A COMPARATIVE-STUDY OF PRESCRIBING OF HORMONE REPLACEMENT THERAPY IN USA AND EUROPE

Objectives: The use of hormone replacement therapy (HRT) has been show n to vary from one country to another through international studies of sample populations and by comparison of data obtained from comparable national studies. Drawing international prescribing comparisons is ve ry difficult as data sources are few, incomplete and of uncertain accu racy and comparability. As an alternative to direct prescribing inform ation, pharmaceutical sales information indicates medication used. Thi s paper sought to demonstrate international differences in the use of HRT using an economic analysis methodology based on national pharmaceu tical sales statistics. Methods: A recognised economic analysis method ology was used to translate 1998/1992 pharmaceutical sales data into w omen treatment years of HRT used in each country. From this was calcul ated the percentage of the female population in each country, eligible for HRT, who would have been taking HRT. Results: The results show a wide variance in the percentage of the eligible female population in e ach country calculated to have been taking HRT, from <1%-20%. The resu lts indicated that HRT usage fell into three groupings: USA being the greatest user with UK and Scandinavian countries in the middle group a nd continental Europe having the lowest usage. Conclusions: National p atterns of HRT usage, as calculated by this study, correlate well with those of other studies. Since similar morbidity could be expected as menopause is a naturally occurring event, not a disease, possible reas ons for the variance in national prescribing patterns are discussed. T he study indicates the need for further research on health beliefs and physicians' and womens' attitudes to HRT in different countries to ex plain the variance in HRT usage, also considering access to healthcare , in particular women's health services. It confirms the validity of u sing economic analysis of pharmaceutical sales data as a proxy for pre scribing data in the arena of prescribing research.