Ongoing initiatives within the Scottish National Health Service to affect the prescribing of selective serotonin reuptake inhibitors and their influence
Abstract
Aim: Increasing use of selective serotonin-reuptake inhibitors (SSRIs) in Scotland, coupled with safety concerns with some SSRIs, and the increasing availability of generic SSRIs, have resulted in multiple initiatives to improve the quality and efficiency of their prescribing in Scotland. Our aim is to assess their influence to provide future direction. Materials & methods: The prescription costs analysis database was used to document utilization and expenditure on SSRIs between 2001 and 2017 alongside documenting the initiatives. Results: Multiple interventions over the years increased international nonproprietary name prescribing up to 99.9% lowering overall costs. This, coupled with initiatives to limit escitalopram prescribing due to concerns with its value, resulted in a 73.7% reduction in SSRI expenditure between 2001 and 2017 despite a 2.34-fold increase in utilization. Safety warnings resulted in a significant reduction in the prescribing of paroxetine, citalopram and escitalopram alongside a significant increase in sertraline Conclusion: Multiple initiatives have increased the quality and efficiency of SSRI prescribing in Scotland providing direction to others.
Formats available
You can view the full content in the following formats:
References
Papers of special note have been highlighted as: • of interest; •• of considerable interest
1.
Garattini S, Bertele V, Godman B, Haycox A, Wettermark B, Gustafsson LL. Enhancing the rational use of new medicines across European healthcare systems. Eur. J. Clin. Pharmacol. 64(12), 1137–1138 (2008).
2.
Malmstrom RE, Godman BB, Diogene E et al. Dabigatran – a case history demonstrating the need for comprehensive approaches to optimize the use of new drugs. Front. Pharmacol. 4, 39 (2013).
3.
Godman B, Ortwijn W, de Waure C et al. Links between Pharmaceutical R&D Models and Access to Affordable Medicines. A Study for the ENVI COMMITTEE (2016). www.europarl.europa.eu/RegData/etudes/STUD/2016/587321/IPOL_STU(2016)587321_EN.pdf.
4.
WHO. Access to new medicines in Europe: technical review of policy initiatives and opportunities for collaboration and research. www.euro.who.int/__data/assets/pdf_file/0008/306179/Access-new-medicines-TR-PIO-collaboration-research.pdf?ua=1.
5.
Godman B, Malmstrom RE, Diogene E et al. Are new models needed to optimize the utilization of new medicines to sustain healthcare systems? Expert Rev. Clin. Pharmacol. 8(1), 77–94 (2015).
6.
Godman B, Acurcio F, Guerra Junior AA et al. Initiatives among authorities to improve the quality and efficiency of prescribing and the implications. J. Pharmaceut. Care Health Sys. 1(3), 1–15 (2014).
7.
Duerden MG, Hughes DA. Generic and therapeutic substitutions in the UK: are they a good thing? Brit. J. Clin. Pharmacol. 70(3), 335–341 (2010).
8.
MHRA. Antiepileptic drugs: updated advice on switching between different manufacturers’ products (2017). www.gov.uk/drug-safety-update/antiepileptic-drugs-updated-advice-on-switching-between-different-manufacturers-products#chm-review-and-update.
9.
Labiris G, Fanariotis M, Kastanioti C et al. Greek physicians’ perceptions on generic drugs in the era of austerity. Scientifica 2015, 251792 (2015). www.ncbi.nlm.nih.gov/pmc/articles/PMC4589622/.
10.
Dunne SS, Shannon B, Cullen W, Dunne CP. Beliefs, perceptions and behaviours of GPs towards generic medicines. Fam. Pract. 31(4), 467–474 (2014).
11.
Fadare JO, Adeoti AO, Desalu OO et al. The prescribing of generic medicines in Nigeria: knowledge, perceptions and attitudes of physicians. Expert Rev. Pharmacoecon. Outcomes Res. 16(5), 639–650 (2016).
12.
