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. 2023 Aug 17;14(1):5005.
doi: 10.1038/s41467-023-40637-8.

Gabapentinoid consumption in 65 countries and regions from 2008 to 2018: a longitudinal trend study

Adrienne Y L Chan #  1   2   3   4 , Andrew S C Yuen #  4   5 , Daniel H T Tsai  6   7 , Wallis C Y Lau  2   3   4   5 , Yogini H Jani  4   5 , Yingfen Hsia  6   8 , David P J Osborn  9   10 , Joseph F Hayes  9   10 , Frank M C Besag  4   11 , Edward C C Lai  7 , Li Wei  4   5 , Katja Taxis  1 , Ian C K Wong  12   13   14   15   16 , Kenneth K C Man  17   18   19   20
Affiliations

Gabapentinoid consumption in 65 countries and regions from 2008 to 2018: a longitudinal trend study

Adrienne Y L Chan et al. Nat Commun. .

Abstract

Recent studies raised concerns about the increasing use of gabapentinoids in different countries. With their potential for misuse and addiction, understanding the global consumption of gabapentinoids will offer us a platform to examine the need for any interventional policies. This longitudinal trend study utilised pharmaceutical sales data from 65 countries and regions across the world to evaluate the global trends in gabapentinoid consumption between 2008-2018. The multinational average annual percentage change of gabapentinoid consumption was +17.20%, increased from 4.17 defined daily dose per ten thousand inhabitants per day (DDD/TID) in 2008 to 18.26 DDD/TID in 2018. High-income countries had the highest pooled gabapentinoid consumption rate (39.92 DDD/TID) in 2018, which was more than six times higher than the lower-middle income countries (6.11 DDD/TID). The study shows that despite differences in healthcare system and culture, a consistent increase in gabapentinoid consumption is observed worldwide, with high-income countries remaining the largest consumers.

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Conflict of interest statement

A.Y.L.C. is supported by the AIR@innoHK programme of the Hong Kong Innovation and Technology Commission. D.P.J.O and J.F.H are supported by the University College London Hospitals NIHR Biomedical Research Centre and the NIHR North Thames Applied Research Collaboration. I.C.K.W. received research funding outside the submitted work from Amgen, Bristol-Myers Squibb, Pfizer, Janssen, Bayer, GSK, Novartis, Takeda, the Hong Kong Research Grants Council, and the Hong Kong Health and Medical Research Fund, National Institute for Health Research in England, European Commission, National Health and Medical Research Council in Australia. He is also a non-executive director of Jacobson Pharma Corporation Limited in Hong Kong and a consultant to the World Health Organization. K.K.C.M. reports grants from the CW Maplethorpe Fellowship, the European Union Horizon 2020, the UK National Institute of Health Research and the Hong Kong Research Grant Council, Hong Kong Innovation and Technology Commission, and reports personal fees from IQVIA, unrelated to the submitted work. The remaining authors declare no competing interests. All funders had no role in study design, data collection, data analysis, data interpretation, or writing of the report. The views expressed in this article are those of the authors and not necessarily those of the NHS, the NIHR, or the Department of Health and Social Care.

Figures

Fig. 1
Fig. 1. Multinational gabapentinoid consumption from 2008 to 2018.
Multinational consumption levels are presented as pooled defined daily dose per 10,000 inhabitants per day with the shaded areas indicating the 95% confidence bands. The multinational consumption levels were computed by pooling the estimates from individual countries using a random-effects model. The multinational consumption levels of different gabapentinoid agents are presented with 95% confidence interval and different colours. Source data are provided as a Source Data file.
Fig. 2
Fig. 2. Consumption levels of different gabapentinoids by countries from 2008 to 2018.
The consumption levels of gabapentin, pregabalin and gabapentin enacarbil of the studied countries from 2008 to 2018 are presented. Each agent is represented by a different colour. The studied countries are grouped according to their geographical locations. Source data are provided as a Source Data file.
Fig. 3
Fig. 3. Gabapentinoid consumption in DDD/TID in 2008 and 2018.
Gabapentinoid consumption of the studied countries in 2008 and 2018 are highlighted. Their consumption levels are represented by different colours. Source data are provided as a Source Data file. DDD/TID—defined daily dose per 10,000 inhabitants per day; NA data not available.
Fig. 4
Fig. 4. Average annual percentage change of gabapentinoid consumption.
Different countries/regions’ average annual percentage change of gabapentinoid consumption are represented ± 95% confidence interval (error bar). Each country/region is represented with a different colour. The average annual percentage change is calculated using a linear regression model, with log-transformed consumption in DDD/TID as the dependent variable and year as the independent variable. The average annual change was expressed as average annual percentage change, calculated by [exp(the coefficient of the year variable) – 1] × 100%. The multinational and regional trend changes were estimated using linear mixed models, controlling for within-country correlations and assuming the correlations between years were autocorrelated. Source data are provided as a Source Data file.
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