A descriptive study of national trends in the dispensing of reimbursed hypnotics in France between 2012 and 2022.

OBJECTIVES

Insomnia and hypnotic consumption are major public health concerns, especially due to issues of dependence, side effects, and misuse. This study aims to describe the dispensing trends of reimbursed hypnotic tablets in France from 2012 to 2022, highlighting the potential impact of public policies designed to mainly reduce prescriptions of benzodiazepines and z-drugs.

METHODS

Data were sourced from the Medic'AM database, managed by French National Health Insurance, which records quantities of all reimbursed medications provided by pharmacies. The study focused on 13 reimbursed hypnotics with specific French marketing authorization for insomnia, including z-drugs (zolpidem, zopiclone), antihistamines (alimemazine, doxylamine, chlorazépate+acepromazine, meprobamate+acepromazine), and benzodiazepines (lormetazepam, loprazolam, estazolam, nitrazepam, temazepam, triazolam, flunitrazepam).

RESULTS

Over the 11-year period, alongside public health policies, a 25.30% decrease in reimbursed dispensed tablets was observed. Z-drugs saw a major 39.54% decrease, primarily due to a 69.15% drop in zolpidem prescriptions following the requirement for secure prescription pads. Antihistamines, mainly represented by alimemazine after the withdrawal and delisting of other antihistaminergic specialties, decreased by 5.48%. Benzodiazepines experienced a 16.98% reduction, mainly represented by lormetazepam and loprazolam, following the withdrawal or delisting of flunitrazepam, temazepam, and nitrazepam. Proportionally, the use of z-drugs decreased in favor of antihistamines, while benzodiazepines remained relatively stable. During the COVID-19 pandemic and its lockdowns, there was a smaller reduction in dispensed hypnotics.

CONCLUSIONS

Analyzing these trends provides insights into the potential impact of concurrent public health policies. While these trends are promising, continued efforts are necessary, emphasizing preventive and nonpharmacological measures, including improved sleep hygiene.