Bennie M, Godman B, Bishop I, Campbell S. Multiple initiatives continue to enhance the prescribing efficiency for the proton pump inhibitors and statins in Scotland. Expert Rev. Pharmacoecon. Outcomes Res. 12(1), 125–130 (2012).
13.
Godman B, Bishop I, Finlayson AE, Campbell S, Kwon HY, Bennie M. Reforms and initiatives in Scotland in recent years to encourage the prescribing of generic drugs, their influence and implications for other countries. Expert Rev. Pharmacoecon. Outcomes Res. 13(4), 469–482 (2013).
14.
Ferner RE, Lenney W, Marriott JF. Controversy over generic substitution. BMJ 340, c2548 (2010).
15.
Leporowski A, Godman B, Kurdi A et al. Ongoing activities to optimize the quality and efficiency of lipid-lowering agents in the Scottish national health service: influence and implications. Expert Rev. Pharmacoecon. Outcomes Res. 18(6), 655–666 (2018).
16.
NHS Scotland. The Scottish Government. National Therapeutic Indicators 2013 – Baseline Report (2013). www.sehd.scot.nhs.uk/publications/DC20131029nti.pdf.
17.
NHS Lothian. LOTHIAN PRESCRIBING BULLETIN. April/May 2008 (2018). www.ljf.scot.nhs.uk/PrescribingBulletins/2008/lpb/LPB%20Issue%20No%2032%20-%20FINAL.pdf.
18.
NHS Greater Glasgow and Clyde. Medicines Update Extra. ORAL PROTON PUMP INHIBITORS (2015). www.ggcprescribing.org.uk/media/uploads/ps_extra/mu_extra_04_-_2015.pdf.
19.
Godman B, Kurdi A, McCabe H et al. Ongoing activities to influence the prescribing of proton pump inhibitors within the Scottish National Health Service: their effect and implications. GaBI J. 7(4), (2018).
20.
Johnson CF, Dougall NJ, Williams B, MacGillivray SA, Buchanan AI, Hassett RD. Patient factors associated with SSRI dose for depression treatment in general practice: a primary care cross sectional study. BMC Fam. Pract. 15, 210 (2014).
•• Good study assessing factors affecting the prescribing of selective serotonin-reuptake inhibitors in the UK.
21.
Pilgrim D, Bentall R. The medicalisation of misery: a critical realist analysis of the concept of depression. J. Mental Health 8(3), 261–274 (1999).
22.
Dowrick C, Frances A. Medicalising unhappiness: new classification of depression risks more patients being put on drug treatment from which they will not benefit. BMJ 347, f7140 (2013).
23.
NHS Scotland, ISD Scotland. Medicines for mental health – years 2007/08 to 2017/18 (2018). www.isdscotland.org/Health-Topics/Prescribing-and-Medicines/Publications/data-tables2017.asp?id=2020#2020.
24.
Godman B, Baker A, Leporowski A et al. Initiatives to increase the prescribing of low cost generics; the case of Scotland in the international context. Med. Res. Arch. 5(3), 1–34 (2017).
25.
Godman B, Bucsics A, Burkhardt T et al. Potential to enhance the prescribing of generic drugs in patients with mental health problems in austria; implications for the future. Front. Pharmacol. 3, 198 (2012).
26.
Martin A, Godman B, Miranda J et al. Measures to improve angiotensin receptor blocker prescribing efficiency in the UK: findings and implications. J. Comp. Eff. Res. 3(1), 41–51 (2014).
27.
Cipriani A, Furukawa TA, Salanti G et al. Comparative efficacy and acceptability of 21 antidepressant drugs for the acute treatment of adults with major depressive disorder: a systematic review and network meta-analysis. Lancet 391(10128), 1357–1366 (2018).
•• Comprehensive study assessing the efficacy and acceptability of different antidepressants.
28.
Thorlund K, Druyts E, Wu P, Balijepalli C, Keohane D, Mills E. Comparative efficacy and safety of selective serotonin reuptake inhibitors and serotonin–norepinephrine reuptake inhibitors in older adults: a network meta-analysis. J. Am. Geriatr. Soc. 63(5), 1002–1009 (2015).
