Comprehensive Comparison of Drug Prescribing in the United States and United Kingdom

Abstract

To compare the frequency of outpatient drug prescribing in the United States and United Kingdom according to individual drugs and therapeutic categories during 2004-2006. Retrospective prescription record review. United Kingdom General Practice Research Database, and the MarketScan Commercial Claims and Encounters Database for U.S. data. In the U.K. database, we identified 1.6 million people younger than 65 years who were prescribed at least one prescription drug in at least one of the calendar years during the study period (2004-2006). For comparison, for each U.K. person identified, we randomly identified one person of the same sex and year of birth in the U.S. database who was also prescribed at least one drug in the same calendar year. We compared the frequency of prescribing of individual drugs, as well as selected therapeutic categories. Substantially higher proportions of people in the United States were prescribed antibiotics, statins, and postmenopausal hormones, but asthma drugs were prescribed more frequently in the United Kingdom. In those younger than 20 years, antidepressants and antipsychotics were prescribed more than twice as frequently in the United States, and males in the United States were far more likely to be prescribed drugs for attention-deficit-hyperactivity disorder than were their counterparts in the United Kingdom. This study provides documented quantification of differing patterns of drug use in the United States and United Kingdom during 2004-2006. The higher proportionate prescribing for most indications in the United States and the greater use of drugs under patent suggest that monetary costs are likely to be considerably higher in the United States than in the United Kingdom.