Trends in incident use of benzodiazepines and Z-drugs in France from 2006 to 2012: a population-based study

Pharmacoepidemiol Drug Saf. 2017 Feb;26(2):162-169. doi: 10.1002/pds.4123. Epub 2016 Nov 3.


Purpose: To study trends in incident use of benzodiazepines in France between 2006 and 2012.

Methods: A cross-sectional study repeated yearly was conducted using data from the French national healthcare insurance system. New benzodiazepine users were defined as users without any benzodiazepine dispensing in the year prior to the first dispensing of benzodiazepine in each year. Relative changes in incidence of use were calculated with the year 2006 as reference; confidence intervals for changes were estimated using the bootstrap method.

Results: Over the study period, the incident use of benzodiazepines decreased from 6.2% to 5.9%; this corresponded to a 5.1% decrease (95%CI: -6.8% to -4.2%) for 2012 compared to 2006. The decrease mainly concerned hypnotics (-15.5%; -21.2% to -15.3%) and appeared more pronounced in people aged 18-44 years. Incident use of anxiolytics remained stable overall during the period (4.0% of the population). Within anxiolytics, incident use of long half-life benzodiazepines (bromazepam, prazepam) decreased in favor of short half-life benzodiazepines (alprazolam, oxazepam). This change concerned patients aged 65-79 and patients aged 80 years and over. Nevertheless, in 2012, nearly one third of incident users aged 65 years and over started a treatment with a long half-life benzodiazepine, mostly bromazepam.

Conclusions: A limited decrease in incident benzodiazepine use was observed in France between 2006 and 2012 that concerned only hypnotics. Although congruent with recommendations, this improvement appears insufficient with regard to the level of exposure to these drugs in France. New actions especially targeting anxiolytic benzodiazepine use should be undertaken to consolidate these results. Copyright © 2016 John Wiley & Sons, Ltd.

Keywords: benzodiazepines; drug utilization; incidence; insurance health reimbursement; pharmacoepidemiology.

MeSH terms

  • Adolescent
  • Adult
  • Age Factors
  • Aged
  • Aged, 80 and over
  • Anti-Anxiety Agents / pharmacokinetics
  • Anti-Anxiety Agents / therapeutic use*
  • Azabicyclo Compounds / therapeutic use
  • Benzodiazepines / pharmacokinetics
  • Benzodiazepines / therapeutic use*
  • Cross-Sectional Studies
  • Drug Utilization / trends
  • Female
  • France
  • Half-Life
  • Humans
  • Hypnotics and Sedatives / pharmacokinetics
  • Hypnotics and Sedatives / therapeutic use*
  • Male
  • Middle Aged
  • Piperazines / therapeutic use
  • Pyridines / therapeutic use
  • Young Adult
  • Zolpidem


  • Anti-Anxiety Agents
  • Azabicyclo Compounds
  • Hypnotics and Sedatives
  • Piperazines
  • Pyridines
  • zopiclone
  • Benzodiazepines
  • Zolpidem