401 036 18 Sandoz 3 145 520 19 Rīgas farmaceitiskā fabrika 3 070 332 20 Baxter 3 070 282 21 Boehringer Ingelheim 2 733 539 22 Grindeks 2 697 346 23 Mepha 2 581 388 St a ti s tic on M e dicin es C u mp tion 2009 24 Zentiva 2 569 536 25 TEVA 2 346 506

Note: figures above do not reflect the volumes of sales completely, as due to mergers, changes into title data for one manufacturer may be divided between several manufacturers. Medicines are sold to pharmacies, hospitals, veterinary medicine establishments and other health care centres.

STATE AGENCY OF MEDICINES 51 Most marketed prescription medicines by DDD/1000 inhabitants/ day

% increase/ International trade name 2005 2006 2007 2008 2009 decrease Enalaprilum 31,14 30,36 27,81 27,65 24,54 -11 Diclofenacum 25,09 23,26 23,48 24,72 21,52 -13 Perindoprilum 5,48 9,29 13,24 20,11 19,03 -5 Amlodipinum 9,52 13,92 15,66 19,85 18,44 -7 Omeprazolum 11,93 13,41 16,51 18,31 16,29 -11 Atorvastatinum* 2,90 5,31 8,95 14,46 16,26 12 Bisoprololum 5,77 8,67 9,60 11,60 11,87 2 Metoprololum 6,98 10,72 10,54 11,76 11,74 0 Ramiprilum 5,30 6,86 8,39 11,19 11,70 5 Metforminum 6,04 6,48 7,59 9,12 9,72 7 Levothyroxinum 4,21 4,71 5,50 7,76 8,46 9 Isosorbidi mononitras 7,12 7,92 8,74 9,21 8,24 -10 Trimetazidinum 3,62 4,64 5,85 6,94 5,74 -17 Betahistinum 1,55 2,47 3,98 5,65 5,60 -1 Glimepiridum 2,69 3,56 4,48 5,38 5,43 1 Indapamidum 6,43 6,36 5,91 5,74 5,15 -10 Salbutamolum 4,31 4,49 4,98 5,03 4,74 -6 Digoxinum 5,92 5,41 5,36 5,10 4,65 -9 Nimesulidum 4,54 5,60 5,97 5,30 4,34 -18 Lacidipinum 2,83 3,52 4,15 4,85 4,29 -12

* - the DDD value has been changed since 2009: from 10 mg (oral dose form) to 20 mg (oral dose form). For the calculations in the table above the new DDD value (20 mg) was used. St a ti s tic on M e dicin es C u mp tion 2009

STATE AGENCY OF MEDICINES 52 Most marketed prescription medicines by turnover in LVL (international trade name)

ATC International % increase/ 2005 2006 2007 2008 2009 code trade name decrease C10AA05 Atorvastatinum 1 059 318 1 622 080 2 721 553 3 453 834 3 130 221 -9 B03XA02 Darbepoetinum alfa 177 247 799 659 1 277 731 1 933 060 2 418 126 25 J07BA01 Vaccinum 1 579 970 1 405 786 1 622 181 3 393 494 2 415 303 -29 encephalitidis ixodibus advectae inactivatum C07AB02 Metoprololi succinas 1 053 173 1 396 840 1 663 469 2 046 229 2 168 025 6 L03AB07 Interferon beta-1a 1 000 770 2 402 446 2 953 207 1 748 370 2 095 589 20 C09BA04 Perindoprili argininum, 450 250 917 499 1 226 939 2 023 766 2 072 437 2 Indapamidum C09AA04 Perindoprili argininum 754 336 1 243 349 1 644 378 2 117 353 2 027 621 -4 B01AC04 Clopidogrelum 592 826 1 153 713 1 712 716 2 318 987 1 778 154 -23 A02BC01 Omeprazolum 1 144 663 1 382 873 1 594 479 1 933 785 1 724 854 -11 R03AK06 Salmeterolum, 882 484 1 109 549 1 513 052 1 777 348 1 714 137 -4 Fluticasoni propionas L01XC02 Rituximabum 118 340 412 834 701 149 819 635 1 486 288 81 B05XA03 Natrii chloridum 854 508 1 012 292 1 039 471 1 053 243 1 529 098 45 S01ED51 Timolol kombinācijās 664 189 786 671 1 044 012 1 305 823 1 510 719 16 B03XA01 Epoetinum beta 785 224 1 123 243 2 423 905 1 591 962 1 460 907 -8 M01AB05 Diclofenacum 1 465 198 1 530 074 1 539 923 1 568 120 1 443 582 -8 natricum S01EE01 Latanoprostum 521 591 690 070 900 574 1 163 121 1 352 953 16 M01AX17 Nimesulidum 1 264 100 1 542 683 1 638 715 1 499 595 1 315 992 -12 L03AB08 Interferonum beta-1b 1 000 770 2 402 446 2 953 207 1 062 988 1 281 468 21 C07AB07 Bisoprololi 548 192 733 492 907 521 1 158 880 1 251 391 8

