Potentially inappropriate prescription of the asthma product Singulair®

Introduction
The asthma product Singulair® was put on the Danish market in February 1998 and became eligible for general reimbursement 13 July 1998. The medicinal product is recommended as a supplement for treatment of mild to moderate asthma as well as for exercise-induced asthma (see recommendations in Danish at www.irf.dk – the website of the Institute for Rational Pharmacotherapy). It is not recommended to prescribe Singulair® for treatment of chronic obstructive pulmonary disease (COPD), as the product’s effect on COPD is not documented. Typically, symptoms of COPD manifest themselves in people aged 40-50. Since many Singulair® users are more than 49 years old, it is interesting to investigate whether Singulair® is prescribed in connection with treatment of COPD.

The Danish report is based on an investigation of Singulair® patients’ use of medicinal products which are typically used for treating chronic obstructive pulmonary disease but only rarely used for treating asthma. The report studies whether Singulair® has been used for treating people older than 49 years, who could very likely be COPD patients according to what medicinal products they use.

Summary
More than half of the Singulair® users were more than 49 years old in the period 1999-2002. Of these between 43 and 46 per cent also used medicinal products, which are primarily used for treating chronic obstructive pulmonary disease (COPD). This indicates that Singulair® is prescribed for treatment of a significant number of COPD patients.

You can read the entire publication (in danish) from the fact box to the right.

The Danish Medicines Agency, 14 October 2003