Background: Recent studies raised concerns about the increasing use of gabapentinoids in different countries. Understanding the global consumption of gabapentinoids will offer us a platform to further examine the prevalence of off-label use and the need for any interventional policies.
Objectives: To evaluate the global trends in gabapentinoid consumption from 2008 to 2018.
Methods: This is a longitudinal trend study. Country-level pharmaceutical sales data of gabapentinoids from the IQVIA-Multinational Integrated Data Analysis System (MIDAS) between 2008 and 2018 were used. 65 countries and regions across the world, representing approximately 70% of the global population were included in the study. Sales data of gabapentin, pregabalin and gabapentin enacarbil were analysed. Consumption rates of gabapentinoids were expressed as defined daily dose per ten thousands inhabitants per day (DDD/TID). Linear mixed models were used to estimate the trend and changes with respect to different geographical regions and income-levels.
Results: An overall increase in gabapentinoid consumption from 2008 to 2018 was observed across different countries. The multinational average annual percentage change of gabapentinoids was +17.20% (95%CI, +15.52% to +18.91%), from 4.17 DDD/TID (95%CI, 2.99 to 5.81) in 2008 to 18.26 DDD/TID (95%CI, 13.54 to 24.63) in 2018. Lower-middle income countries demonstrated the largest growth in consumption (+23.28%; 95%CI, +18.55% to +28.21%). Regional annual increase in consumption was the highest in Northern Africa (+35.91%; 95%CI, +26.17% to +46.41%) followed by Eastern Europe (+23.77%; 95%CI, +17.06% to +30.86%) and Central Asia, (+20.45%; 95%CI, -0.53% to +45.85%). In 2018, high-income countries had the highest pooled gabapentinoid consumption rate (39.92 DDD/TID; 95%CI, 32.35 to 49.26), which was almost 6 times higher than the lower-middle income countries (6.11 DDD/TID; 95%CI, 2.12 to 17.61). Pooled regional gabapentinoid consumption rates were highest in North America (124.62 DDD/TID; 95%CI, 95.77 to 162.16), followed by Oceania (68.88 DDD/TID; 95%CI, 37.14 to 127.72) and Northern Europe (54.66 DDD/TID; 95%CI, 38.59 to 77.43).
Conclusions: Disregarding the differences in healthcare system and culture, a worldwide increase in gabapentinoid consumption was observed and high-income countries remained the largest consumer by the end of the study period.