hemifumaras St a ti s tic on M e dicin es C u mp tion 2009 C08CA01 Amlodipinum 999 171 1 276 677 1 444 239 1 691 372 1 204 887 -29 A10AB05 Insulinum aspart 313 161 508 758 673 734 913 948 1 133 959 24 A10BD03 Rosiglitazonum, 69 962 449 358 777 972 996 567 1 125 970 13 Metformini hydrochloridum A10BA02 Metformini 688 504 696 986 808 876 986 769 1 083 536 10 hydrochloridum A10AE04 Insulinum glarginum 232 993 414 335 658 925 906 441 1 071 463 18 C09DA07 Telmisartanum, 11 138 126 730 450 080 893 730 1 067 949 19 Hydrochloro­thiazidum

STATE AGENCY OF MEDICINES 53 Most marketed prescription medicines by turnover in LVL (original trade name)

Original trade name % increase/ decrease Aranesp 25 Plavix -26 Rebif 44 micrograms - solution for injection 43 Tico Vac 0,5 ml suspension for injection in prefilled syringe -15 Mabthera 81 Seretide Diskus inhalation powder -2 Xalatan 0,005 % eye drops 16 Betaferon 19 Noliprel Forte Arginine 5mg/1,25mg film-coated tablets 0 Avandamet 13 NovoRapid FlexPen 30 Lantus 18 Neorecormon -33 Prestarium 5 mg film-coated tablets -6 Sodium chloride BBraun 0,9 % solution for infusion 50 Diphereline 11,25 mg prolonged-release powder and solvent for 2 suspension for injection FOSAVANCE -40 Glivec 49 Preductal MR 35 mg modified release film-coated tablets -10 NovoMix 30 FlexPen 13 Copaxone 20 mg/ml solution for injection, pre-filled syringe 98 Infanrix penta 6 Betaloc ZOK 100 mg controlled-release tablets 5 St a ti s tic on M e dicin es C u mp tion 2009 Levemir 100 U/ml solution for injection in a pre-filled pen 33 Betaserc 24 mg tablets 12

STATE AGENCY OF MEDICINES 54 Most marketed non-prescription medicines by DDD/1000 inhabitants/ day

% increase/ International trade name 2005 2006 2007 2008 2009 decrease Acidum acetylsalicylicum - 30,71 38,55 39,79 45,29 43,56 -4 antitrombotisks agent Acidum ascorbicum 46,89 32,62 28,47 24,21 23,95 -1 Xylometazolinum 11,41 12,85 14,24 15,90 13,50 -15 Ibuprofenum 7,41 9,13 10,44 12,86 13,25 3 Natrii fluoridum 7,10 9,96 10,66 9,72 6,85 -30 Extractum Ginkgo bilobae 6,72 7,63 6,36 5,77 4,75 -18 Ranitidinum 2,90 4,89 5,04 4,66 3,98 -15 Drotaverini hydrochloridum 5,05 5,19 5,12 4,96 3,93 -21 Belladonna alkaloids, 5,19 5,08 4,27 3,76 3,74 -1 tertiary amines Naphazolini nitras 6,94 6,43 8,32 6,02 3,02 -50 Bisacodylum 2,82 3,17 3,11 2,98 2,82 -5 Bromhexinum 3,82 2,32 2,54 2,12 1,92 -10 Paracetamolum 1,99 1,61 1,90 1,60 1,67 5 Acetylcysteinum 1,93 1,50 1,83 1,93 1,66 -14 Natrii picosulfas 1,69 2,00 1,99 1,82 1,61 -11 Ambroxolum 2,03 1,66 2,17 1,83 1,60 -13 Clemastinum 1,42 1,61 2,00 1,93 1,43 -26 Lactulosum 4,83 1,43 1,62 1,92 1,39 -27 Acidum acetylsalicylicum - 2,02 0,97 1,00 0,91 0,82 -10 Analgesic, antipyretic Glucosamini sulfas 0,04 0,13 0,11 0,16 0,76 379 St a ti s tic on M e dicin es C u mp tion 2009