• Good study assessing the comparative effectiveness and safety of different selective serotonin-reuptake inhibitors.
29.
Bauer M, Pfennig A, Severus E, Whybrow PC, Angst J, Moller HJ. World Federation of Societies of Biological Psychiatry (WFSBP) guidelines for biological treatment of unipolar depressive disorders, part 1: update 2013 on the acute and continuation treatment of unipolar depressive disorders. World J. Biol. Psychiatry 14(5), 334–385 (2013).
30.
NHS Greater Glasgow and Clyde Annual Review 2010 Self Assessment (2010). www.nhsggc.org.uk/media/230557/nhsggc_annual_review_2009-10_self_assessment.pdf.
31.
Scottish Medicines Consortium. Escitalopram 5mg, 10mg and 20mg tablets (Cipralex) No. 253/06 (2006). www.scottishmedicines.org.uk/files/escitalopram_Cipralex__253-06_.pdf.
32.
Svensson S, Mansfield PR. Escitalopram: superior to citalopram or a chiral chimera? Psychother. Psychosom. 73(1), 10–16 (2004).
33.
NHS Lothian. LOTHIAN PRESCRIBING BULLETIN. www.ljf.scot.nhs.uk/PrescribingBulletins/2007/lpb/LPB%20Issue%20No%2026.pdf.
34.
Godman B, Persson M, Miranda J et al. Changes in the utilization of venlafaxine after the introduction of generics in Sweden. Appl. Health Econ. Health Policy 11(4), 383–393 (2013).
• Interesting study assessing the impact of restricting prescribing of antidepressants in Sweden.
35.
Wagner G, Schultes M-T, Titscher V, Teufer B, Klerings I, Gartlehner G. Efficacy and safety of levomilnacipran, vilazodone and vortioxetine compared with other second-generation antidepressants for major depressive disorder in adults: a systematic review and network meta-analysis. J. Affect. Disord. 228, 1–12 (2018).
36.
Hertfordshire Partnership University, NHS Foundation Trust East and North Hertfordshire Clinical Commissioning Group, Herts Valleys Clinical Commissioning Group. Guidelines on Choice and Selection of Antidepressants for the Management of Depression (2016). www.hpft.nhs.uk/media/1584/guidelines-on-choice-and-selection-of-antidepressants-for-the-management-of-depression-final-oct-2016.pdf.
37.
Wooltorton E. Paroxetine (Paxil, Seroxat), increased risk of suicide in pediatric patients. CMAJ 169(5), 446 (2003).
38.
Aursnes I, Tvete IF, Gaasemyr J, Natvig B. Suicide attempts in clinical trials with paroxetine randomised against placebo. BMC Med. 3(1), 14 (2005).
39.
Breggin P. Court filing makes public my previously suppressed analysis of paxil's effects. Ethical Hum. Psychol. Psychiatry 8(1), 77–84 (2006).
40.
Waechter F. Paroxetine must not be given to patients under 18. BMJ 326(7402), 1282 (2003).
41.
Sharma T, Guski LS, Freund N, Gotzsche PC. Suicidality and aggression during antidepressant treatment: systematic review and meta-analyses based on clinical study reports. BMJ 352, i65 (2016).
42.
Stone M, Laughren T, Jones ML et al. Risk of suicidality in clinical trials of antidepressants in adults: analysis of proprietary data submitted to US Food and Drug Administration. BMJ 339, b2880 (2009).
43.
NICE. Depression in adults: recognition and management. Clinical guideline [CG90] published October 2009 (2018). www.nice.org.uk/guidance/cg90/chapter/1-Guidance#treatment-choice-based-on-depression-subtypes-and-personal-characteristics.
44.
Tran E, Dishman B. Citalopram-induced QTc prolongation: a brief review of the data. Mental Health Clinician 2(6), 139–141 (2012).
45.
