Dose dispensing in the primary health sector - the first six months of 2004

On 1 October 2001, a new executive order entered into force which allows patients to have their medicinal products dose dispensed at their pharmacy by means of mechanical dose dispensing. Until then, it had only been possible to offer manual dose dispensing. In connection with the new executive order, pharmacies are obligated to report their sales of dose dispensed medicinal products to the Danish Medicines Agency’ Register of Medicinal Product Statistics, and clearly indicate when a medicinal product is sold in dose dispensed form. This makes it possible to follow the use of dose dispensing in detail. In this note, the use of dose dispensing in the primary health sector is described during the period from the first 6 months of 2003 to the first 6 months of 2004. As of 1 June 2004, a total of 10 pharmacies were able to offer mechanical dose dispensing.

Number of people and weekly packages

The number of weekly packages distributed during periods of 6 months appears from table 1. Under special circumstances pharmacies may dispense products for more than 2 weeks at the time, and newer products for more than 4 weeks. The number of people using dose dispensed medicinal products has more than doubled within a year (table 1). During the first 6 months of 2004, the number of weekly packages was approximately 350,000, and almost all dose dispensing was carried out according to doctor’s orders.

Table 1. Number of people and number of weekly packages during periods of 6 months. Dose dispensed medicinal products.

Figure 1 shows the distribution of sex and age of people who have received dose dispensed medicinal products during the first 6 months of 2004. It appears that 75 per cent of the users are 70 years or older and of these, women constitute 72 per cent.

Figure 1. Number of people who have used dose dispensed medicinal products during the first 6 months of 2004.

Quantity consumption and turnover

Table 2 shows quantity consumption and turnover of dose dispensed medicinal products divided into periods of 6 months.

As with number of people and packages, a significant increase has taken place from the first 6 months of 2003 to the first six months of 2004, during which both quantity consumption and turnover has tripled. Expenses for fees are DKK 20m, which equals just under one third of the medicinal product turnover.

However, the distribution of dose dispensing is still only limited. The quantity consumption of dose dispensed medicinal products during the first 6 months of 2004 was 12.5m DDD which equals 1.1 per cent of the total sale of medicinal products in the primary health sector during the same period.

Table 2. Quantity consumption (DDD), turnover (calculated by means of pharmacy selling price (exclusive of fees)) and expenses for fees. Dose dispensed medicinal products.

Contents of the weekly packages

The average number of different medicinal products contained in the weekly packages increased slightly from 5.5 different medicinal products during the first 6 months of 2003 to 5.9 different medicinal products during the first 6 months of 2004.

The table below shows the median number of different medicinal products (25% - 75% quartiles) during each period.

Table 3. Number of different medicinal products in weekly packagings. Dose dispensed medicinal products.

Regardless of period, the primary contents of the packages were medicinal products for the nervous system (33.1-36.0 per cent of the total quantity consumption) and for the heart and circulation (35.4-37.1 per cent of the total quantity consumption).

During the first 6 months of 2004, the packages also contained an average of 1.3 free trade products or proprietary articles, which in this connection is typically a dietary supplement, hereunder vitamins.

On average 35.5 DDDs were packed for a week. In 25 per cent of the packages there were more than 46.1 DDD per week, whereas 25 per cent of the packages contained less than 20 DDD per week.