Pharmaceutical consumption has been increasing for decades, driven by a growing need for medicines to treat age‑related and chronic diseases, and by changes in clinical practice. This section examines the consumption of four categories of medicines used in selected chronic conditions: antihypertensives, lipid-modifying agents (such as cholesterol-lowering medicines), antidiabetic agents and antidepressants (Figure 9.6). These medicines address illnesses for which the prevalence has increased markedly across OECD countries in recent decades.
Consumption of antihypertensive medicines in OECD countries increased by around 8% on average between 2011 and 2021, but nearly tripled in Chile. It remained highest in Germany, which reported consumption levels almost five times those seen in Korea. These variations probably reflect both differences in the prevalence of hypertension and variations in clinical practice.
Much greater growth was seen in the use of lipid-modifying agents, with consumption in OECD countries increasing by almost 60% between 2011 and 2021 on average. Denmark, the United Kingdom and Norway reported the highest levels of consumption per capita in 2021, with over a five‑fold variation in consumption levels across OECD countries.
The use of antidiabetic medications also grew dramatically, by 30% over the same period and more than doubled in Canada and Chile. The growth in countries may be explained in part by the rising prevalence of diabetes, which is largely linked to the increasing prevalence of obesity, a major risk factor for development of type 2 diabetes. In 2021, consumption of anti-diabetic medicines was highest in Canada and lowest in Austria and Latvia, with more than a two‑fold variation.
Consumption of antidepressant medicines increased by nearly 50% in OECD countries between 2011 and 2021, more than tripling in Chile and doubling in Korea, Latvia and Estonia. As well as a potential increased burden of mental ill-health, this may also reflect improved recognition of mental health disorders and evolving clinical guidelines and availability of therapies, as well as longer-term prescribing (Bogowicz et al., 2021[1]; Madeira, Queiroz and Henriques, 2023[2]). There was significant variation between countries in 2021, Iceland reported the highest level of consumption, at a rate eight times that of Latvia.
More recently, pharmaceutical consumption in each of these four categories increased by around 10% in OECD countries on average between 2019 and 2021, except for antihypertensive medicines, where consumption remained relatively stable and even decreased in some countries. Increases were highest for lipid-lowering medicines in Lithuania and Türkiye, for antidiabetic medicines in Chile and Canada, and for antidepressants in Chile and Korea. These consumption patterns may in part reflect differences in the burden of the disease since the COVID‑19 pandemic – for example, the increased prevalence of anxiety and depression (see section on “Mental health” in Chapter 3).
