Benzodiazepine hypnotics, zolpidem and zopiclone on private prescriptions. Use between 1993 and 2012

Previous analyses showed that benzodiazepine hypnotics as well as zolpidem and zopiclone (Z drugs) were increasingly being dispensed on so-called private prescriptions (Privatverordnungen) in Germany. Any doctor can provide private prescriptions for prescription drugs which are fully funded by the patient. This study aimed to analyze the amount of private prescriptions for hypnotics over the last 20 years. We compared utilization data from statutory health insurance claims with purchasing statistics from community pharmacies for the years 1993-2012. From 1993 to 2012 purchased packages of hypnotics decreased (from 14.9 to 9.9 million). Benzodiazepines were dispensed less and Z drugs more often. In 2012 zopiclone (4.3 million packages of which 42.7 % were private prescriptions), zolpidem (3.6 million, 57.6 %) and lormetazepam (0.8 million, 57.8 %) were most often prescribed. Trends in prescribing Z drugs are particularly noticeable whereby zolpidem was dispensed more often on private prescriptions than zopiclone. This seems to be further evidence for a higher dependence and abuse potential of zolpidem.