Tampi RR, Balderas M, Carter KV et al. Citalopram, QTc Prolongation, and Torsades de Pointes. Psychosomatics 56(1), 36–43 (2015).
46.
NHS Greater Glasgow and Clyde. Medicines Update Extra. Drug induced Qt prolongation (2015). www.ggcprescribing.org.uk/media/uploads/ps_extra/medicines_update_extra_qt_prolongation_may_15_incl_hydroxyzine.pdf.
47.
NHS Greater Glasgow and Clude. Post Script Extra. Drug Induced Qt Prolongation (2012). www.ggcprescribing.org.uk/media/uploads/ps_extra/pse_21.pdf.
48.
TAYSIDE PRESCRIBER. Citalopram & escitalopram:QT interval prolongation (2012). www.nhstaysideadtc.scot.nhs.uk/Antibiotic%20site/pdf%20docs/Tayside%20Prescriber%20122%20-%20escitalopram%20and%20citalopram%20May%2012.pdf.
49.
MHRA. Medicines and healthcare products regulatory agency. Citalopram and escitalopram: QT interval prolongation (2011). www.gov.uk/drug-safety-update/citalopram-and-escitalopram-qt-interval-prolongation.
50.
Cipriani A, La Ferla T, Furukawa TA et al. Sertraline versus other antidepressive agents for depression. Cochrane Database Syst. Rev. (4), Cd006117 (2010).
• Good study assessing the effectiveness and safety of sertraline.
51.
NHS Grampian. NHS Grampian Guidance for Initiating Antidepressants (2017). http://foi.nhsgrampian.org/globalassets/foidocument/foi-public-documents1---all-documents/AntDepS.pdf.
52.
Johnson CF, Williams B, MacGillivray SA, Dougall NJ, Maxwell M. ‘Doing the right thing’: factors influencing GP prescribing of antidepressants and prescribed doses. BMC Fam. Pract. 18(1), 72 (2017).
•• Interesting study assessing factors influencing the prescribing of antidepressants in the UK.
53.
Adli M, Baethge C, Heinz A, Langlitz N, Bauer M. Is dose escalation of antidepressants a rational strategy after a medium-dose treatment has failed? A systematic review. Eur. Arch. Psychiatry Clin. Neurosci. 255(6), 387–400 (2005).
54.
Godman B, Wettermark B, van Woerkom M et al. Multiple policies to enhance prescribing efficiency for established medicines in Europe with a particular focus on demand-side measures: findings and future implications. Front. Pharmacol. 5, 106 (2014).
55.
Abbing-Karahagopian V, Huerta C, Souverein PC et al. Antidepressant prescribing in five European countries: application of common definitions to assess the prevalence, clinical observations, and methodological implications. Eur. J. Clin. Pharmacol. 70(7), 849–857 (2014).
56.
Lewer D, O'Reilly C, Mojtabai R, Evans-Lacko S. Antidepressant use in 27 European countries: associations with sociodemographic, cultural and economic factors. Brit. J. Psych. 207(3), 221–226 (2015).
• Interesting study assessing antidepressant prescribing across Europe.
57.
WHO. Improving access to and appropriate use of medicines for mental disorders (2017). http://apps.who.int/iris/bitstream/handle/10665/254794/9789241511421-eng.pdf;jsessionid=EA10F15C6B514516A8AD9CCED0C55F9C?sequence=1.
58.
Cameron A, Ewen M, Ross-Degnan D, Ball D, Laing R. Medicine prices, availability, and affordability in 36 developing and middle-income countries: a secondary analysis. Lancet 373(9659), 240–249 (2009).
59.
Cameron A, Mantel-Teeuwisse AK, Leufkens HG, Laing RO. Switching from originator brand medicines to generic equivalents in selected developing countries: how much could be saved? Value Health 15(5), 664–673 (2012).
60.
WHO. WHO Model List of Essential Medicines – March 2017; Amended August 2017. www.who.int/medicines/publications/essentialmedicines/20th_EML2017_FINAL_amendedAug2017.pdf?ua=1.
