Prescribing of Opioid Analgesics in Germany: Opposite Trends When Different Quantification Measures are Used

To describe trends in prescribing of opioid analgesics in Germany using different quantification measures.

We conducted annual cross-sectional studies for the years 2005 to 2020 based on the so-called German Pharmacoepidemiological Research Database (GePaRD; claims data covering ~20% of the German population). Opioid prescribing was assessed based on outpatient dispensations of opioid analgesics. For each year, we calculated the age- and sex-specific and -standardized prescription prevalence (number of persons with ≥1 prescription per 1000 persons) as well as the sum of oral morphine equivalents (OMEs) in mg per 1000 person-years.

The standardized prescription prevalence per 1000 persons showed a relative decrease by 14.1% between 2005 (52.3/1000) and 2016 (44.9/1000) and a further decrease by 5.6% until 2020 (42.4/1000). Based on the standardized OME per 1000 person-years, there was a relative increase by 51.4% until 2016 (2005: 191,987 mg; 2016: 290,733 mg) and a decrease by 5.3% thereafter (2020: 275,218 mg).

In Germany, opposite trends for opioid prescription prevalence and OMEs were observed between 2005 and 2016, while after 2016, both quantification measures showed a decreasing trend. Our study illustrates that trends in prescribing of opioid analgesics can vary depending on the quantification measure; therefore, it is advisable to calculate both measures when monitoring opioid prescribing.