The impact of patent expiry on drug prices: insights from the Dutch market.

: Currently literature on the impact of patent expiry on drug prices is lacking. : To determine the impact of patent expiration and generic entry on drug prices in the Netherlands. : Prescription and price data from 1999 up to and including December 2016 were collected from two national databases.

Pharmacological treatment of increased vascular risk and cognitive performance in middle-aged and old persons: six-year observational longitudinal study.

Background: Lowering vascular risk is associated with a decrease in the prevalence of cardiovascular disease and dementia. However, it is still unknown whether lowering of vascular risk with pharmacological treatment preserves cognitive performance in general. Therefore, we compared the change in cognitive performance in persons with and without treatment of vascular risk factors.

Urinary Calcium Excretion and Risk of Chronic Kidney Disease in the General Population.

Introduction: High urinary calcium excretion (UCaE) has been shown to lead to accelerated renal function decline in individuals with renal tubular diseases. It is not known whether this association also exists in the general population. Therefore, we investigated whether high UCaE is associated with risk of developing chronic kidney disease (CKD) in community-dwelling subjects.

Prevalence and Effects of Functional Vitamin K Insufficiency: The PREVEND Study.

Matrix Gla Protein (MGP) is a strong vitamin K-dependent inhibitor of soft tissue calcification. We assessed the prevalence of functional vitamin K insufficiency, as derived from plasma desphospho-uncarboxylated MGP (dp-ucMGP), and investigated whether plasma dp-ucMGP is associated with all-cause and cardiovascular mortality in a large general population-based cohort. We included 4275 subjects (aged 53 ± 12 years, 46.

Screening for elevated albuminuria and subsequently hypertension identifies subjects in which treatment may be warranted to prevent renal function decline.

Background: We investigated whether initial population screening for elevated albuminuria with subsequent screening for hypertension in case albuminuria is elevated may be of help to identify subjects at risk for accelerated decline in kidney function.

Methods: We included subjects who participate in the PREVEND observational, general population-based cohort study and had two or more glomerular filtration rate (eGFR) measurements available during follow-up. Elevated albuminuria was defined as an albumin concentration ≥20 mg/L in a first morning urine sample confirmed by an albumin excretion ≥30 mg/day in two 24-h urines.

The association of albuminuria and high-sensitivity C-reactive protein with the efficacy of HMG-coenzyme A reductase inhibitors for cardiovascular event prevention.

Background: It is not clear which hypercholesterolemic patients benefit most from β-hydroxy-β-methylglutaryl coenzyme A reductase inhibitors with respect to the prevention of cardiovascular events. Early signs of atherosclerotic vascular damage may identify high-risk patients.

Design: We studied whether subjects with hypercholesterolemia will benefit more from starting statin treatment in the case of high albuminuria and/or high-sensitivity C-reactive protein (hsCRP).

Statin use and cognitive function: population-based observational study with long-term follow-up.

We aimed to evaluate the association between statin use and cognitive function. Cognitive function was measured with the Ruff Figural Fluency Test (RFFT; worst score, 0; best score, 175 points) and the Visual Association Test (VAT; low performance, 0-10; high performance, 11-12 points) in an observational study that included 4,095 community-dwelling participants aged 35-82 years. Data on statin use were obtained from a computerized pharmacy database.

Statin use and cognitive function: population-based observational study with long-term follow-up.

We aimed to evaluate the association between statin use and cognitive function. Cognitive function was measured with the Ruff Figural Fluency Test (RFFT; worst score, 0; best score, 175 points) and the Visual Association Test (VAT; low performance, 0-10; high performance, 11-12 points) in an observational study that included 4,095 community-dwelling participants aged 35-82 years. Data on statin use were obtained from a computerized pharmacy database.

24 h urinary free cortisol in large-scale epidemiological studies: short-term and long-term stability and sources of variability.

Background: Function of the hypothalamus-pituitary-adrenal (HPA) axis has been associated with several somatic and psychiatric health problems. The amount of free cortisol excreted in the urine during 24h (24-h UFC) has often been used as a proxy for HPA-axis function. Reference values for 24-h UFC and their stability in the short and long term, as well as sources of variability, are largely lacking.

Cost-effectiveness of statins for primary prevention in patients newly diagnosed with type 2 diabetes in the Netherlands.

Background: Statins are lipid-lowering drugs that reduce the risk of cardiovascular events in patients with diabetes.

Objectives: The objective of this study was to determine whether statin treatment for primary prevention in newly diagnosed type 2 diabetes is cost-effective, taking nonadherence, baseline risk, and age into account.

Methods: A cost-effectiveness analysis was performed by using a Markov model with a time horizon of 10 years.

Angiotensin-converting enzyme inhibitor treatment and the development of urinary tract infections: a prescription sequence symmetry analysis.

Background: Angiotensin-converting enzyme inhibitors (ACEi) can reduce urine output, especially when treatment is first started. Since bacterial clearance from the urinary tract is dependent on urine output, it was hypothesized that ACEi may also increase the risk of urinary tract infections (UTIs).

Objective: Our objective was to assess the risk of UTIs associated with ACEi therapy initiation in the general population.

The population-based prescription database IADB.nl: its development, usefulness in outcomes research and challenges.

Research databases with large numbers of prescriptions in observational settings can provide valuable information in addition to the initial randomized controlled trials. This paper reports on the development of prescription database IADB, formerly known as InterAction Database. IADB contains prescriptions from 54 community pharmacies in The Netherlands and covers a population of 500,000 people.

The effects of antitussive treatment of ACE inhibitor-induced cough on therapy compliance: a prescription sequence symmetry analysis.

