Geographic and Temporal Patterns in Biologic Prescriptions for Inflammatory Bowel Diseases in the Public Healthcare System in Brazil: An Ecological Study.

IF 2.4 4区医学 Q3 PHARMACOLOGY & PHARMACY

Pharmacoepidemiology and Drug Safety Pub Date : 2025-02-01 DOI:10.1002/pds.70114

Caroline Tianeze de Castro, Marcio Dos Santos Natividade, Marcos Pereira, Samilly Silva Miranda, Erika Aragão, Carlos Antonio de Souza Teles Santos, Djanilson Barbosa Dos Santos

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引用次数: 0

Abstract

Purpose: To analyze the geographic and temporal patterns of biologic prescriptions for inflammatory bowel disease (IBD) in Brazil's public national unified health system (SUS).

Methods: This ecological study used data from patients with IBD in the SUS Outpatient Information System between 2008 and 2022. Prais-Winsten regression was used to estimate the trends in prescription rate of biologics. For geographic analysis, average prescription rate of biologics was calculated by state for three periods: 2008-2012, 2013-2017, and 2018-2022. Global Moran's index (GMI) and local indicators of spatial autocorrelation (LISA) were used to assess spatial autocorrelation and identify spatial clusters of biologic prescriptions, respectively.

Results: The prescription rate of biologics increased from 3.0% to 16.7%. Infliximab was the most prescribed drug from 2008 to 2012 (3.0%-4.2%), and adalimumab was the most widely prescribed drug from 2013 to 2022 (4.3%-9.1%). Higher prescription rates of biologics were observed in patients with Crohn's disease than in those with ulcerative colitis (40.5% vs. 3.2%). Biologics were primarily prescribed in the Southeast and South; however, the central-western and northern regions showed greater changes in prescription rates over time. There were increased clusters of high biologic prescriptions across the three evaluated periods.

Conclusions: The increase in biologic prescriptions over time may be attributed to their enhanced efficacy in inducing and maintaining IBD remission. Biologic prescriptions in Brazil are experiencing temporal and geographical changes, indicating that disparities in drug prescriptions may decrease with universal, equitable healthcare access, despite administrative challenges in obtaining these medications through SUS.

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巴西公共卫生系统中炎症性肠病生物处方的地理和时间模式：一项生态学研究。

目的：分析巴西公共国家统一卫生系统（SUS）炎症性肠病（IBD）生物处方的地理和时间模式。方法：这项生态研究使用了2008年至2022年SUS门诊信息系统中IBD患者的数据。采用Prais-Winsten回归估计生物制剂处方率的变化趋势。在地理分析方面，按各州计算2008-2012年、2013-2017年和2018-2022年三个时期的生物制剂平均处方率。采用全局Moran指数（GMI）和局部空间自相关指数（LISA）分别评价生物处方的空间自相关性和空间聚类。结果：生物制剂处方率由3.0%提高到16.7%。2008 - 2012年英夫利昔单抗是处方最多的药物（3.0%-4.2%），2013 - 2022年阿达木单抗是处方最多的药物（4.3%-9.1%）。克罗恩病患者的生物制剂处方率高于溃疡性结肠炎患者（40.5%对3.2%）。生物制剂主要在东南部和南部开处方；然而，随着时间的推移，中西部和北部地区的处方率变化更大。在三个评估期间，高生物制剂处方的数量有所增加。结论：随着时间的推移，生物处方的增加可能归因于它们在诱导和维持IBD缓解方面的疗效增强。巴西的生物处方正在经历时间和地理变化，这表明药物处方的差异可能会随着普遍、公平的医疗保健获得而减少，尽管通过单一系统获得这些药物存在行政上的挑战。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Pharmacoepidemiology and Drug Safety 医学-药学

CiteScore

4.80

自引率

7.70%

发文量

173

审稿时长

3 months

期刊介绍： The aim of Pharmacoepidemiology and Drug Safety is to provide an international forum for the communication and evaluation of data, methods and opinion in the discipline of pharmacoepidemiology. The Journal publishes peer-reviewed reports of original research, invited reviews and a variety of guest editorials and commentaries embracing scientific, medical, statistical, legal and economic aspects of pharmacoepidemiology and post-marketing surveillance of drug safety. Appropriate material in these categories may also be considered for publication as a Brief Report. Particular areas of interest include: design, analysis, results, and interpretation of studies looking at the benefit or safety of specific pharmaceuticals, biologics, or medical devices, including studies in pharmacovigilance, postmarketing surveillance, pharmacoeconomics, patient safety, molecular pharmacoepidemiology, or any other study within the broad field of pharmacoepidemiology; comparative effectiveness research relating to pharmaceuticals, biologics, and medical devices. Comparative effectiveness research is the generation and synthesis of evidence that compares the benefits and harms of alternative methods to prevent, diagnose, treat, and monitor a clinical condition, as these methods are truly used in the real world; methodologic contributions of relevance to pharmacoepidemiology, whether original contributions, reviews of existing methods, or tutorials for how to apply the methods of pharmacoepidemiology; assessments of harm versus benefit in drug therapy; patterns of drug utilization; relationships between pharmacoepidemiology and the formulation and interpretation of regulatory guidelines; evaluations of risk management plans and programmes relating to pharmaceuticals, biologics and medical devices.