The Use of Medicines: Historical Trends and International Comparisons

Abstract

An historical review of the development of current levels of medicine consumption is presented with a literature review of cross-national and limited surveys and national statistics on rates of medicine use. Medicine use has increased worldwide at rates exceeding increases in national incomes in many countries. Variations in estimates of medicine use are documented by cross-national data on expenditure and prescription rates adjusted to increase comparability. Differences in levels of use appear greater than can be accounted for by methodologic problems of comparison. That differences are great is supported by results of the World Health Organization International Collaborative Study of Medical Care Utilization (WHO/ICS-MCU) which indicate that age-sex standardized medicine use rates developed from a household survey in 12 areas of seven countries show several-fold differences in rates of prescribed and nonprescribed medicine use. Differences in these rates are not explained by area levels of morbidity or variations in physician visiting or prescribing patterns. Areas tend to be high or low in rates of use of both prescribed and nonprescribed drugs. Problems in the use of data for international comparison of medicine use are discussed.