STATE AGENCY OF MEDICINES 55 Most marketed non-prescription medicines by turnover in LVL (international trade name)

ATC International % increase/ 2005 2006 2007 2008 2009 code trade name decrease M01AE01 Ibuprofenum 1 135 484 1 482 968 1 793 371 1 994 565 2 190 588 10 Xylometazolini 761 477 971 754 1 158 330 1 343 545 1 247 684 R01AA07 hydrochloridum -7 Rimantadini 247 956 175 128 480 276 328 014 979 803 J05AC02 hydrochloridum 199 A09AA02 Pancreatis pulvis 687 723 811 800 762 497 851 562 736 704 -13 Anas barbariae hepatis et cordis extractum 220 585 266 114 405 222 545 942 730 391 V03AX 200 k 34 Acidum acetylsalicylicum, 214 341 378 867 469 001 619 647 710 066 paracetamolum, N02BA51 coffeinum 15 Magnesium, pyridoxini 635 344 706 668 778 322 832 247 662 569 A12CC06 hydrochloridum -20 M02AA10 Ketoprofenum 746 550 775 040 764 763 787 269 601 084 -24 A05BA03 Silymarinum 123 428 209 424 313 339 278 472 593 679 113 A02BA02 Ranitidinum 266 188 366 648 472 914 548 623 568 978 4 Extractum ginkgo 629 669 754 458 721 623 709 877 560 586 N06DX02 biloba -21 Diosminum, - - - - 524 479 C05CA53 hesperidinum1 - Calcium, 1 019 284 1 330 530 1 507 876 1 536 972 445 846 A12AX cholecalciferolum -71 Paracetamolum, pseudoephedrini hydrochloridum, 272 591 276 492 375 697 414 844 422 215 dextromethorphani N02BE51 hydrobromidum 2 Paracetamolum, acidum ascorbicum, St a ti s tic on M e dicin es C u mp tion 2009 464 529 496 606 583 042 563 569 557 630 phenylephrini N02BE51 hydrochloridum -1 R05CB01 Acetylcysteinum 322 603 247 961 310 739 344 759 386 515 12 N02BE01 Paracetamolum 296 104 352 638 362 886 338 635 368 934 9 R05CB06 Ambroxolum 378 840 385 023 451 281 406 010 379 911 -6 M09AB52 Trypsin, kombinācijas2 48 407 46 372 49 136 46 550 359 748 673 A05BA Phospholipida ex sojae 295 992 322 025 384 456 442 899 354 877 -20 G03AC03 Levonorgestrelum 222 780 304 106 407 349 449 267 345 990 -23 A03AX13 Simethiconum 251 975 302 170 358 388 395 802 339 097 -14 Mentholum, menthylii 212 830 249 736 312 807 386 024 336 106 C01EX isovaleras -13 Drotaverini 421 629 414 007 410 384 400 303 334 738 A03AD02 hydrochloridum -16 Acidum 275 717 276 594 282 957 359 459 334 106 B01AC06 acetylsalicylicum -7

1 non-prescription drug status was assigned to these medicines only in 2009

2 In 2009 the ATC code for Wobenzym was changed to the current one and consequently the consumption for this ATC code increased

STATE AGENCY OF MEDICINES 56 Most marketed non-prescription medicines by turnover in LVL (original trade name)