61.
Barbui C, Ostuzzi G, Godman B. Public health psychopharmacology: a new research discipline comes of age? Epidemiol. Psychiatr. Sci. 27(1), 24–28 (2018).
62.
ISD Scotland. Community dispensing. Prescription cost analysis. http://isdscotland.org/Health-Topics/Prescribing-and-Medicines/Community-Dispensing/Prescription-Cost-Analysis/.
63.
WHO. WHO Collaborating Centre for Drug Statistics Methodology. ATC/DDD Index. www.whocc.no/.
64.
Godman B, Shrank W, Andersen M et al. Comparing policies to enhance prescribing efficiency in Europe through increasing generic utilization: changes seen and global implications. Expert Rev. Pharmacoecon. Outcomes Res. 10(6), 707–722 (2010).
65.
NHS Scotland. National therapeutic indicators. 2012 – baseline data. www.sehd.scot.nhs.uk/pca/PCA2012(M)08report.pdf.
66.
Wettermark B, Godman B, Jacobsson B, Haaijer-Ruskamp FM. Soft regulations in pharmaceutical policy making: an overview of current approaches and their consequences. Appl. Health Econ. Health Policy 7(3), 137–147 (2009).
67.
Godman B, Wettermark B, Hoffmann M, Andersson K, Haycox A, Gustafsson LL. Multifaceted national and regional drug reforms and initiatives in ambulatory care in Sweden: global relevance. Expert Rev. Pharmacoecon. Outcomes Res. 9(1), 65–83 (2009).
68.
Godman B, Sakshaug S, Berg C, Wettermark B, Haycox A. Combination of prescribing restrictions and policies to engineer low prices to reduce reimbursement costs. Expert Rev. Pharmacoecon. Outcomes Res. 11(1), 121–129 (2011).
69.
Martikainen JE, Saastamoinen LK, Korhonen MJ, Enlund H, Helin-Salmivaara A. Impact of restricted reimbursement on the use of statins in Finland: a register-based study. Med. Care 48(9), 761–766 (2010).
70.
Fulcher BD, Little MA, Jones NS. Highly comparative time-series analysis: the empirical structure of time series and their methods. J. R. Soc. Interface 10(83), 20130048 (2013).
71.
NHS Greater Glasgow and Clyde. The Greater Glasgow and Clyde Formualary. Third Edition August 2009 (2009). www.nhsggc.org.uk/media/226772/Document%207%20NHS%20Formulary%202009.pdf.
72.
Scottish Medicines Consortium. Escitalopram (Cipralex) (2003). www.scottishmedicines.org.uk/media/1651/escitalopramresubmission_070303_.pdf.
73.
Audit Scotland. Supporting prescribing in general practice - a progress report (2003). www2.gov.scot/Publications/2010/01/18120533/3.
74.
LOTHIAN PRESCRIBING BULLETIN (2003). www.ljf.scot.nhs.uk/PrescribingBulletins/2003/lpb/LPB%20Issue%20No%202.pdf.
75.
NHS Lothian Prescribing Bulletin January 2013 (2013). www.ljf.scot.nhs.uk/PrescribingBulletins/2013Issues/LPB/Lothian%20Prescribing%20Bulletin%20Issue%2059%20Jan%202013%20FINAL.pdf.
76.
NHS Scotland. Mental Health Collaborative Programme Newsletter (2009). www2.gov.scot/Publications/2009/02/13140255/0.
77.
Johnson CF, Macdonald HJ, Atkinson P, Buchanan AI, Downes N, Dougall N. Reviewing long-term antidepressants can reduce drug burden: a prospective observational cohort study. Brit. J. Gen. Pract. 62(604), e773–e779 (2012).
•• Good study discussing the rationale for reviewing patients on long-term antidepressants.
78.
Lockhart P, Guthrie B. Trends in primary care antidepressant prescribing 1995–2007: a longitudinal population database analysis. Brit. J. Gen. Pract. 61(590), e565–e572 (2011).
79.
