Psychotropic drug use in Italy, 1984-99: the impact of a change in reimbursement status

After years of corruption surrounding drug reimbursement, in 1994, a change in drug reimbursement status was implemented in Italy according to cost-ef fectiveness criteria. The aim of this study was to assess the impact of the se changes on the use of psychotropic drugs. National trends in antipsychot ic, antidepressant and benzodiazepine prescriptions were analysed from 1984 to 1999. During the study period, prescriptions of antipsychotic drugs wer e stable from 1984 to 1994 but, in the subsequent 5 years, increased by 54% . Although the use of atypical compounds in 1999 accounted for only 6% of t otal antipsychotics sold, the cost of these new drugs accounted for almost one-half the total antipsychotic expenditure. The use of benzodiazepines in creased by 53%. In 1999, the psychotropic drugs lorazepam and alprazolam we re the most sold by value. From 1984 to 1999, the total antidepressants sol d increased by 55%. Although the use of selective serotonin reuptake inhibi tors and newer antidepressants in 1999 accounted for less than 50% of total antidepressants sold, the cost of these drugs accounted for 65% of total a ntidepressant expenditure. This analysis highlights specific areas of conce rn which should become the object of public health programs. (C) 2001 Lippi ncott Williams & Wilkins.