Study finds "alarming" hike in antidepressant costs during COVID-19

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Researchers in the UK have found that there was a four million rise in prescriptions for antidepressants in England during 2020, adding £139 million to NHS costs.

The team from the University of Huddersfield said the findings highlight an "urgent need" for new mental health strategies to make sure antidepressants are being used appropriately, particularly in adolescents and younger adults.

While an increase in the number of prescriptions had been predicted because of the pandemic, the scientists said it was the sharp rise in antidepressant prescription costs which was a potential cause for concern.

In fact, the four million increase is at the top end of normal increases in prescription antidepressant use in England, which have typically increased by three to four million per year, although monthly spending on these drug by NHS England has tended to decrease.

During the pandemic, the total monthly cost rose dramatically from around £16 million in September 2019 to £35 million in April 2020, write the researchers in the DARU Journal of Pharmaceutical Sciences.

All told, the number of prescriptions rose to 78 million last year, peaking in March and April as the pandemic started to gather pace, and one single drug – sertraline – accounted for £113 million of the additional costs.

The scientists attribute the rise to active pharmaceutical ingredient (API) shortages witnessed during COVID-19, coupled with a significantly higher price of generic drugs during the pandemic.

Shortage-related price concessions data published last May indicated the price of sertraline was up 823% to £14.32 for a pack of 100mg tablets, a big leap on the usual £1.55, although it reduced to £6.72 by August and since then is no longer listed on the monthly concession list.

Last  year, the Competition and Markets Authority (CMA) warned it will look at medicine price rises during the pandemic and consider action against any "unjustifiable" increases.

The Huddersfield team are also concerned about observational data pointing to a rise in prescribing of antidepressants in young people up to 25 years of age.

Lead author Dr Hamid Merchant said it is "important to optimise the safe use of antidepressants, particularly in young adults…not only to help with mental health but also in preventing the associated side-effects that may further increase the morbidity and mortality associated with depression."

The scientists also point in the paper to a meta-analysis of 100,000 patients using antidepressants which concluded that the risk of suicide doubled in children and adolescents.

Further studies are needed to assess the age distribution of antidepressant prescriptions particularly focusing on adolescents and young adults, they add.

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