Sleep medicine · 2026
Impact of the 2017 secured-prescription regulation of zolpidem on hypnotic dispensing in France: a nine-year interrupted time-series analysis.
СтатьяНазвание и аннотация: Перевод пока не подготовлен
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Rochoy Michaël, Albaric Chloé
Аннотация
BACKGROUND: In April 2017, France required a secure prescription, normally reserved for narcotics, for all zolpidem prescribing, because of its misuse. Published evaluations covered the first years after the measure, before or at the start of the COVID-19 period.
METHODS: Interrupted time series of national open reimbursement data (Médic'AM; all schemes, community pharmacies) from January 2015 to February 2026 (134 monthly points). Reimbursed boxes per day of zolpidem, zopiclone and all hypnotics combined were modelled by segmented regression with seasonality and Newey-West standard errors. The pre-intervention model, projected forward with its 95% prediction interval, served as the counterfactual. Two sensitivity analyses tested dependence on the pandemic months.
RESULTS: Zolpidem fell abruptly in April 2017 (-22,186 boxes/day, p < 0.001) and kept declining, reaching 59% below the expected level by 2026 (-72% in 2025 versus 2015-2016). Zopiclone rose (+9147 boxes/day, p < 0.001), offsetting 39% of that fall, but the substitution faded: it exceeded the counterfactual prediction interval in 50 months between May 2017 and June 2023 and in none since, annual dispensing returning from 16.6 (2018) to 14.3 million boxes (2025). All hypnotics stood 14% below expectation. Deviations in 2020-2021 stayed within pre-pandemic dispersion (zolpidem -5.0%, all hypnotics -0.5%), and the April 2017 estimates were unchanged when those months were excluded or modelled.
CONCLUSIONS: Nine years on, a molecule-specific measure was followed by a durable reduction in zolpidem and in hypnotics overall (59% and 14% below expectation), and the displacement toward zopiclone has receded. Such measures deserve long follow-up, and reimbursed access to cognitive behavioural therapy for insomnia.
METHODS: Interrupted time series of national open reimbursement data (Médic'AM; all schemes, community pharmacies) from January 2015 to February 2026 (134 monthly points). Reimbursed boxes per day of zolpidem, zopiclone and all hypnotics combined were modelled by segmented regression with seasonality and Newey-West standard errors. The pre-intervention model, projected forward with its 95% prediction interval, served as the counterfactual. Two sensitivity analyses tested dependence on the pandemic months.
RESULTS: Zolpidem fell abruptly in April 2017 (-22,186 boxes/day, p < 0.001) and kept declining, reaching 59% below the expected level by 2026 (-72% in 2025 versus 2015-2016). Zopiclone rose (+9147 boxes/day, p < 0.001), offsetting 39% of that fall, but the substitution faded: it exceeded the counterfactual prediction interval in 50 months between May 2017 and June 2023 and in none since, annual dispensing returning from 16.6 (2018) to 14.3 million boxes (2025). All hypnotics stood 14% below expectation. Deviations in 2020-2021 stayed within pre-pandemic dispersion (zolpidem -5.0%, all hypnotics -0.5%), and the April 2017 estimates were unchanged when those months were excluded or modelled.
CONCLUSIONS: Nine years on, a molecule-specific measure was followed by a durable reduction in zolpidem and in hypnotics overall (59% and 14% below expectation), and the displacement toward zopiclone has receded. Such measures deserve long follow-up, and reimbursed access to cognitive behavioural therapy for insomnia.