PHARMACOEPIDEMIOLOGY AND PRESCRIPTION
T. Walley Æ P. Folino-Gallo Æ U. Schwabe
E. Van Ganse Æ P. Stephens
Comparison of national administrative and commercial databases
to monitor expenditure and costs of statins across Europe
Received: 5 April 2004 / Accepted: 15 June 2004 / Published online: 13 August 2004
Ó Springer-Verlag 2004
Abstract Objectives: To compare data on statin utilisa-
tion and costs across Europe from routine administra-
tive databases with those from a commercial source.
Methods: Observational study in European Union
member states and Norway. Comparison of data col-
lected from national administrative databases used to
reimburse pharmacists and data from a standard com-
mercial source (Intercontinental Marketing Services
Health): detailed data by drug for the year 2000.
Results: There were differences among the data from
administrative databases and those from the commercial
source; these differences were of a consistent pattern in
each country. In general, the commercial data recorded
greater utilisation (reflecting both public and private use,
range from 0 to +55%, median +15%), lower cost per
defined daily doses (as commercial data sources used ex-
factory price rather than expenditure to the state used in
administrative databases, range from À70% to –6%,
median À39%) and similar utilisation per 1000 head of
population per day (range from À15 to +47%, median
À1%).
Conclusions: Administrative databases can give useful
utilisation data, which are broadly comparable with
those from commercial sources. Cost data differ more,
and the figures for each may be useful in different set-
tings. Standards for data collection from the adminis-
trative databases are required.
Introduction
Governments and pharmaceutical companies require
detailed information about the pharmaceutical market
in their own and other countries. Intercontinental
Marketing Services (IMS), a commercial company, col-
lects drug utilisation data at many different levels of
complexity and time periods, comparing countries.
These data are sold to industry and governments and are
sometimes provided free of charge for academic
research. IMS data are usually based on wholesaler
returns and, hence, cover all utilisation, public and pri-
vate. Most countries have administrative databases on
publicly funded usage of medicines, based on pharmacist
claims for reimbursement. These data might be very
valuable to European governments and to the European
Commission to benchmark national performance in
studies of morbidity, to ascertain differences in treat-
ment patterns and prescribing culture and to determine
inequity of provision across Europe. The nature of these
databases varies with each health service, so it is
uncertain how comparable such data are among coun-
tries.
Coronary heart disease remains the major cause of
death in most European countries, although there are
substantial variations [1]. Extensive public health mea-
sures are directed at either preventing or treating heart
T. Walley, P. Folino-Gallo, U Schwabe and E. Van Ganse on
behalf of the EuroMedStat group (see Appendix).
T. Walley (&)
Department of Pharmacology and Therapeutics,
University of Liverpool, 70 Pembrooke Place,
Liverpool, L69 3GF, UK
E-mail: twalley@liv.ac.uk
Tel.: +44-151-7948123
P. Folino-Gallo (&)
IRPPS / CNR, via Nizza 128, 00198 Rome, Italy
E-mail: p.folino@irpps.cnr.it
U. Schwabe (&)
Pharmakologisches Institut,
Ruprecht-Karls-Universita
¨
t Im Neuenheimer
Feld 366, 69120 Heidelberg, Germany
E-mail: ulrich.schwabe@urz.uni-heidelberg.de
E. Van Ganse (&)
Pharmacoe
`
pide
´
miologie, CHU-Lyon-Sud,
Claude-Bernard University, EA 3091,
Batiment 5F-Sainte Euge
´
nie, 69495
Pierre-Be
´
nite Cedex, France
E-mail: eric.vanganse@chu-lyon.fr
P. Stephens (&)
IMS Health, 7 Harewood Avenue,
London, NW1 6JB, UK
E-mail: Pstephens@uk.imshealth.com
Eur J Clin Pharmacol (2004) 60: 503–511
DOI 10.1007/s00228-004-0801-9