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Master Thesis

Impact de l’Arrêté du 07 janvier 2017 sur la prescription de zolpidem en ancienne Aquitaine

Abstract : Objectives: to analyse the impact of the zolpidem prescription new measure on its delivery in old Aquitaine and to observe concomitantly the evolution of zopiclone delivery's rate, as well as other frequently prescribed hypnotic molecules. Methods: we realized a retrospective comparative study of quantitative variables. The study focuses on the reimbursement of molecules by CPAM and SLM in old Aquitaine. The study population corresponds to all beneficiaries of the CPAM and SLM of this region, during the first trimester of 2017 and first trimester of 2018. The database was provided by the CPAM of Aquitaine. Results: the study shows a total of -1,957,073 zolpidem tablets reimbursed during the first trimester of 2018 compared to 2017. The average difference of tablets per month is 652,357.6 less. The proportion of beneficiaries who had a reimbursement of zolpidem is 1.6 % in 2017 against 1.1 % in 2018. Regarding zopiclone, we observe an additional 821 588 tablets reimbursed, which makes an average difference of 273,862.6 more tablets per month. The proportion of beneficiaries who received a reimbursement for zopiclone alone increased by 0.2 % in 2018. Conclusion: the study showed a real impact of the decree, with a decrease in the number of zolpidem tablets reimbursed. At the same time, the increase of reimbursement of zopiclone tablets shows a transfer of prescription from one molecule to another. This highlights the fact that prescription modifications alone are not enough. Therefore, it is the combination of reimbursement methods, development of training on cognitive and behavioural therapies, associated with binding prescribing modalities that could allow to manage better chronic insomnia and bring the practice closer to HAS national recommendations.
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Master Thesis
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Submitted on : Monday, January 20, 2020 - 5:52:31 PM
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Martin Denis. Impact de l’Arrêté du 07 janvier 2017 sur la prescription de zolpidem en ancienne Aquitaine. Médecine humaine et pathologie. 2019. ⟨dumas-02446365⟩

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