Original trade name % increase/ decrease

Ibumetin 400 mg film-coated tablets 1 Remantadīns 50 mg tabletes 200 Oscillococcinum 34 Carsil 35 mg coated tablets 113 Mezym 3500 U film-coated tablets -15 Citramons forte tabletes 14 Linex capsules, hard -23 Detralex 500 mg film-coated tablets -25 Magne B6 coated tablets -13 Futura Fish Oil 1000 mg capsules -12 Fastum 2,5 % gel -26 Theraflu ND 1000 mg/60 mg/30 mg powder for oral solution -23 Prostamol uno 320 mg soft capsules -27 Wobenzym gastro-resistant tablets -19 Essentiale forte N 300 mg hard capsules -20 Validolum 60 mg tablets -12 Raniberl 150 mg film-coated tablets -8 No-spa 40 mg tablets -17 Oftan Catachrom 0,675/2/20 mg/ml eye drops, solution 7 Xymelin 1 mg/ml nasal spray, solution 19 Nurofen for children 100 mg/5 ml oral suspension 45 Heart function improving drops Valentis, oral drops, liquid 11 Lioton 1000 IU/g gel -24 St a ti s tic on M e dicin es C u mp tion 2009 Decatylen 0,25 mg/0,03 mg lozenges -14 Daleron Cold3 film-coated tablets -4

STATE AGENCY OF MEDICINES 57 Medicines consumption by ATC groups (DDD/1000 inhabitants/ day in %) in 2009

DDD/1000 ATC 1st level code inhabitants/ day C – Cardiovascular system 200,48 A - Alimentary tract and metabolism 105,40 N – Nervous system 60,22 M - Musculo-skeletal system 56,98 B - Blood and blood forming organs 53,95 R - Respiratory system 42,84 H - Systemic hormonal preparations 18,12 J - Anti-infectives for systemic use 14,92 G - Genito urinary system and sex hormones 10,20 S, L, P, D, V groups 13,89 St a ti s tic on M e dicin es C u mp tion 2009

STATE AGENCY OF MEDICINES 58 Medicines consumption by ATC groups (DDD/1000 inhabitants/ day) through years

C - Cardiovascular system, A - Alimentary tract and metabolism, N - Nervous system, M - Musculo-skeletal system, B – Blood and blood forming organs, R - Respiratory system, H - Systemic hormonal preparations, J - Anti-infectives for systemic use, G - Genito urinary system St a ti s tic on M e dicin es C u mp tion 2009 and sex hormones, , Other – medicines consumption in other ATC groups.

STATE AGENCY OF MEDICINES 59 Medicines consumption by ATC groups (consumption (LVL)) in 2009*

ATC 1st level code Amount (LVL) C – Cardiovascular system 36 430 333,84 A - Alimentary tract and metabolism 26 752 915,90 N – Nervous system 23 825 139,77 L - Antineoplastic and immunomodulating agents 18 394 464,29 J – Anti-infectives for systemic use 17 875 844,30 B - Blood and blood forming organs 14 250 048,88 R – Respiratory system 13 882 400,39 M - Musculo-skeletal system 13 637 018,29 G - Genito-urinary system and sex hormones 8 474 973,03 V - Various 5 726 114,90 S – Sensory organs 5 438 145,53 D - Dermatologicals 4 559 165,23 H - Systemic hormonal preparations 2 654 280,40 P - Antiperasitic products, insecticides and repellents 612 576,35

*excludes medicines without a marketing authorisation in the Republic of Latvia sold in 2009 St a ti s tic on M e dicin es C u mp tion 2009

STATE AGENCY OF MEDICINES 60 Medicines consumption by ATC groups (consumption in LVL) through years *

* excluding not registered medicines St a ti s tic on M e dicin es C u mp tion 2009

STATE AGENCY OF MEDICINES 61 Most marketed medicines of ATC 2nd level (DDD/1000 inhabitants/ day)

