The frequency of photosensitizing drug dispensings in Austria and Germany: a correlation with their photosensitizing potential based on published literature

Abstract

Background Drug‐induced photosensitivity refers to the development of cutaneous adverse events due to interaction between a pharmaceutical compound and sunlight. Although photosensitivity is a very commonly listed side‐effect of systemic drugs, reliable data on its actual incidence are lacking so far. Objectives A possible approach to evaluate the real‐life extent of drug‐induced photosensitivity would be an analysis of the frequency of exposure to a given photosensitizing drug combined with an indicator of its photosensitizing potential. This could serve as a basis for developing a pharmaceutical ‘heatmap’ of photosensitivity. Methods The present study investigated the number of reimbursed dispensed packages of potentially photosensitizing drugs in Germany (DE) and Austria (AT) between 2010 and 2017 based on nationwide health insurance‐based databases. In addition, an indicator for the photosensitizing potential was established for each drug based on the number of reports on photosensitivity in the literature. Results This analysis includes means of 632 826 944 (+/−14 894 918) drug dispensings per year in DE and 113 270 754 (+/−1 964 690) in AT. Out of these, the mean percentage of drugs that enlist photosensitivity as a potential side‐effect was 49.5% (±0.7) in DE and 48.2% (±1.2) in AT. When plotting the number of reimbursed dispensed packages vs. the number of reports on photosensitivity, two categories of drugs show high numbers for both parameters, that is diuretics and non‐steroidal anti‐inflammatory drugs (NSAIDs). Conclusions Diuretics and NSAIDs appear to be responsible for the greatest part of exposure to photosensitizing drugs with potential implication on public health.

Impact of angiotensin receptor blocker product recalls on antihypertensive prescribing in Germany

“…This drug utilization study used the database of the German Institute for Drug Use Evaluation (DAPI) containing anonymous dispensing data of community pharmacies [11]. Data from a representative sample of more than 80% (until 06/2019) and more than 95% (from 07/2019 onwards) of German community pharmacies were available.…”

Environmental effects of stratospheric ozone depletion, UV radiation, and interactions with climate change: UNEP Environmental Effects Assessment Panel, Update 2020

“…New photosensitising drugs are emerging, including proton-pump inhibitors and statins [ 86 ]. An analysis of drugs dispensed between 2010 and 2017 in Germany and Austria found that of > 632 million (Germany) and > 113 million (Austria) drugs dispensed, almost 50% had photosensitising potential [ 87 ].…”

Drug‐induced photosensitivity: culprit drugs, potential mechanisms and clinical consequences

“…Given the unknown incidence combined with the high dark figure, the following data seem particularly intriguing. A study investigating the number of reimbursed dispensed packages containing potentially photosensitive drugs in Germany and Austria from 2000–2017 based on nation‐wide health insurance‐based databases revealed that of around 630 million (Germany) and 113 million (Austria) drugs dispensed per year, the mean percentages of photosensitive drugs dispensed were 49.5 % in Germany and 48.2 % in Austria [38]. One might conclude that exposure to potential photosensitizers is substantial, at least in industrialized countries.…”

“…In addition, a systematic comparative analysis of the photosensitive potential of different photosensitizers would be desirable but is lacking so far. A recent research paper used the number of publications associating an agent with its capability to induce photosensitive cutaneous reactions as an indicator for its photosensitizing potential, which resulted in a "heatmap" of photosensitivity [38]. This indicator is incorporated into Table 1 in order to highlight agents with high numbers (n ≥ 15) of reports on photosensitivity (shown in bold).…”