Consumption of cardiovascular and antithrombotic drugs during the spread of coronavirus infection in retail sector of the Samara region pharmaceutical market

Abstract

Aim. Study of multi-year sales statistics in pharmacy market segment to assess the volume and structure of consumed cardiovascular and antithrombotic drugs under COVID-19 pandemic conditions.
 Material and methods. Data on nomenclature and sales volumes of drugs in pharmacy segment of Samara region in 20152020.
 Results. It is shown that the share of basic cardiovascular drugs in physical terms is insignificant (5.2-3%). The largest volume of sales are drugs of angiotensin-converting enzyme inhibitor group (28%) and b-adrenoblockers (23.5%). Fixed combinations of hypotensive drugs account for only 13% of the volume of sold basic cardiovascular drugs, and the share of statins is 7.6%, which does not correspond to their role as the most effective drugs in primary and secondary cardiac prevention. The share of antithrombotic drugs in total sales in volume terms was 0.45% in 20152019. In absolute terms, sales of anticoagulants and disaggregants increased in 20182020, which was accompanied by an average 15% increase in the cost per daily dose. Among disaggregants, acetylsalicylic acid (66.6%), clopidogrel (21.6%), and dipyridamole (10.2%) are most frequently sold. The share of disaggregants in sales fell from 74.8 to 57.6% at the expense of acetylsalicylic acid drugs. In 2020, consumption of dipyridamole increased significantly to 16.6% due to inclusion of the drug in protocols for managing patients with COVID-19. Among anticoagulants, the proportion of new oral medications is characterized by a progressive increase from 7.8% in 2015 to 27% in 2020. During the COVID-19 pandemic, the most demanded group of Xa factor blockers is dominated by apixaban (63.8%), which can be explained by the lower cost (by 16%) of a daily equivalent dose compared to rivaroxaban.
 Conclusion. Low consumption of basic cardiovascular drugs among the population of Samara region, especially statins and combined hypotensive drugs was observed. During COVID-19 pandemic there was an increase in consumption of antithrombotic drugs, due to dipyridamole and new oral anticoagulants.

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“…Our results coincide with the data obtained in the study by Petrukhina I. et al [23], where sales statistics were studied in the pharmacy market segment of the Samara region to assess the volume and structure of consumed cardiovascular and antithrombotic drugs during the COVID-19 pandemic, including DOACs. We can speculate that one of the reasons for the increased consumption of apixaban is due to its lower price compared to rivaroxaban.…”

“…In 2020, there was a significant increase in demand for DOACs and apixaban consumption in our study was in the leading position what is comparable to the results of another study [22]. In 2021, when the highest gross national consumption of apixaban was noted, almost every patient with COVID-19 received apixaban, and every second patient was prescribed rivaroxaban, which is probably due to the growth of the disease and the advantage of the drug compared to rivaroxaban: higher efficiency in reducing the risk of secondary episodes of venous thrombosis and pulmonary embolism, better tolerability-lower risk of minor bleeding and a favorable price [23] See Figures 3 and 4.…”

“…The last domain in the AGREE II is called Editorial Independence and it consists of two items (items [22][23]. This domain score reflects whether the authors of a CPG could have had any conflicts of interest in the matter of creating the CPG.…”