McManus S, Bebbington P, Jenkins R, Brugha T. Mental health and wellbeing in England – Adult Psychiatric Morbidity Survey 2014 Executive Summary (2014). https://files.digital.nhs.uk/pdf/s/5/adult_psychiatric_study_executive_summary_web.pdf.
80.
Moore M, Yuen HM, Dunn N, Mullee MA, Maskell J, Kendrick T. Explaining the rise in antidepressant prescribing: a descriptive study using the general practice research database. BMJ 339, b3999 (2009).
81.
Sinclair JE, Aucott LS, Lawton K, Reid IC, Cameron IM. The monitoring of longer term prescriptions of antidepressants: observational study in a primary care setting. Fam. Pract. 31(4), 419–426 (2014).
82.
Cleare A, Pariante CM, Young AH et al. Evidence-based guidelines for treating depressive disorders with antidepressants: a revision of the 2008 British Association for Psychopharmacology guidelines. J. Psychopharmacol. 29(5), 459–525 (2015).
83.
Godman B, Wettermark B, Miranda J, Bennie M, Martin A, Malmstrom RE. Influence of multiple initiatives in Sweden to enhance ARB prescribing efficiency following generic losartan; findings and implications for other countries. Int. J. Clin. Pract. 67(9), 853–862 (2013).
84.
Bennie M, Bishop I, Godman B et al. Are specific initiatives required to enhance prescribing of generic atypical antipsychotics in Scotland?: international implications. Int. J. Clin. Pract. 67(2), 170–80 (2013).
85.
Bennie M, Bishop I, Godman B et al. Are prescribing initiatives readily transferable across classes: the case of generic losartan in Scotland? Qual. Prim. Care 21(1), 7–15 (2013).
86.
Dylst P, Simoens S. Does the market share of generic medicines influence the price level?: a European analysis. PharmacoEconomics 29(10), 875–882 (2011).
87.
Fitzgerald A, Lethaby A, Cikalo M, Glanville J, Wood H. Review of Systematic Reviews Exploring the Implementation/Uptake of Guidelines. Yorh Health Economics Consortium. www.nice.org.uk/guidance/ph56/evidence/evidence-review-2-431762366.
88.
Brusamento S, Legido-Quigley H, Panteli D et al. Assessing the effectiveness of strategies to implement clinical guidelines for the management of chronic diseases at primary care level in EU Member States: a systematic review. Health Policy 107(2–3), 168–183 (2012).
89.
Sandora TJ, Fung M, Melvin P, Graham DA, Rangel SJ. National variability and appropriateness of surgical antibiotic prophylaxis in US children's hospitals. JAMA Pediatrics 170(6), 570–576 (2016).
Information & Authors
Information
Published In
Copyright
© 2019 Future Medicine Ltd.
History
Received: 23 November 2018
Accepted: 11 February 2019
Published online: 26 April 2019
Keywords:
Topics
Authors
Metrics & Citations
Metrics
Article Usage
Article usage data only available from February 2023. Historical article usage data, showing the number of article downloads, is available upon request.
Citations
How to Cite
Ongoing initiatives within the Scottish National Health Service to affect the prescribing of selective serotonin reuptake inhibitors and their influence. (2019) Journal of Comparative Effectiveness Research. DOI: 10.2217/cer-2018-0132
Export citation
Select the citation format you wish to export for this article or chapter.
Citing Literature
- Esther de Vries, Petra Denig, Taco B. M. Monster, Peter G. M. Mol, Mixed Impact of Direct Healthcare Professional Communications When Considering Proximal Outcomes and the Targeted Population: A Systematic Review, Pharmacoepidemiology and Drug Safety, 10.1002/pds.70135, 34, 3, (2025).
- Weimiao Li, Xiaoyu Li, Yaoguang He, Luwen Shi, Jing Chen, Effects of Generic Entry on Market Shares and Prices of Originator Drugs: Evidence from Chinese Pharmaceutical Market, PharmacoEconomics - Open, 10.1007/s41669-025-00570-6, 9, 4, (639-648), (2025).
