High sales were recorded in the 2019 Medicines Report for oncology, immunosuppressant and antidiabetic drugs. But also analgesics are at the top of the list. Doctors often do not prescribe pain medication as directed, the report said.
With 47.8 million prescriptions, analgesics rank seventh on the list of best-selling drug groups. But: "For analgesics, our prescription profiles are not compatible with international guidelines," warns co-editor Professor em. Dr. Ulrich Schwabe, Ruprecht-Karls University Pharmacology Institute in Heidelberg. He is delighted with the trend of new expensive drugs, although there are good alternatives. "For potent opioid analgesics, classic morphine in 1996 was still prescribed 60%. Since then, more and more expensive opioid analgesics have been prescribed."
Return to gold standard recommended morphine
Morphine now makes up only 9%, though it is still recommended as the best choice opioid for severe cancer pain in the current guidelines of the European Society of Medical Oncology (ESMO). Our pain therapy was therefore not in line with the guidelines, "because with the newer opioids the costs were artificially inflated." Currently, legal health insurance costs are € 809 million: "By returning to the gold standard morphine, we could save € 435 million."
Professor Schwabe describes the situation of nonopioid analgesics as "worse." In Germany, almost only metamizole is prescribed (94%), while metamizole is banned because of fatal Agranulozitozen in many countries or never approved. And in Germany, metamizole was severely restricted due to the risks prescribed in 1986 and indications. "After that, however, metamizole prescriptions did not decline, but increased fourteen times," the expert criticized. The Medicines Commission has pointed to deadly risks for many years. "The least that could happen to us is a radical limitation of the indication to exclusive use in the hospital, where careful monitoring is ensured," Professor Schwabe demands.
For 35 years, the Medical Prescription Report has been evaluating medical prescriptions for patients with compulsory health insurance. The report is considered standard work for the German pharmaceutical market.
AkdÄ and WIdO press conference