1. Int J Pharm Pract. 2014 Apr;22(2):105-11. doi: 10.1111/ijpp.12048. Epub 2013 Jul 
7.

Drug substitution associated with a hospital stay in Belgium: a retrospective
analysis of a claims database.

Simoens S(1), Dubois C, Spinewine A, Foulon V, Paulus D.

Author information: 
(1)Department of Pharmaceutical and Pharmacological Sciences, KU Leuven, Leuven,
Belgium.

OBJECTIVES: This study measures the extent of drug substitution associated with a
hospital stay in Belgium.
METHODS: Data were extracted from the 2006-2007 dataset of the Belgian Agency of 
Health Insurance Funds on drug use of patients hospitalized in acute hospitals.
Reimbursed drugs received in ambulatory care during the 3 months prior to
hospitalization were compared with drugs received during the 3 months following
hospital discharge. Both a narrow definition and a broad definition were used for
drug substitution. Narrow substitution (switches between generic and originator
drugs) was computed for 14 drug classes for chronic conditions with the highest
public expenditure. Broad substitution (changes between chemical substances
within the drug class at ATC level 4, changes in brand name) was calculated for
statins and proton-pump inhibitors only.
KEY FINDINGS: The database included 17 764 patients (mean age 66 ± 17 years; 60% 
female). In 71% of cases an originator drug was received prior to and following
hospitalization. A generic drug was received prior to and following
hospitalization in 25% of cases. Some form of narrow substitution occurred in 4% 
of cases: a generic drug was replaced by an originator drug in 2% of cases and an
originator drug was replaced by a generic drug in 2% of cases. Some form of broad
substitution occurred in 25% of cases for proton-pump inhibitors and 13% of cases
for statins.
CONCLUSIONS: Hospitalization was not a trigger for changes between originator and
generic versions of a drug. Broad substitution associated with a hospital stay
was relatively limited for statins and proton-pump inhibitors.

© 2013 Royal Pharmaceutical Society.

PMID: 23829345  [PubMed - in process]