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Prescribing trends for nicotine replacement therapy in primary care
1National Centre for Pharmacoeconomics, St. James's Hospital, Dublin 8, Ireland.
Irish Medical Journal
|December 1, 2004
Summary
Free nicotine replacement therapy (NRT) in Ireland increased its use among eligible patients. Prescribing patterns show NRT is most popular in early months, with patches being the preferred method for adults aged 25-54.
Area of Science:
- Pharmacoeconomics
- Public Health
- Clinical Pharmacy
Background:
- Nicotine replacement therapy (NRT) became free for Irish medical cardholders in April 2001.
- This policy change aimed to improve access to smoking cessation aids for a significant portion of the population (29.84%).
Purpose of the Study:
- To analyze NRT prescribing patterns before and after the reimbursement change.
- To evaluate the utilization, expenditure, and characteristics of NRT and bupropion prescriptions in eligible patients.
Main Methods:
- Analysis of the General Medical Services Payments Board prescription database for Ireland in 2002.
- Inclusion of 1,168,745 eligible patients across all health board areas.
- Detailed examination of NRT (ATC code N07BA) and bupropion (ATC code N07BA02) prescriptions, including dosage, duration, and patient demographics.
Main Results:
- In 2002, 49,826 patients received smoking cessation products; 94.6% used NRT, and 5.4% used bupropion.
- Nicotine patch therapy constituted 82.8% of all NRT dispensed.
- NRT use peaked in January-February, with highest expenditure in Q1. Prescribing was highest in the 25-54 age group, particularly 35-44 years.
Conclusions:
- NRT prescribing in primary care aligns with NICE guidance on dosage and duration.
- Most patients received NRT for ≤4 weeks, with 77% of nicotine gum users receiving one month's supply.
- The 2002 NRT expenditure of €2,709,954 is considered value for money, indicating effective public health investment.