Pharmacoepidemiology of anxiolytics in the Russian Federation

Objective: To assess the structure and volume of anxiolytic consumption in the Russian Federation in 2019–2024.

Material and methods. Data on sales of medicines belonging to the Anatomical Therapeutic Chemical Classification class N05B (anxiolytics) contained in the IQVIA database and selected to treat patients with neurotic stress-related and somatoform disorders according to the current Russian clinical guidelines were derived. The study period of 2019–2024 covered such drugs as diazepam, alprazolam, lorazepam, bromdihydrochlorophenylbenzodiazepine, tofizopam, fabomotizole, etifoxine, buspirone, and hydroxyzine. Consumption was assessed at defined daily doses (DDDs) in each year of observation. The number of DDDs per 1000 individuals per day was calculated. For drugs without specified DDDs, consumption was calculated based on the absolute value sold in rubles in each year of the study.

Results. During the 2019–2024 period, an almost twofold increase in the sales of anxiolytics was noted: from 43 million DDDs in 2019 to 77.5 million DDDs in 2024. This increase was primarily attributed to a 2.5-fold increase in the sales of hydroxyzine (to 44.1 million DDDs in 2024) and a twofold increase in the sales of buspirone (to 2.3 million in 2024). The estimated consumption per 1000 individuals per day increased from 0.8 DDDs in 2019 to 1.45 DDDs in 2024. The sales of benzodiazepines decreased from 24.4% in 2019 to 10.9% in 2024. Among the anxiolytics without specified DDDs, fabomotizol ranked first in terms of acquisition costs, amounting to 2.1 billion rubles in 2019 and 3.2 billion rubles in 2024. The sales of bromodihydrochlorophenylbenzodiazepine decreased 2.7 times during the study period: from 806 million rubles in 2019 to 292 million rubles in 2024.

Conclusions. Due to the reduction in benzodiazepines consumption, the risks of prescribing other classes of psychotropic drugs, such as antipsychotics including off-label indications, are high. This requires careful monitoring of adverse drug reactions, including those associated with low compliance.

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