Pharmaceutical usage in the context of demographic change- the significance of growing medication consumption

1. Paris, 5 February 2018
OECD Workshop on Managing Contaminants of Emerging Concern in
Surface Waters: Scientific developments and cost-effective policy responses
Paris, 5 February 2018
OECD Workshop on Managing Contaminants of Emerging Concern in
Surface Waters: Scientificdevelopments and cost-effective policy responses

2. ©civity2017
Human and veterinary medicines get through improper
disposal and excretion into the aquatic environment
Main pathways for human and vetinary medicines
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The individual use of medicinal drugs has increased during
the last years
Consumption of prescription drug within statutory health insurance (Germany)
in DDD1) per capita per year
3
488 507 520 538 549 563 569
20122010 20112009 2013 20152014
+ 2.6 % per year
Additional consumption within private insurance and market of self-
medication (OTC) increase individual usage furtherly
1) defined daily dose
Source: Arzneiverordnungs-Report (2010-2016)

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Older age groups clearly dominate the medicinal drug
consumption
Dispersion from usage by age groups (AG) within statutory health insurance
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• Per capita
usage grows
exorbitantly
with age
• Middle age
classes with
strong increase
too
• Individual
growth of
usage as a
phenomenon of
society as a
whole
Quelle: Arzneiverordnungs-Report (2010-2016)

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Our forecast model combines the demographic ageing
process with the dynamic per capita consumption
Forecast model
Growth of total usage + 68,5 percent by 2045

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The daily usage increase from 46 to 77 billion daily dosis –
only in the statutory health insurance
Prognosis of total usage and share of age groups
DDD bn, only satutory health insurance
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Share of older age groups of total usage rises from 64 to 71 percent

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The total usage of medicinal drugs increases up to
70 percent by 2045 in the progressive scenario
Growth prognosis for the consumption of prescription drugs for human use
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The need for taking counteractive measures will rise futher
Recommendation for action
• Avoidance of discharge of medicinal drugs necessary on entire consumption chain
• Solely implenting end-of-pipe measures in the water industry falls short
• Holistic approach/strategy on medicinal consumption of all stakeholder is necessary
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Polluter pays‘ and precautionary principle

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Friederike Lauruschkus