Reimbursed psychotropic medication

In 2019, the number of defined daily doses of reimbursable psychotropic drugs per day and per 1,000 people in Belgium amounted to 21.5%. There is no sustainable development goal for this indicator.

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Reimbursed psychotropic medication - Belgium

doses per day per 1000 persons insured

 2008201020132015201720182018//20082018//2013
Belgium79.585.490.094.996.197.32.11.6
//: Average Growth Rates

Doses refer to defined daily doses.

FPB calculations based on EPS (Échantillon Permanent(e) Steekproef, IMA).

Reimbursed psychotropic medication by region - Belgium

doses per day per 1000 persons insured

 2008201020132015201720182018//20082018//2013
Brussels-Capital Region71.674.975.377.779.579.41.11.1
Flemish Region71.877.583.088.290.392.12.52.1
Walloon Region99.5106.7111.6116.9116.9117.71.71.1
unknown7.99.612.413.521.120.710.010.8
//: Average Growth Rates

Doses refer to defined daily doses.

FPB calculations based on EPS (Échantillon Permanent(e) Steekproef, IMA).

Reimbursed psychotropic medication by sex - Belgium

doses per day per 1000 persons insured

 2008201020132015201720182018//20082018//2013
females103.1109.4113.1119.1120.2121.51.71.4
males55.060.466.169.871.372.32.81.8
//: Average Growth Rates

Doses refer to defined daily doses.

FPB calculations based on EPS (Échantillon Permanent(e) Steekproef, IMA).

Reimbursed psychotropic medication by age - Belgium

doses per day per 1000 persons insured

 2008201020132015201720182018//20082018//2013
<2510.811.612.013.014.515.23.44.8
25-6488.496.6102.5109.0110.5112.32.41.8
>64162.7169.3173.2176.4174.0173.20.60.0
//: Average Growth Rates

Doses refer to defined daily doses.

FPB calculations based on EPS (Échantillon Permanent(e) Steekproef, IMA).

Reimbursed psychotropic medication by type - Belgium

doses per day per 1000 persons insured

 2008201020132015201720182018//20082018//2013
antipsychotics10.911.813.213.513.813.92.41.1
antidepressants and mood stabilizers64.168.672.377.278.579.72.22.0
psychostimulants1.11.31.31.31.31.42.11.2
anti-dementia drugs3.43.73.32.92.52.4-3.3-6.1
//: Average Growth Rates

Doses refer to defined daily doses.

FPB calculations based on EPS (Échantillon Permanent(e) Steekproef, IMA).

Definition: the number of defined daily doses of reimbursable psychotropic drugs per day and per 1,000 people.

Drugs for the treatment of mental illnesses and psychological conditions are known as psychotropic drugs. To compare the usage of a psychotropic drug over time or between population categories, it is necessary to calculate the number of defined daily doses (DDD) of that drug per day and per 1,000 inhabitants. A DDD is the assumed average maintenance dose per day to treat the main therapeutic indication of the drug. Defined daily doses of psychotropic drugs are determined by the World Health Organization (WHO) or by nationally competent experts (WHO, 2020).

The psychotropic drug consumption data used here were calculated using data from the EPS (Échantillon Permantent(e) Steekproef) longitudinal database (IMA, 2020). The data cover the period 2008-2018. For a sample of approximately 340,000 members of Belgian mutual companies, the EPS keeps a record of all health expenditure reimbursed by sickness and disability insurance as well as some socio-economic characteristics. The source database for data on the use of medicines within the EPS is Farmanet. The Farmanet database contains information on reimbursed medicines and medical devices that are dispensed in pharmacies accessible to the public (hospital pharmacies are not included). Dispensed pharmaceuticals are grouped according to the Anatomical Therapeutic Chemical Classification (ATC) drawn up by the WHO. Psychotropic drugs are included among the pharmaceuticals that have an inhibiting (ATC class N05) or stimulating (ATC class N06) effect on the nervous system.

Pharmanet holds usage data on the following psychotropic drugs, expressed in DDD per day and per 1,000 insured persons, within the scope of compulsory medical care insurance in Belgium.

  • Antipsychotics (ATC classification N05A): these drugs treat psychosis, specifically partial or complete loss of perception of reality over a certain period.

  • Antidepressants and mood stabilisers (ATC classification N06A): these drugs treat low mood that is accompanied by loss of interest in or enjoyment of almost all activities and that is not attributable to other factors. This state severely impedes performance of everyday tasks.

  • Psychostimulants (ATC classification N06B): these drugs improve cognitive functioning. These analeptics are only reimbursed within the health insurance system for those aged 6 to 17 (IMA, 2020).

  • Anti-dementia drugs (ATC classification N06D): these drugs treat dementia, which is a chronic and progressive condition involving multiple disturbances of cognitive functioning, especially in older persons.

These usage data represent only a portion of total usage of psychotropic drugs in Belgium, specifically that portion that is reimbursable under compulsory medical care insurance and is supplied by public pharmacies. Furthermore, Pharmanet does not contain any information regarding other psychotropic drugs, particularly anxiolytics (ATC classification N05B), hypnotics and sedatives (ATC classification N05C), and psycholeptics and psychoanaleptics in combination (ATC classification N06C). These concern psychotropic drugs that are not reimbursable and are supplied by public pharmacies or psychotropic drugs that are supplied by hospital pharmacies.

Goal: there is no sustainable development goal for the number of defined daily doses of reimbursable psychotropic drugs per day and per 1,000 people.

The Sustainable Development Goals (SDGs) adopted by the United Nations in 2015 include target 3.4: "By 2030, reduce by one third premature mortality from non-communicable diseases through prevention and treatment and promote mental health and well-being.".

International comparison: Time series on the total consumption of reimbursed psychotropic medicines, as recorded in the EPS or Pharmanet database, are not available for the EU27. On the basis of another source, it may be mentioned that in Belgium the consumption of a certain type of psychotropic drugs, namely antidepressants and mood stabilisers (ATC class NO6A), was systematically higher than the average for 11 European countries (Italy, Netherlands, Luxembourg, Germany, Austria, Finland, Spain, Belgium, Sweden, Portugal and the United Kingdom) during the period 2000-2016. For 2016, this figure was 12.5% higher (For a Healthy Belgium, 2020).

UN indicator: the selected indicator does not correspond to any monitoring indicator for the SDGs but is related to target 3.4 since psychotropic drugs, whether or not in combination with psychotherapy, treat non-communicable diseases and are intended to improve mental health.

Sources

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