[Trends of non-steroidal anti-inflammatory drugs use in Spain, 1990 through 2003]

To know the trends of supply, consumption and pattern of use of non-steroidal anti-inflammatory drugs (NSAIDs) in Spain from 1990 through 2003, as well as their costs.

Drug utilization study.

National Health System, outpatient setting.

Information on drug utilization was obtained from the ALHAQUEM database of the Spanish Ministry of Health, which contains the number of packages sold in community pharmacies and charged to the National Health System. Data were expressed in defined daily doses (DDD) per 1000 inhabitants per day (DHD).

NSAIDs consumption in Spain increased from 23.67 DHD in 1990 to 45.82 DHD in 2003 (a 93.6% increase). Ibuprofen was the NSAID which showed the greatest increase (15.33 DHD in 2003). The consumption of coxibs reached a maximum of 7.74 DHD in 2001, but decreased to 3.59 DHD in 2003 once prior-authorization programs were set up. Over the study period the share of NSAIDs use with a low gastrointestinal risk increased from 29% to 59%. Overall costs of NSAIDs increased from 117 million euro in 1990 to 329 million euro in 2003.

Over the study period the consumption of NSAIDs in Spain has increased twofold while costs increased threefold. The pattern of use has remarkably changed showing an increasing use of NSAIDs with a better gastrointestinal profile. The impact of coxibs marketing has been moderate.