Background: A common adverse effect of angiotensin-converting enzyme inhibitors (ACEI) is a persistent dry cough. Physicians and pharmacists who fail to recognise dry cough to be ACEI related may prescribe antitussives, instead of recommended ACEI substitution.

Objective: The aim of this study was to determine the influence of antitussive treatment of ACEI-induced cough on ACEI therapy compliance.

Effect of pravastatin and fosinopril on recurrent urinary tract infections.

Objectives: Recurrent urinary tract infections (UTIs) are a problem affecting both women and men. Animal experiments and in vitro studies indicate that statins might prevent recurrent UTIs. We assessed the effects of pravastatin on UTI antibiotic prescribing among adults.

Compliance, persistence, and switching patterns for ACE inhibitors and ARBs.

Objectives: To investigate compliance, persistence, and switching patterns for angiotensin-converting enzyme (ACE) inhibitors and angiotensin receptor blockers (ARBs).

Study Design: Drug-utilization analysis using a large prescription database.

Methods: Prescription data for more than 50,000 incident users of ACE inhibitors or ARBs were collected, cumulating close to 200,000 patient-years of medication use.

Association of cognitive function with albuminuria and eGFR in the general population.

Background And Objectives: Recent studies found different associations of cognitive function with albuminuria or estimated GFR (eGFR). Most studies were limited to the elderly or did not take both renal variables into account. Therefore, this study analyzed the association of cognitive function with albuminuria and eGFR in community-dwelling persons aged 35 to 82 years.

Prevalence, cumulative incidence, monotherapy and combination therapy, and treatment duration of frequently prescribed psychoactive medications in the Netherlands: retrospective database analysis for the years 2000 to 2005.

Background: Psychoactive drugs have been reported to impair daily activities (eg, driving), but data regarding the use of such drugs in the Netherlands are lacking.

Objective: The aim of this work was to examine the prevalence, cumulative incidence, use of monotherapy and combination therapy, and treatment duration of frequently prescribed psychoactive drug classes in the Netherlands.

Methods: Data for the years 2000 through 2005 were derived from IADB.

Screen-and-treat strategies for albuminuria to prevent cardiovascular and renal disease: cost-effectiveness of nationwide and targeted interventions based on analysis of cohort data from the Netherlands.

Background: Albuminuria is a marker for renal and cardiovascular (CV) risk, allowing early diagnosis of subjects with elevated renal and CV risk.

Objective: This study aimed to estimate the cost-effectiveness and budget impact of various population-based screen-and-treat scenarios for elevated albuminuria levels (ie, microalbuminuria) in the Netherlands.

Methods: A multistate transition Markov model was developed to simulate the natural course of albuminuria-based disease progression to dialysis and occurrence of CV events.

Results of a retrospective database analysis of drug utilization and costs for treatment of chronic hepatitis B virus infection in the northern Netherlands between 2000 and 2006.

Objectives: The main aims of this work were to describe patterns of medication use in the treatment of chronic hepatitis B virus (HBV) infection in patients in the northern part of the Netherlands and to compare these practices with established guidelines. In addition, the duration of use and the costs of these treatments were investigated.

Methods: We selected subjects from the University of Groningen's IADB.

Cost effectiveness of angiotensin receptor blocker monotherapy in patients with hypertension in the Netherlands: a comparative analysis using clinical trial and drug utilization data.

Background And Objective: Health gains and related cost savings achieved by optimizing treatment in hypertensive patients is highly important. The aim of this study was to evaluate the costs and cost effectiveness of treatment with angiotensin II receptor antagonists (angiotensin II receptor blockers [ARBs]) in patients with essential hypertension and to compare within-trial with real-life dosing of ARBs.

Methods: Cost effectiveness was estimated based on a published clinical trial comparing the BP-lowering effects of olmesartan, losartan, valsartan, and irbesartan.

Antibiotic usage, dosage and course length in children between 0 and 4 years.

Aim: Antibiotic drugs are most frequently used by 0- to 4-year-old children. We performed a cross-sectional study in the Netherlands using a pharmacy prescription database to investigate the use, dose and course length of antibiotic drugs in 0- to 4-year-olds.

Methods: We used a database with pharmacy drug-dispensing data.

Large increase of the use of psycho-stimulants among youth in the Netherlands between 1996 and 2006.

Aim: To describe the use of psycho-stimulants in the Netherlands between 1996 and 2006 in children and adolescents, and in relation to age and sex.

Methods: With the pharmacy prescription database the IADB.nl, yearly prevalences of psycho-stimulants per 1000 children were calculated, as was the length of psycho-stimulant use with Kaplan-Meier method in SPSS 12.

Replacing hormone therapy--is the decline in prescribing sustained, and are nonhormonal drugs substituted?

Objectives: After two cautioning landmark studies in 2002 and 2003, a dramatic decrease in hormonal therapy (HT) prescribing for menopausal symptoms was seen. Our objectives were to (1) determine whether this decline in HT prescribing sustained until 2007 and (2) investigate nonhormonal drug prescribing for women who stopped HT.

Methods: We analyzed drug dispensing data from community pharmacies in The Netherlands.

Baseline albuminuria predicts the efficacy of blood pressure-lowering drugs in preventing cardiovascular events.

What Is Already Known About This Subject: Albuminuria has been proven to be associated with cardiovascular morbidity and mortality. Such an association has been found not only in subjects with diabetes and hypertension, but also in the general population. It could therefore be expected that especially subjects with higher albuminuria levels may benefit from blood pressure-lowering agents to improve their cardiovascular outcome.