Pharmaceutical consumption has been increasing for decades, driven by a growing need for medicines to treat age‑related and chronic diseases, and by changes in clinical practice. This section examines the consumption of four categories of medicines used in select chronic conditions: antihypertensives, lipid-modifying agents, antidiabetics and antidepressants (Figure 9.6). These medicines address illnesses for which prevalence has increased markedly across OECD countries.
Consumption of antihypertensive medicines in OECD countries increased by around 6% on average between 2013 and 2023, but grew by almost 50% in Chile. Consumption levels remain highly variable across OECD countries, reflecting differences in prevalence of hypertension and clinical practice.
Much greater growth was seen in the use of lipid-modifying agents, with consumption in OECD countries increasing by almost 65% between 2013 and 2023 on average. Denmark and Finland reported the highest levels of consumption per capita in 2023, while Türkiye recorded the lowest, highlighting a more than five‑fold variation across OECD countries.
The use of antidiabetic medications also grew dramatically, by 50% over the same period and more than tripled in Canada and the Slovak Republic. Growth may be explained in part by the rising prevalence of diabetes, which is largely linked to obesity, and by the increasing use of certain A10 medicines for other indications such as obesity, heart failure, or kidney disease. In Canada, Drug Information System data from certain provinces – covering all dispensed prescriptions – documented a real surge in consumption, driven in part by increased prescribing of Semaglutide following its 2021 market authorisation for obesity, even though it was not publicly reimbursed for this indication. In the Slovak Republic, the increase was driven by physicians following clinical studies supporting the extension of A10 drug indications to cardiological and nephrological uses. In 2023, consumption of antidiabetic medicines was highest in the Slovak Republic and Canada, and lowest in Latvia, New Zealand and Austria, with more than a four‑fold variation.
Consumption of antidepressant medicines increased by over 40% in OECD countries between 2013 and 2023, and more than doubled in Chile, Estonia, Korea and Latvia. As well as a potential increased burden of mental ill-health, this may also reflect improved recognition of mental health disorders, evolving clinical guidelines and availability of therapies, as well as longer-term prescribing (Bogowicz et al., 2021[1]; Madeira, Queiroz and Henriques, 2023[2]). Iceland and Portugal reported the highest level of consumption in 2023, at a rate around six times that of Latvia.
More recently, pharmaceutical consumption in each of these four categories increased by around 20‑30% in OECD countries on average between 2019 and 2023, except for antihypertensive medicines, where consumption remained relatively stable. These consumption patterns may in part reflect differences in the burden of the disease since the COVID‑19 pandemic – for example, the increased prevalence of anxiety and depression (see section on “Mental health” in Chapter 3).
