Introduction: The extraordinary circumstances due to the COVID-19 pandemic and related restrictions altered the management of mental health disorders, including the use of antipsychotics. We aimed to examine the changes in antipsychotic utilization and expenditure in Turkey throughout pandemic-associated restriction periods.
Methods: Nationwide drug sales and projected prescribing data from 01.03.2018 to 31.12.2022 were obtained from IQVIA Turkey. We assessed average monthly consumption, expenditure, and quarterly prescribing levels across three periods: "before restrictions" (BfR, 01.03.2018-31.03.2020), "during restrictions" (DuR, 01.04.2020-31.03.2022), and "after restrictions" (AfR, 01.04.2022-31.12.2022). Consumption and prescribing levels were measured using "defined daily dose/1000 inhabitants/day" (DID) parameter.
Results: Antipsychotic consumption throughout periods increased from 8.4 ± 0.6 DID in BfR to 9.9 ± 1.6 DID in DuR (p < 0.001), and to 10.1 ± 0.9 DID in AfR (p < 0.001 vs. BfR). Atypical antipsychotics followed the overall trend, whereas typical antipsychotics remained stable from DuR to AfR, deviating from this pattern. Antipsychotic expenditure rose from €16.7 m ± 1.1 m in BfR to €19.0 m ± 2.7 m in DuR (p < 0.001), then shifted to €18.3 m ± 1.9 m in AfR (p > 0.05 vs. BfR and DuR). High-cost antipsychotic use increased after the pandemic onset (p < 0.001) and remained elevated in AfR (p < 0.001). Prescribing for schizophrenia declined from 2.2 ± 0.3 DID in BfR to 1.3 ± 0.2 DID in DuR (p < 0.001), then escalated to 1.8 ± 0.3 DID in AfR (p = 0.015 vs. DuR).
Conclusions: Our study revealed an upsurge in antipsychotic utilization in Turkey with the start of the pandemic. A range of factors may have contributed, notably the impact of policies facilitating the dispensing of chronic medications without prescription or a tendency towards polypharmacy.
Keywords: drug consumption; drug expenditure; pandemic; prescribing; schizophrenia.
The COVID‐19 pandemic and related restrictions changed how mental health problems were managed, including the use of antipsychotic drugs. In this study, we looked at how antipsychotic consumption and costs changed in Turkey before, during, and after the restriction periods. We used nationwide drug sales and prescribing data between March 2018 and December 2022. Drug use was measured as “defined daily doses per 1000 people per day” (DID). Overall, antipsychotic use went up during the pandemic. Average use rose from about 8.4 DID before restrictions to 9.9 DID during restrictions, and further to 10.1 DID after restrictions. Atypical antipsychotics followed this pattern, while typical ones remained stable after restrictions. Costs increased from €16.7 million before restrictions to €19.0 million during restrictions, then slightly decreased to €18.3 million after restrictions. Use of high‐cost drugs grew after the pandemic started and stayed high. Prescribing for schizophrenia fell during restrictions but rose again afterward. In summary, antipsychotic use in Turkey increased with the pandemic, likely influenced by policies allowing easier access to medications and possible increases in polypharmacy.
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