Use of NSAIDs in France: Analysis from French reimbursement (CNAM-TS) database

Background: Reimbursement databases provide indirect data regarding drug use or its exposure. In France, approximately 85% of the general population is covered by the national health insurance system (Caisse Nationale d’ Assurance Maladie des Travaileurs Salariés (CNAM-TS), which reimburses prescribed drugs and other medical expenses to salaried persons and families. Since analysis of reimbursement databases ensures that the prescribed drugs have at least been dispensed, even if not used, the present study was conducted to assess the utilization pattern of nimesulide and other NSAIDs in French population from reimbursement database (CNAM-TS). Method: Reimbursement data of NSAIDs (ATC code M01) were extracted from CNAM-TS database for the period 2002-2007. The defined daily doses (DDDs) were calculated from the number and size of packages of each NSAID and the different NSAIDs were ranked on the basis of total defined daily doses prescribed. Results: Paracetamol was the most used antipyretic and analgesic drug with the percentage consumption of 42.07%. The top ten NSAIDs were ketoprofen (10.23%), ibuprofen (8.70%), piroxicam (6.92%), diclofenac (6.88%), celecoxib (6.46%), naproxen (4.97%), rofecoxib (3.70%), nimesulide (2.53%), aceclofenac (1.29%) and nabumetone (1.12%). Conclusion: Analysis on the percentage of money reimbursed to patients and prescribers (special category and general category) reflects the prescription and consumption habits of prescribers and patients respectively. The ranking of the NSAIDs based on their consumption in French population were similar with previous studies where ketoprofen ibuprofen, piroxicam, diclofenac, and nimesulide were among the top 5 NSAIDs in Slovakia, Finland, Norway, Zagreb and Croatia.