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What medicines are prescribed the most in Australia?
While statin medications take the lion’s share, antidepressants are being prescribed more, and antibiotics less.
Over the last year, Australians have been prescribed more antidepressants and less antibiotics.
Australian Prescriber has revealed the NPS MedicineWise 10 most prescribed medicines of the year.
The list, based on Pharmaceutical Benefits Scheme (PBS) and Repatriation PBS (RPBS) prescriptions from the date of supply, includes both subsidised and non-subsidised prescriptions.
Between July 2020 – June 2021, eight of the most used medicines in Australia were for cholesterol lowering and blood pressure lowering.
The most used medicine was atorvastatin, used to prevent cardiovascular disease in those at high risk and to treat abnormal lipid levels. Defined daily dose (DDD) of the drug is 76.22 per 1000 population per day.
This is followed by rosuvastatin, and blood pressure medication perindopril coming in third.
Unsurprisingly, the use of medicines to treat depression and anxiety has grown in the wake of the COVID-19 pandemic, with a rise in mental health issues and resulting general practice presentations.
Sertraline was new to the NPS MedicineWise top 10 list last year but has risen to number eight this year. DDD of the drug is 27.42 per 1000 population per day, an increase from 25.67 in 2019–20.
Escitalopram, another selective serotonin reuptake inhibitor (SSRI), was the sixth-most prescribed drug over the same 12 month period, with sertraline again in eighth place using this metric.
Dr Kate Annear, GP and NPS MedicineWise medical advisor, is not surprised by the medicines that made the list.
‘[The increase of sertraline use] is a reflection of the increasingly high volume of antidepressants being prescribed in Australia,’ she said.
‘We are seeing more people experiencing depression and anxiety disorders, many of these for the first time. The COVID pandemic has likely had an impact on this.
‘[And] it is not surprising that the most pills dispensed were to prevent and treat heart disease and stroke. Cardiovascular disease is the leading cause of death in Australia.’
Following sertraline, diabetes drug metformin sits at number nine in the list, with a DDD of 26.59 per 1000 population per day.
When examining the number of prescriptions dispensed, rosuvastatin led at 14,185,361, followed by atorvastatin at 11,673,109.
Another noteworthy change is the reduced use of the antibiotics included in last year’s list. Cephalexin dropped from sixth place to ninth for prescription counts, while amoxicillin dropped off the top 10 completely.
The pandemic has again brought changes to medicine use, with the dip in antibiotic prescribing a potential silver lining helping to address antimicrobial resistance. The rise of antimicrobial resistance has been labelled the ‘global warming of healthcare’, and Dr Annear said it is positive to see a drop in prescribing.
‘This is good news, as prescribing antibiotics when they are not needed is driving antibiotic resistance,’ she said.
‘This continues a downward trend in antibiotic use over the last years, but Australia still has high use – more than double that of some European countries.’
Although prescriptions dispensed for cancer medications ranked lower in the list, government expenditure was highest for this class of drugs.
Aflibercept, used to treat macular degeneration and metastatic colorectal cancer, cost the most at $443,729,600 – not including rebates.
Between the July 2020 – June 2021 period, there were only 364,846 prescriptions for the drug.
Pembrolizumab, used to treat various types of cancer including lung and melanoma, was the second mostly costly at $431,701,955, with only 49,694 prescriptions.
Top 10 PBS/RPBS drugs by DDD/1000 pop/day
- Atorvastatin – 76.22
- Rosuvastatin – 66.54
- Perindopril – 54.35
- Amlodipine – 53.35
- Candesartan – 34.56
- Telmisartan – 34.55
- Irbesartan – 29.36
- Sertraline – 27.42
- Metformin – 26.59
- Ramipril – 26.52
Top 10 PBS/RPBS drugs by prescription counts
- Rosuvastatin – 14,185,361
- Atorvastatin – 11,673, 109
- Pantoprazole – 9,299,295
- Esomeprazole – 8,396,611
- Perindopril – 6,890,787
- Escitalopram – 5,470,158
- Metformin – 5,406,768
- Sertraline – 5,106,720
- Cefalexin – 4,617,588
- Amlodipine – 4,475,471
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