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Impact of angiotensin receptor blocker product recalls on antihypertensive prescribing in Germany by Rudolph, Ulrike Maria; Enners, Salka; Kieble, Marita; Mahfoud, Felix; Böhm, Michael; Laufs, Ulrich; Schulz, Martin is a Medicine article available to read on EtoBox.

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## Abstract In Germany, ~8 million patients take angiotensin receptor blockers (ARBs) and 2.25 million of them valsartan. In 2018, contamination of generic ARBs with probable carcinogenic nitrosamines resulted in more than 30 recalls. The impact of such a huge recall has never been explored in Europe. We analyzed the utilization of valsartan, all ARBs, and other alternative antihypertensive drugs in Germany. We used our database of anonymized dispensing data from >80% of community pharmacies at the expense of the statutory health insurance (SHI) funds from January 2017 to December 2019. We analyzed 290.8 million prescriptions, including all oral mono- and fixed-dose combinations of ARBs and plausible alternatives, i.e. ACE inhibitors (ACEi), beta-blockers (BB), and calcium channel blockers (CCB). Utilization was calculated by defined daily doses per 1000 SHI-insured persons per day (DID). Valsartan use decreased substantially after the recalls in July 2018 from 39.0 to 14.2 DID (−64%) in the second quarter of 2019 and to 16.9 DID (−57%) in the fourth quarter of 2019. Simultaneously, the use of alternative ARBs increased from 77.7 DID in the second quarter of 2018 to 121.9 DID (+57%

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Author

Rudolph, Ulrike Maria; Enners, Salka; Kieble, Marita; Mahfoud, Felix; Böhm, Michael; Laufs, Ulrich; Schulz, Martin

Publisher

Nature Publishing Group; Springer Science and Business Media LLC (ISSN 0950-9240)

Published

2020

Language

EN

Field

Medicine (Health Sciences)