% increase/ ATC 2nd level 2005 2006 2007 2008 2009 decrease C09 Agents acting on the renin- 53,01 58,85 63,13 75,22 69,55 -8 angiotensin system B01 Antithrombotic agents 32,82 43,34 45,71 52,33 50,70 -3 M01 Antiinflammatory and 44,97 44,59 47,45 51,78 47,73 -8 antirheumatic products C08 Calcium channel blockers 21,95 27,39 30,23 35,80 32,56 -9 A10 Drugs used in diabetes 18,29 20,44 22,10 26,76 28,25 6 C07 Beta blocking agents 16,55 23,43 24,33 28,26 28,19 0 C01 Cardiac therapy 26,95 27,51 29,30 29,54 25,48 -14 A11 Vitamins 48,20 34,29 30,38 25,19 25,07 0 A02 Drugs for acid related disorders 16,76 19,23 23,62 25,89 23,24 -10 N05 Psycholeptics 16,10 16,14 22,56 23,48 22,33 -5 C10 Lipid modifying agents 8,16 13,44 21,08 33,09 20,28 -39 R01 Nasal preparations 21,35 21,81 25,99 25,51 19,84 -22 C03 Diuretics 16,38 16,96 17,14 17,67 16,72 -5 N06 Psychoanaleptics 13,50 14,47 13,46 14,23 13,01 -9 J01 Antibacterials for systemic use 15,35 14,32 15,04 12,92 11,35 -12 R03 Drugs for obstructive airway 10,86 10,50 11,40 11,60 10,86 -6 diseases A03 Drugs for functional 13,12 13,25 12,78 12,02 10,30 -14 gastrointestinal disorders N07 Other nervous system drugs 7,49 8,03 9,06 10,79 9,79 -9 H03 Thyroid therapy 5,42 6,07 6,87 9,28 9,78 5

S01 Ophthalmologicals 5,92 6,78 7,30 8,58 9,60 12 St a ti s tic on M e dicin es C u mp tion 2009

STATE AGENCY OF MEDICINES 62 Most marketed medicines of ATC 3rd level (DDD/1000 inhabitants/ day)

% increase/ ATC 3rd level 2005 2006 2007 2008 2009 decrease C09A Agents acting on the renin- 52,66 56,73 59,12 68,75 62,78 -9 angiotensin system B01A Antithrombotic agents 32,82 43,34 45,71 52,33 50,70 -3 M01A Antiinflammatory and 44,95 44,58 47,44 51,77 47,72 -8 antirheumatic products, non- steroids C08C Selective calcium channel 20,95 26,36 29,20 34,61 31,43 -9 blockers with mainly vascular effects C07A Beta blocking agents 16,55 23,43 24,33 28,26 28,19 0 A11G Ascorbic acid (vitamin c), 46,93 32,62 28,99 24,21 24,32 0 incl. Combinations A02B Drugs for peptic ulcer and 16,76 19,23 23,62 25,89 23,24 -10 gastro-oesophageal reflux disease (gord) C10A Lipid modifying agents, plain 8,16 13,44 21,08 33,09 20,28 -39 R01A Decongestants and other 21,22 21,69 25,83 25,30 19,58 -23 nasal preparations for topical use A10B Blood glucose lowering 13,23 14,57 15,15 18,16 18,77 3 drugs, excl. Insulins N05B Anxiolytics 7,71 7,03 11,63 11,53 10,99 -5 C01D Vasodilators used in cardiac 11,89 11,92 12,73 12,05 10,31 -14 diseases S01E Antiglaucoma preparations 5,92 6,78 7,30 8,58 9,60 12 and miotics A10A Insulins and analogues 5,06 5,87 6,95 8,60 9,48 10 St a ti s tic on M e dicin es C u mp tion 2009 N07C Antivertigo preparations 7,13 7,66 8,54 10,30 9,46 -8 H03A Thyroid preparations 4,21 4,71 5,50 7,76 8,46 9 H02A Corticosteroids for systemic 6,06 6,18 6,85 7,29 7,99 10 use, plain N05A Antipsychotics 6,15 7,07 7,30 7,88 7,25 -8 A01A Stomatological preparations 7,30 10,27 11,04 10,14 7,11 -30 C09C Angiotensin II antagonists, 0,35 2,12 4,01 6,47 6,77 5 plain

STATE AGENCY OF MEDICINES 63 2009 sales figures for the market of veterinary medicines

A successful collaboration has been established between the State Agency of Medicines (SAM) and wholesalers of veterinary medicines in Latvia. As a result the data on sales amounts for these medicines in Latvia has been obtained. Since the 2nd half of 2008 the data is being collected and assembled every quarter.