- Mathieu Charbonneau, Steven G. Morgan, Camille Gagnon, Cheryl A. Sadowski, James L. Silvius, Cara Tannenbaum, Justin P. Turner, Factors influencing the effects of policies and interventions to promote the appropriate use of medicines in high-income countries: A rapid realist review, Health Policy, 10.1016/j.healthpol.2024.105027, 142, (105027), (2024).
- Irina Iaru, Camelia Bucsa, Andreea Farcas, Cristina Pop, Anamaria Cristina, Sebastian Armean, Irina Brumboiu, Oliviu Vostinaru, Cristina Mogosan, Utilization of psychotropic medicines in Romania during 1998–2018, Frontiers in Pharmacology, 10.3389/fphar.2023.1157231, 14, (2023).
- Hye-Young Kwon, Brian Godman, Editorial: Pharmaceutical policy, impact and health outcomes, Frontiers in Pharmacology, 10.3389/fphar.2023.1150055, 14, (2023).
- Rogério Hoefler, Taís Freire Galvão, Inês Ribeiro-Vaz, Marcus Tolentino Silva, Trends in Brazilian market of antidepressants: A five-year dataset analysis, Frontiers in Pharmacology, 10.3389/fphar.2022.893891, 13, (2022).
- Ileana Mardare, Stephen M. Campbell, Johanna C. Meyer, Israel Abebrese Sefah, Amos Massele, Brian Godman, Enhancing Choices Regarding the Administration of Insulin Among Patients With Diabetes Requiring Insulin Across Countries and Implications for Future Care, Frontiers in Pharmacology, 10.3389/fphar.2021.794363, 12, (2022).
- Brian Godman, Magdalene Wladysiuk, Stuart McTaggart, Amanj Kurdi, Eleonora Allocati, Mihajlo Jakovljevic, Francis Kalemeera, Iris Hoxha, Anna Nachtnebel, Robert Sauermann, Manfred Hinteregger, Vanda Marković-Peković, Biljana Tubic, Guenka Petrova, Konstantin Tachkov, Juraj Slabý, Radka Nejezchlebova, Iva Selke Krulichová, Ott Laius, Gisbert Selke, Irene Langner, András Harsanyi, András Inotai, Arianit Jakupi, Svens Henkuzens, Kristina Garuolienė, Jolanta Gulbinovič, Patricia Vella Bonanno, Jakub Rutkowski, Skule Ingeberg, Øyvind Melien, Ileana Mardare, Jurij Fürst, Sean MacBride-Stewart, Carol Holmes, Caridad Pontes, Corinne Zara, Marta Turu Pedrola, Mikael Hoffmann, Vasileios Kourafalos, Alice Pisana, Rita Banzi, Stephen Campbell, Bjorn Wettermark, Utilisation Trend of Long‐Acting Insulin Analogues including Biosimilars across Europe: Findings and Implications, BioMed Research International, 10.1155/2021/9996193, 2021, 1, (2021).
- Amanj Kurdi, Opioids and Gabapentinoids Utilisation and Their Related-Mortality Trends in the United Kingdom Primary Care Setting, 2010–2019: A Cross-National, Population-Based Comparison Study, Frontiers in Pharmacology, 10.3389/fphar.2021.732345, 12, (2021).
- Brian Godman, Joseph Fadare, Hye-Young Kwon, Carolina Zampirolli Dias, Amanj Kurdi, Isabella Piassi Dias Godói, Dan Kibuule, Iris Hoxha, Sylvia Opanga, Zikria Saleem, Tomasz Bochenek, Vanda Marković-Peković, Ileana Mardare, Aubrey C Kalungia, Stephen Campbell, Eleonora Allocati, Alice Pisana, Antony P Martin , Johanna C Meyer, Evidence-based public policy making for medicines across countries: findings and implications for the future, Journal of Comparative Effectiveness Research, 10.2217/cer-2020-0273, 10, 12, (1019-1052), (2021).