PURPOSE: The COVID-19 pandemic had an impact on health care, with disruption to routine clinical care. Our aim was to describe changes in prescription drugs dispensing in the primary and outpatient sectors during the first year of the pandemic across Europe. METHODS: We used routine administrative data on dispensed medicines in eight European countries (five whole countries, three represented by one region each) from January 2017 to March 2021 to compare the first year of the COVID-19 pandemic with the preceding 3 years. RESULTS: In the 10 therapeutic subgroups with the highest dispensed volumes across all countries/regions the relative changes between the COVID-19 period and the year before were mostly of a magnitude similar to changes between previous periods. However, for drugs for obstructive airway diseases the changes in the COVID-19 period were stronger in several countries/regions. In all countries/regions a decrease in dispensed DDDs of antibiotics for systemic use (from -39.4% in Romagna to -14.2% in Scotland) and nasal preparations (from -34.4% in Lithuania to -5.7% in Sweden) was observed. We observed a stockpiling effect in the total market in March 2020 in six countries/regions. In Czechia the observed increase was not significant and in Slovenia volumes increased only after the end of the first lockdown. We found an increase in average therapeutic quantity per pack dispensed, which, however, exceeded 5% only in Slovenia, Germany, and Czechia. CONCLUSIONS: The findings from this first European cross-national comparison show a substantial decrease in dispensed volumes of antibiotics for systemic use in all countries/regions. The results also indicate that the provision of medicines for common chronic conditions was mostly resilient to challenges faced during the pandemic. However, there were notable differences between the countries/regions for some therapeutic areas.

Department of Biomedical and Neuromotor Sciences Alma Mater Studiorum University of Bologna Bologna Italy

Department of Medical Biophysics Faculty of Medicine in Hradec Králové Charles University Hradec Králové Czech Republic

Department of Medicinal Products Health Insurance Institute of Slovenia Ljubljana Slovenia

Department of Pathology Forensic Medicine and Pharmacology Institute of Biomedical Sciences Faculty of Medicine Vilnius University Vilnius Lithuania

Department of Pharmacology Therapeutics and Toxicology Universitat Autònoma de Barcelona Barcelona Spain

Department of Pharmacy Uppsala University Uppsala Sweden

Drug Department Catalan Health Service Barcelona Spain

Healthcare Administration Azienda Unità Sanitaria Locale della Romagna Ravenna Italy

Pharmaceuticals Information Systems and Analyses AOK Research Institute Berlin Germany

Pharmacy Center Faculty of Medicine Vilnius University Vilnius Lithuania

Public Health and Intelligence Public Health Scotland Edinburgh UK

School of Public Health and Community Medicine Sahlgrenska Academy University of Gothenburg Göteborg Sweden

Section of Pricing and Reimbursement Regulation State Institute for Drug Control Praha Czech Republic

Strathclyde Institute of Pharmacy and Biomedical Sciences University of Strathclyde Glasgow UK

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Comparison of drug prescribing before and during the COVID-19 pandemic: A cross-national European study