In this data on consumption of medicines the information regarding the sales amounts from one veterinary medicines wholesaler to another is ignored because in this case the medicines do not reach the consumer and remain at the wholesaler level. As the information of sales figures in LVL is not available to the State Agency of Medicines, we have carried out a consumption analysis based on the number of packagings sold. In 2009 most of the veterinary medicines sold were from the ATCvet group QP53AF03 (dimpylate (diazinon)). In 2009 the most demanded veterinary medicine according to the original brand name was Ungezieferband Hund und Katze, polyvinyl chloride collars impregnated with Diazinon and manufactured by Beaphar B. V. (Netherlands), leaving the 2nd place for Vanguard Plus 7 - a vaccine manufactured by Pfizer Animal Health S.A. (Belgium) for immunisation of healthy dogs against diseases caused by the dog plague virus, 1st and 2nd type dog adenoviruses, dog parainfluenza virus, dog parvovirus, Leptospira canicola and Leptospira icterohaemorrhagiae.

. St a ti s tic on M e dicin es C u mp tion 2009

STATE AGENCY OF MEDICINES 64 The most demanded veterinary medicines in 2009 after ATCvet level 5 (according to the number of packagings sold)

Number of ATCvet code International trade name packagings sold QP53AF03 dimpylate (diazinon) 52 871 QP53AX15 fipronil 32 506 QP52AA51 praziquantel, combinations 30 012 QI07AI02 live canine distemper virus + live canine adenovirus + 22 384 live canine parainfluenza virus + live canine parvovirus + inactivated leptospira QG03DA02 medroxyprogesterone 21 723 QJ51RV01 antibacterials and corticosteroids 18 111 QJ51CF02 cloxacillin 17 983 QJ51RF03 lincomycin, combinations with other antibacterials 17 623 QI07AA02 rabies virus 15 248 QJ51RD01 cefalexin, combinations with other antibacterials 14 558 St a ti s tic on M e dicin es C u mp tion 2009

STATE AGENCY OF MEDICINES 65 The most demanded antiinfectives for systemic use (according to the number of packagings sold)

ATCvet Number of packagings Starptautiskais nosaukums code sold QJ51RV01 antibacterials and corticosteroids 18 111 QJ51CF02 cloxacillin 17 983 QJ51RF03 lincomycin, combinations with other antibacterials 17 623 QJ51RD01 cefalexin, combinations with other antibacterials 14 558 QJ51RC* Beta-lactam antibacterials, penicillins, combinations with 14 474 other antibacterials QJ01CA04 amoxicillin 13 572 QJ51CR50 combinations of penicillins 12 513 QJ01RA01 penicillins, combinations with other antibacterials 12 355 QJ01MA90 enrofloxacin 11 042 QJ51RC23 procaine penicillin, combinations with other antibacterials 10 733 St a ti s tic on M e dicin es C u mp tion 2009

* - veterinary medicines with the following level 4 ATCvet code assigned to them: QJ51RC, except for products with a sublevel 5 code of this ATCvet code assigned to them

STATE AGENCY OF MEDICINES 66 Composition of the sales amount of ATCvet group QJ51RV01 (antibiotics and corticosteroids) veterinary medicines St a ti s tic on M e dicin es C u mp tion 2009

STATE AGENCY OF MEDICINES 67 Quarterly division of the sales amount of the most demanded antiinfectives for systemic use in 2009 (according to the number of packagings sold)

* - veterinary medicines with the following level 4 ATCvet code assigned to them: QJ51RC, except for products with a sublevel 5 code of this ATCvet code assigned to them St a ti s tic on M e dicin es C u mp tion 2009

QJ51RV01 - antibacterials and corticosteroids; QJ51CF02 – cloxacillin; QJ51RF03 - lincomycin, combinations with other antibacterials; QJ51RD01 - cefalexin, combinations with other antibacterials; QJ51RC* - beta-lactam antibacterials, penicillins, combinations with other antibacterials; QJ01CA04 – amoxicillin; QJ51CR50 - combinations of penicillins; QJ01RA01 - penicillins, combinations with other antibacterials; QJ01MA90 – enrofloxacin; QJ51RC23 - procaine penicillin, combinations with other antibacterials.

STATE AGENCY OF MEDICINES 68 The most demanded veterinary medicines in 2009 according to the number of packagings sold (by original brand name) St a ti s tic on M e dicin es C u mp tion 2009

STATE AGENCY OF MEDICINES 69