Asthma, Antibiotic Prescriptions Dropped From 2019 to 2020, Finnish Study Finds

It is already known that the 2020 lockdown across many countries due to the global pandemic caused a drop in childhood infections. Researchers in Finland, in a recently published study, said that antibiotic and asthma prescriptions fell there as well, reducing reimbursement costs.

Researchers examined the quantity of systemic antibiotics and asthma medicines dispensed to children aged 0−12 years before and during the pandemic and analyzed the effect on reimbursement costs.

In Finland, all citizens receive free public health care and drugs are covered by partial or full reimbursement, depending on the medicine.

Data for 2019 and 2020 came from the national Finnish register of reimbursable prescriptions. Prescription rates per 1000 children were calculated for each quarter and compared using rate ratios and 95% confidence intervals.

For antibiotics, there were 331,857 dispensed prescriptions, 69.1% in 2019 and 30.9% in 2020. The most common antibiotic dispensed in 2019-2020 was amoxicillin (55.4%), and most antibiotics were dispensed in 2019. Prescriptions for all antibiotics dropped by 55.3% in 2020, with the largest decrease in macrolides (59.2%). The smallest was for cephalosporins.

The biggest reduction in macrolides was observed for children aged 0−5 years (59.6%, 95% CI, 60.9%−58.2%).

Total reimbursable expenses for antibiotics were €1.95 million (US$2.21 million) in 2020 and €4.3 million (US$4.88 million) in 2019, for a saving of €2.3 million (US$2.6 million) (54.5%).

For asthma, there were 337,911 asthma drugs dispensed in 2019 and 2020, with 55.5% in 2019 and 44.5% in 2020.

Asthma medicines decreased by 19.8%, mostly in the category of short-acting beta-agonists for children aged 0−5 years (35.2%, 95% CI 36.1%−34.2%). This suggests that there were lower rates of asthma exacerbations and wheezing episodes in early 2020, the researchers said.

Total reimbursable expenses in 2020 were €2.94 million (US$3.33 million) and €3.83 million (US$4.34 million) in 2019, down 23% to €0.88 million (US$998,337).

Taken together, the lower number of medications dispensed in both categories reduced reimbursement costs by €3.4 million (US$3.85 million) from 2019 to 2020.

The researchers also looked at primary care visits for children. While they fell from March to June 2020, they rebounded in August and overall were higher in 2020 than in 2019.

Even as primary care visits increased, the number of dispensed medications fell, suggesting that the lower number of antibiotics was due to lower infections and not from a barrier to care.

Reference

Haapanen M, Renko M, Artama M, Kuitunen I. Systemic antibiotics and asthma medicines dispensed to 0−12 year olds significantly decreased during the COVID-19 pandemic in 2020. Acta Paediatr. 2022;111:376-382. doi:10.1111/apa.16144